Epidemiology of suicide in Estonia, 2000–2024: trends, demographic patterns, and implications for the National Suicide Prevention Action Plan

Abstract Background Suicide remains a significant public health concern in Estonia. Despite a marked decline in mortality since the early 2000s, rates continue to exceed the European Union average, particularly among men. Estonia adopted its first National Suicide Prevention Action Plan (SETK) for 2025–2028, providing a structured framework for evidence-based prevention. Methods A descriptive time-trend study was conducted using data from the Estonian Causes of Death Registry for the period 2000–2024. Suicide deaths coded as ICD-10 X60–X84 and Y87.0 were analysed by year, sex, age group (0–19, 20–39, 40–59, 60–79, 80+), nationality, educational level, and method. Age-standardized rates per 100,000 population were computed. Temporal trends were examined using general linear models (GLM), Pearson correlation, ANOVA, and linear regression. Method-specific trends were assessed using chi-square tests with linear-by-linear association. Results Between 2000 and 2024, 6,188 suicide deaths were registered (79.4% male). Total standardized suicide rates declined by approximately 56%, from the highest suicide rate of 28.8 per 100,000 (N 401) in 2001 to 12.7 (N 175) in 2024. Gender remained the dominant predictor of suicide mortality (partial η² = .904). Hanging (X70) accounted for 75.6% of all deaths. For the period 2000–2024, suicide rates among individuals aged 0–19 showed no significant temporal change. Suicide rates were highest among individuals with basic education, with divergent temporal trends across educational groups. Conclusions Estonia has achieved substantial reductions in suicide mortality, yet persistent gender disparities and evolving method patterns underline the need for targeted, gender-responsive prevention strategies. The findings directly inform implementation of the 2025–2028 National Suicide Prevention Action Plan (SETK) and the broader Mental Health Action Plan 2023–2026.