Shah Ajit, Bhat Ravi
Ethnicity and Mental Health, University of Central Lancashire, Preston, U.K. and West London Mental Health NHS Trust, London, U.K.
Int Psychogeriatr. 2008 Jun;20(3):605-15. doi: 10.1017/S1041610207006552. Epub 2007 Nov 30.
Elderly suicide rates may be influenced by mental health funding, service provision and national policy.
A cross-national study examining the relationship between elderly suicide rates and (i) the presence of national policy on mental health, (ii) funding for mental health, and (iii) measures of mental health service provision was undertaken by utilizing data from the World Health Organization website.
The main findings are: (i) there is no relationship between suicide rates in both sexes in both elderly age-bands and different measures of mental health policy, except they were increased in countries with a substance abuse policy; and (ii) suicide rates in both sexes in both elderly age-bands were higher in countries with greater provision of mental health services, including the number of psychiatric beds, psychiatrists, psychiatric nurses, and the availability of training in mental health for primary care professionals.
Cross-national ecological studies using national-level aggregate data are not helpful in establishing a causal relationship (and the direction of this relationship) between elderly suicide rates and mental health funding, service provision and national policies. The impact of introducing national policies on mental health, increasing funding for mental health services and increasing mental health service provision on elderly suicide rates requires further examination in longitudinal within-country studies.
老年人自杀率可能受到心理健康资金、服务提供和国家政策的影响。
利用世界卫生组织网站的数据进行了一项跨国研究，考察老年人自杀率与以下因素之间的关系：（i）国家心理健康政策的存在情况；（ii）心理健康资金；（iii）心理健康服务提供的衡量指标。
主要发现如下：（i）在两个老年年龄段的男性和女性自杀率与不同的心理健康政策衡量指标之间均无关联，不过在有药物滥用政策的国家自杀率有所上升；（ii）在心理健康服务提供更多的国家，包括精神病床位数量、精神科医生、精神科护士数量以及为初级保健专业人员提供心理健康培训的可及性方面，两个老年年龄段的男性和女性自杀率都更高。
使用国家层面汇总数据的跨国生态研究无助于确定老年人自杀率与心理健康资金、服务提供和国家政策之间的因果关系（以及这种关系的方向）。引入国家心理健康政策、增加心理健康服务资金以及增加心理健康服务提供对老年人自杀率的影响需要在国内纵向研究中进一步考察。
