Suicide rates, life satisfaction and happiness as markers for population mental health

Objective: To examine the association of variables from survey data on well-being with suicide rates and other markers of population mental health in Europe. Design: Ecological study correlating (Spearman's rank correlation) life satisfaction and happiness (European Values Survey 1999/2000) in 32 countries with suicide rates (WHO Mortality Database), rates of hospital discharge for mental and behavioural disorders and prevalence of mental disorders based on registered mental patients (WHO Regional Office for Europe) and Mental Health Index (MHI)-5 survey data (European Opinion Research Group). Results: An inverse association exists between suicide rates and life satisfaction (r = -0.44; 95% CI: -0.68, -0.11) and happiness (r = -0.42; 95% CI: -0.67, -0.08). Similar though weaker associations were seen with hospital discharge data and MHI-5 data but not with the prevalence of mental disorders. The association between suicide rates and life satisfaction was weaker amongst 15-44 year olds (r = -0.31; 95% CI: -0.59, 0.04) than amongst 45-64 year olds (r = -0.47; 95% CI: -0.70, -0.14). It was strongest in the 65+ age group (r = -0.54; 95% CI: -0.75, -0.23). A similar pattern was observed for the association with happiness. In a subgroup analysis, the association between suicide and life satisfaction in Eastern Europe was similar to that in the whole dataset (r = -0.35) but a positive association was seen in Western Europe (r = 0.47). Conclusions: Life satisfaction and happiness were modestly associated with other indicators of population mental health. Since all such markers have their limitations, surveys of well-being may be useful indicators of population mental health.