10 September was the World Day for the Prevention of Suicide. On that occasion, AGE worked with the network of mental health organisations, GAMIAN-Europe, to put a spotlight on suicide and suicidal thoughts among older persons – an often-overlooked phenomenon.
Suicidal thoughts and behaviours: widespread but taboo
More than a phenomenon, each suicide means that a whole community of close relatives are affected beyond the person who reached this point of distress. In 2021, almost 52,000 deaths of people over 70 have been attributed to intentional self-harm. For people aged 55+, the rate was at almost 20 deaths per 100,000 people. The overall rate for the general EU population was 12.5 per 100,000.
Despite declining suicide rates in all EU member states except Greece, the rates of older persons are higher than average in all EU Member States. The vast majority of people who die by suicide at older age are men. There is a large dark number, as the context that led to suicide is not always explored. All deaths that might be due to suicide tend indeed not to be accounted as such, because of stigma or ‘respect’ for the person. Ageism and stereotypes sometimes lead to the idea that depression and resignation are ‘normal’ side-effects of ageing, while they are actually warning signs for distress.
There are factors that can lead to thoughts of self-harm and suicide which are common to all age groups, but also specific factors that can explain higher rates at older age: social isolation and loneliness due to the loss of close relationships; physical health and chronic disease which emphasise feeling of vulnerability and hopelessness; financial difficulties in the context of rising old-age poverty and exclusion or high costs of care, but also linked to the loss of ability to manage one’s finance; the change of social status when retiring; as well as stigma and discrimination.
The importance of the community
In focus groups and in a small, transnational survey, GAMIAN and AGE worked out how people who are affected by suicide feel. Besides the factors raised above, survey participants emphasised the importance of community involvement and close relationships. Volunteer work, community groups and intergenerational initiatives can provide a sense of purpose and fulfilment for older persons, to overcome feelings of loneliness. The family and meaningful contact with close ones is also an important source of motivation.
Mental health must be integrated in all health care settings
As health issues and care contexts are areas where people can be facing their loss of autonomy, enduring pain and longer-lasting impairments, it is vital that mental health support is provided in these contexts at all levels: from the general practitioner, who asks the right questions when a person is seen for a seemingly minor issue, to the more intensive care practitioner, they all must be trained to detect the signs of psychological distress and know where to find help.
We can act to reduce suicide and improve mental health in older age
In the GAMIAN-Europe report, we sketch a number of recommendations on how to tackle high suicide rates among older persons specifically, but also how to improve mental health in older age more generally:
- Lifting the stigma around mental health by training and giving resources to health and care practitioners on warning signs and preventive actions
- Establish national strategies for mental health, monitoring and prevention of suicides
- Support and increase the availability of community resources, volunteer groups, social associations, clubs, centres for older persons, as well as cultural work with older persons to fight loneliness and isolation
- Specific social support groups for people who have had experiences with suicide or thoughts of self-harm and their close ones
- Promote social inclusion, fight the increase of old-age poverty and social exclusion
- Implement person-centred, integrated care under the principles of the EU Care Strategy
- Improve data collection around mental health and suicide.
There is an urgency to implement some of these actions, as demographic ageing may lead to an increase of the absolute number of suicides among older persons despite the decrease of suicide rates overall.
More importantly, it is vital that citizens of all ages feel included and respected as full participants in society. AGE’s call for an EU Age Equality Strategy and our recent election manifesto go into these directions. It is now up to the institutions to seize the urgency.
Thinking about harming yourself? Get help!
If you or a close one are thinking about harming yourself or themselves, do not stay alone and look for help! Take their comment seriously and do not leave them alone. Call the EU emergency number 112 or get a mental support helpline for your country at https://findahelpline.com/
credit for featured image in news gallery: Centre for Ageing Better
Contact
Philippe Seidel Leroy
Policy Manager on Social Protection & European Parliament Liaison
