SuicidePreventionWhat the Numbers Say

In the mid-1980s, France returned to its early twentieth-century level: 22 suicides per 100,000 residents. The rate then fell slowly, eventually dropping, in 2012, below the mark of 15.

According to the ONS, this decline seems to have reached a plateau at the turn of the 2020s. The slight uptick in 2022 was primarily driven by those who were already, by far, the most exposed: men over 85.

The two following years partly contradict this. According to Inserm's CépiDc, France recorded 8,868 suicides in 2023, then 8,744 in 2024, down from 9,200 in 2022. The plateau may not be one after all; subsequent years will be needed to tell.

The most exposed profile is that of a man over eighty-five years old. Among them, there were 86 suicides per 100,000 in 2022, compared with 11 among women of the same age. The ONS points to loss of autonomy, disabling illnesses, bereavement, reduced income following the death of a spouse, and social isolation; for men, retirement can also bring the loss of a role and of connections.

Women are more frequently hospitalized following an attempt, but it is men who die from it most. This gender paradox is observed across most countries in the world. The research sees this primarily as the effect of gender norms: women are socialized to express their emotions, while men are socialized to conceal them.

Among young adults, who have low overall mortality, suicide is the second leading cause of death, after road accidents. In 2022, one in five deaths among men aged 25 to 34 was a suicide.

Risk also follows the position one holds. According to the ONS, those most vulnerable to disruptions of social ties, in work as in life, are at the highest risk: the unemployed, the economically inactive, and those in precarious jobs. Hospitalizations for self-inflicted harm are nearly three times more frequent among the poorest 20% than among the wealthiest 20%, and particularly elevated among young people living outside a family home, adolescent girls living with a single parent, and young single mothers.

Rural areas also pay their share. According to the Agricultural Social Mutual Fund (MSA), across the entire 15-64 age group, suicide risk is nearly half again as high in "rural margins," unattractive territories with fragile populations. Among insured members of the agricultural scheme receiving healthcare, it exceeds that of all insured individuals of the same age by 43% (ages 15-64, 2015-2016), and is twice as high after age 65, especially among former farm operators. Santé publique France also notes, in certain years, excess mortality among agricultural operators, and the agricultural sector has its own dedicated prevention plan.

The National Observatory on Suicide also devotes a fact sheet to prison inmates, among whom it notes a rising suicide rate.

None of these characteristics explains a suicide on its own. They compound with health status, psychiatric disorders—chief among them depression—and life events.

Suicide cannot be reduced to those who die from it. Relative to suicides in the same year, estimated attempts in 2021 represent twenty to thirty attempts for every death.

It is among adolescent girls and young women that the trajectory reversed direction. Their hospitalizations for self-inflicted harm have been rising since 2016, and the increase accelerated from 2020 onward. Among boys and young men, these indicators remain stable. The pandemic itself did not drive up suicides overall: a study covering 21 countries, published in 2021 in The Lancet Psychiatry, found no significant increase in any of them during its opening months.

Between 2015 and 2023, the hospitalization rate for young women aged 15 to 19 for this reason increased by more than half. The suicide rate among women under 25 doubled between 2015 and 2022, even though it remains the lowest among all age and sex categories. 183 adolescent girls and young women died by suicide in 2022, compared with 132 in 2019, though still slightly fewer than in the 1980s and 1990s.

The ONS connects this trend to the rise in suicidal ideation and depressive syndromes observed among a subset of young women since 2014. Among the hypotheses it puts forward: the sexual and gender-based violence to which adolescent girls are exposed, and gender expectations amplified by social media.

According to the WHO, suicide kills more people worldwide than malaria, HIV/AIDS, or breast cancer. It is the third leading cause of death among 15-29-year-olds, and the second among young women. Men die from it more than twice as often as women.

The decline has not been uniform everywhere. The rate fell by nearly half in the European and Western Pacific regions, by only 3% in Africa, and the Americas was the only region to see an increase, of 17%. At the current pace, the target set by the United Nations, a one-third reduction by 2030, would not be met.

Behind these averages lie substantial disparities between countries. According to WHO estimates for 2021, Lesotho records 40.7 suicides per 100,000 residents and Eswatini 31.7; in Asia and Europe, South Korea (20.5), Russia (17.8), and Lithuania (16.6) are among the hardest hit. Yet these figures are largely modeled: the WHO has good-quality data for only 86 of its 183 Member States, while the other 97, where rates are estimated, account for roughly 61% of global suicides.

According to the WHO, many suicides occur in moments of crisis, when the capacity to deal with life stresses gives way. Help received at that moment can prevent a suicide. Among the reasons for the decline in recent decades, research cited by the ONS includes improved treatments for mental disorders and national programs featuring help lines and follow-up care for those who have attempted suicide.

Having previously attempted suicide is, according to the WHO, one of the primary risk factors. The VigilanS system therefore maintains contact with these individuals, by phone or mail, from a few days up to six months after their attempt. Evaluated by Santé publique France across more than 23,000 patients between 2015 and 2017, it reduces the risk of a repeat attempt within the year by 38%. France had 32 VigilanS centers in 2023.

3114. Since October 1, 2021, France has had a national suicide prevention hotline, staffed by trained nurses and psychologists across 18 response centers. It is available to people experiencing suicidal thoughts, to their loved ones, and to healthcare professionals seeking advice.

Across rural Asia, agricultural pesticide bottles long sat within easy reach in homes or sheds. Swallowed during an impulsive crisis—a family dispute, a debt, a bereavement—organophosphate insecticides inhibit an enzyme in nerve synapses, acetylcholinesterase: respiratory muscles become paralyzed and the victim dies of asphyxiation, often far from a hospital equipped with mechanical ventilators. When the substance available at home is less forgiving, a brief crisis that would not have proven fatal elsewhere turns deadly.

In Sri Lanka, the suicide rate multiplied eightfold between 1950 and 1995, reaching 47 per 100,000 residents. The country then banned the import and sale of the most toxic pesticides (WHO Class I in 1995, followed by endosulfan in 1998). Within ten years, the national rate was halved, without a massive shift toward other methods.

A study published in 2007 in the International Journal of Epidemiology counted 19,769 fewer suicides between 1996 and 2005 than during the previous ten years, unrelated to trends in unemployment, alcohol, divorce, or civil war. The foundational demonstration came from Europe. In the United Kingdom, between 1960 and 1971, domestic coal gas gradually ceased to be toxic; a study published in 1976 shows that across all age and sex groups, suicides by domestic gas declined in step with the fall in its carbon monoxide content.

The WHO now designates restricting access to means (pesticides, firearms, certain medications) as the first pillar of its LIVE LIFE program, ahead even of responsible media reporting, adolescent support, and follow-up care for individuals in crisis.

At the end of the eighteenth century, The Sorrows of Young Werther, Goethe's novel in which the protagonist takes his own life, was followed by suicides across Europe and banned in several countries. The phenomenon has since borne his name: certain ways of talking about suicide lead to additional suicides.

A meta-analysis published in 2020 in the BMJ quantified this: following media coverage of a celebrity suicide, suicides increase by an average of 13% in the subsequent weeks, especially when coverage is repetitive, prominent, describes the method or location, or encourages identification. Young people, individuals experiencing mental health conditions, those with prior attempts, and people bereaved by suicide are the most vulnerable to this effect.

The opposite effect bears the name of Papageno, a character in Mozart's The Magic Flute who chooses not to die when those around him remind him of alternative paths. According to the WHO, stories of individuals overcoming a suicidal crisis can lead to fewer suicides. In the United States, a hit song titled with the national prevention hotline number was followed by nearly 10,000 additional calls and, according to an estimate in the BMJ (2021), 245 fewer suicides than expected over 34 days (interval of 36 to 453).

The WHO advises journalists (2023 update) to provide information on where to find help, omit details of method and location, refrain from portraying suicide as a solution or reducing it to a single cause, and give a voice to those who have gone through a crisis. In France, the Papageno program works alongside newsrooms.

Suicides are poorly counted. In France, the last evaluation, covering 2006, estimated that they were undercounted by 9.4%, hidden among deaths of unknown cause or undetermined intent; it has never been redone. Since 2018, the death certificate has included a "suicide" box, and the Paris Forensic Institute has transmitted its data. The apparent increase in 2018-2019 compared to 2017 is therefore largely attributable to better counting rather than a genuine rise in suicides.

The very definition has its boundaries. Where medical aid in dying is legal, these deaths are not classified as suicides: in Oregon, statute provides that utilizing aid in dying "is not suicide," and health authorities advise physicians to record the underlying illness as the cause of death, with the manner of death listed as "natural."

A statistical rate also reveals nothing of the bereaved loved ones left behind, some of whom are themselves at heightened risk. But a social fact can be undone. The past forty years in France, like the example of Sri Lanka, show that these numbers can fall.