Temporal trends 1990-2020 in youth suicide: a global analysis based on the WHO Mortality Database

Abstract Suicide is a serious but preventable public health issue globally, with substantial geographical disparities. Although mortality from suicide is higher in older age groups, it ranks as the fourth leading cause of death among youth. This study analysed global suicide trends for the age group 10-24, from 1990 to 2020. Using data on certified deaths from suicide (codes ICD-9: E950-959; ICD-10: X60-X84, Y87.0) and population from the WHO mortality database for 52 countries with valid data, age-standardised suicide rates (ASR) were computed (by sex, country, and calendar year) and joinpoint regression analyses were carried out to identify significant changes in trends. High variability in suicide rates and trends was observed, with male-to-female ratios ranging from two to five. From 1990 to 2020, most European countries reported declining suicide trends, with some exceptions. Particularly concerning trends emerged in the United Kingdom, with increases of 2.5% per year among males since 2005 and 8.5% among females since 2012. Southern Europe exhibited the most favourable trends and lowest suicide rates, with 3.1/100,000 males in Italy (2020) and 3.5/100,000 males in Spain (2021), and 0.9/100,000 females in Italy (2020) and 1.1/100,000 females in Romania (2019) among females. Conversely, Central-Eastern Europe showed the highest rates, with 10.2/100,000 males in the Russian Federation (2019) and 10.0/100,000 males in Poland (2002). Non-European areas reported higher suicide rates and significant increases. The highest ASR was 15.5/100,000 males in the United States of America, with an increase of 3.8% per year among males from 2009 to 2020 and 6.7% among females from 2007 to 2017, followed by a levelling off. Youth suicide rates and trends vary widely globally. Interpretation of temporal and geographical comparisons in suicide mortality should be approached cautiously due to potential misclassification or under-reporting of suicide deaths in some countries. Key messages • Albeit data on suicide mortality should be interpreted with caution, the study reveals high variability in suicide rates and trends among youths aged 10-24 across different countries worldwide. • Timely and accurate monitoring of epidemiological trends should support the planning, implementation, and evaluation of setting-specific health promotion strategies in mental health.