Every suicide death is one too many and casts a heavy shadow over the bereaved, who may be affected by stress, anxiety, and complicated grief (Pitman, et al., 2014, Erlangsen, et al., 2017a). Furthermore, it is tragic as suicides are often preceded by a serious life crisis or an overwhelming psychological pain. By ensuring that the right help is available, society can in many cases, prevent suicide.
The Nordic Council Welfare Committee's 2025 Ambition sets a goal of reducing the number of suicides by 25% in 2025 - with or without COVID-19 (Nordic Council of Ministers, 2020). This is in line with the United Nation's World Goals for Sustainable Development. The aim 3.4.2 in the goals, which was introduced in 2015, specifies the reduction of the suicide mortality rate in the world by 33% by 2030 (United Nations, 2015). This aim was acknowledged by the Nordic Council of Ministers' Agenda 30, which was published in 2021 (Nordic Council, 2021). It yet remains to be established whether the recent trends in the Nordic rates of suicide are moving in the direction of achieving these goals.
Suicide has previously been defined as an act of deliberately taking one’s life. The same behaviour with a non-fatal outcome may be considered as deliberate self-harm, also referred to as suicide attempt (World Health Organization, 2014).
The World Health Organization (WHO) recommends that countries adopt a strategy for suicide prevention to guide national efforts. The LIVE LIFE guide published by the WHO builds on the existing evidence in suicide prevention and promotes four key interventions accompanied by seven public health pillars to support their implementation (World Health Organization, 2021a). This resource may serve as inspiration for local stakeholders as well as government agencies. A strength of the guide is that the suggested key initiatives may be implemented at any scale and, thus, are equally useful for local volunteer organisations as for policymakers. It also emphasizes the importance of summarizing existing efforts and main challenges through a Situation Analysis.
More than 27 million people live in the Nordic countries and self-governing nations, consisting of Denmark, Faroe Islands, Finland, Greenland, Iceland, Norway, Sweden, and Aaland Islands (Appendix 1). Every day, 10 people die from suicide in the Nordic countries. Seen in an international context, the suicide rate has remained at a relatively low level in most Nordic countries over recent decades (World Health Organization, 2014). Nevertheless, one of the countries, Greenland, accounts for one of the highest suicide rates in the world (Naghavi, 2019).
The Nordic countries share many similarities, including social welfare models, universal and free health care, and register-based linkage data (Erlangsen, et al., 2018a). These and other features may facilitate sharing suicide preventive strategies and interventions between countries. The fact that several of the Nordic countries have national action plans for suicide prevention as well as experiences with different types of interventions are further arguments for exchange. A mapping of existing efforts, their evaluations, and identified challenges will, thus, be of mutual benefit and allow for optimization of national initiatives. The Nordic countries have, with their register data, unique opportunities for identifying and monitoring risk groups, evaluating initiatives and quantifying priority areas, for instance by calculation of effect measures and population attributable risks (Erlangsen, et al., 2018a, Nordentoft, et al., 2021). Register-based data may also facilitate monitoring of real-time trends. Finally, collaborations exist between Nordic research teams within suicide prevention have already resulted in several joint research outputs (Morthorst, et al., 2020a, Titelman, et al., 2013, Oskarsson, et al., 2023).
The present report provides a situation analysis for the Nordic countries for the period 2000-2023. It is based on available evidence from official databases, peer-reviewed publications, government issued reports, sources identified online, such as official news outlets and websites from institutions, stakeholders, and nongovernmental organizations (NGOs) operating within the field of suicide prevention. Certain information was collected through interviews with Key Informers from each of the Nordic countries. The goal of the report is to provide an overview of current trends, and to identify main challenges and opportunities for intervention to reduce the number of suicides and self-harm events. The report aims to provide information of relevance for policymakers, researchers, NGOs, and people who are interested in reducing the burden of suicide in the Nordic countries. It may also serve as a basis for forming alliances and setting up joint projects in the region.
The report is divided into an epidemiological overview of trends by sex in suicide rates over recent years, followed by a presentation of established risk and protective factors of suicide based on evidence from the Nordic countries. Other topics, which are addressed, include registration of suicidal events, legislative aspects. Central concepts regarding national suicide prevention are presented together with a status report on national efforts each of the countries. Also, an overview of the existing evidence on effective interventions and suggestions for relevant measures is presented. Lastly, resources related to suicide prevention in the individual countries are listed in a series of appendices.