National suicide prevention, local mental health resources, and suicide rates in Japan

Background: Suicide rates in Japan are relatively high in OECD countries. A national fund to help local authorities implement suicide prevention programs was launched in 2009. The national suicide prevention project was transferred from the Cabinet Office to the Ministry of Health, Labor, and Welfare on April 2016, with a greater focus on mental health promotion by local governments. Aims: The aim of the present study was to (a) identify local authorities' implementation of suicide prevention programs in terms of local health policies, and (b) examine the associations between local health resources and suicide rates in Japan. Method: We investigated the types of programs implemented under the fund, and correlations with authorities' sociodemographic characteristics and mental health and welfare resources. Results: A majority of authorities implemented general suicide prevention programs. More focused programs addressing issues such as mental health in the workplace, alcohol problems, and attempted suicide were less frequently implemented. There were significantly fewer suicides in health regions with a higher ratio of psychiatrists to residents or a lower ratio of psychiatric beds. Limitations: A causal relationship between suicide rates and characteristics of local authorities cannot be inferred from the data. Conclusion: A community mental health system that operated in parallel to the current system may result in fewer inpatients and a reduction in Japan's suicide rate.