The societal costs of suicide – a Norwegian register-based study

Abstract

Suicide constitutes a serious public health problem, leaving many more bereaved. It also represents a major economic burden to society, and the aim of this study was to estimate the societal costs of suicide in Norway. This cost-of-illness study included direct suicide-related costs and indirect costs in the form of lost economic productivity. It is the first study of suicide using individual register data on the deceased’s earnings to estimate productivity losses. Estimates incorporated productivity growth and life expectancy adjustments but excluded intangible costs and unpaid work. In 2018, the mean societal costs per suicide were NOK 5,510,518 (USD 634,041). Productivity losses constituted the largest cost component (98.8%), whereas direct costs only represented 1.2%. The societal costs for women were significantly lower than for men. A large proportion of those who died by suicide was outside the workforce prior to death, reducing the level of productivity losses. Individuals with prior contact with specialized mental health services had significantly lower societal costs than those without. The total societal costs of all 675 suicides in 2018 were NOK 3.7 billion (USD 428 million), corresponding to 13,548 potential productive years lost. The mean and total societal costs of suicide are substantial, yet lower than reported in most previous studies, as the individual, register-based data reveals low workforce participation and high levels of contact with mental health services before death. Nonetheless, the societal costs and burden of suicide underscore the need for increased development of cost-effective suicide prevention.