The Economist has an absolutely fascinating and thought provoking look at suicide trends across the world. The most interesting item in the article is the graph above, which shows two things. First, suicide worldwide is declining. Second, the United States is the exception – we’re the only place in the western world where suicide is increasing, which is terribly upsetting.

The article is well worth reading, but it is a long one. I’ll try to summarize some of the trends it notes.

First, and most importantly: Suicide rates are down 38% from 1994. That’s fantastic news. But, of course, those decreases haven’t occurred evenly across all subgroups.

In China and India, significantly less women are killing themselves. This is attributed to public policy changes – and changes in culture – which have given women more freedom and independence. As gender norms have changed, women have gained more control over their lives, thus leading to lowered suicide rates. In other words, gender equality can save lives.

Increased urbanization is helping with this as well, as rural suicide rates are higher than urban ones – a trend which seems to be relatively constant across the word.

In Russia, cultural and political changes contributed to massive spike in suicides among middle aged men. That number, though still high when compared to the rest of the world, is now at half of its peak in the 1990s. This is attributable to a few things. First, the article notes that men have learned how to live in Russia’s new society and economy, having more success at getting a job and earning a living. Unemployment and economic upheaval leads to suicide, so as more men get jobs, they are less likely to kill themselves, and this is a constant across the world, in all cultures.

Additionally, studies have noted that suicide rates are tied with health care access. In countries where the unemployed still had access to health care, suicide rates did not increase during recessions – something that was not true in countries where health care was harder to come by.

Alcohol is also linked to suicide – alcohol consumption and suicide rates move together, though the article was unclear about whether or not one caused the other or a third factor moved both.

Suicide rates are higher among the elderly than they are the young or middle-aged population. As health care and poverty improves among this group, suicide rates fall.

The article also notes that means reduction – be it with guns, poison or gas – can have a major effect on suicides. The impulse to kill oneself is often fleeting, and reducing access to deadly weapons can absolutely reduce suicides.

What are the broad, global conclusions of this article? The one thing that I get out of it – more than anything else – is that public policy can have a major, major impact on suicide. Efforts to enhance economic security, increase access to health care, spread economic freedom and enhance gender equality plays a big role in reducing suicides. These are important factors which must be taken into account for any mental health conversation.