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Unemployment and suicide: is alcohol the missing link?

2009; Elsevier BV; Volume: 374; Issue: 9697 Linguagem: Inglês

10.1016/s0140-6736(09)61787-6

1474-547X

Woody Caan,

Global Health Care Issues

Like driving, handguns, and housefires, unemployment can kill—but are there specific antecedents mediating those increased suicides now predicted for the current economic depression (July 25, p 270)?1Lundin A Hemmingsson T Unemployment and suicide.Lancet. 2009; 374: 270-271Summary Full Text Full Text PDF PubMed Scopus (37) Google Scholar The study of European Union countries2Stuckler D Basu S Suhrcke M Coutts A McKee M The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis.Lancet. 2009; 374: 315-323Summary Full Text Full Text PDF PubMed Scopus (1001) Google Scholar that reported an association between unemployment and increased suicide and homicide also found increased deaths directly from alcohol abuse. The missing link is that concurrent alcohol intoxication could be a factor in as many as 65% of suicides.3Alcohol ConcernBriefing 5: suicide & alcohol misuse.http://www.alcoholconcern.org.uk/servlets/doc/613Google Scholar That is no more improbable than alcohol being a factor in some irresponsible car crashes or unpremeditated murders. The alcohol and violence special interest group of the UK Public Health Association has been focusing on the need to make policy makers aware that people with alcohol problems usually have multiple needs and they typically present for health care on the basis of those other needs.4Caan W Misfortunes never come singly.Persp Public Health. 2009; 12: 210-211Crossref Scopus (5) Google Scholar Risky drinking often overlaps with experiences such as clinical depression or homelessness or domestic abuse but, for example, a depressed woman fleeing from a violent spouse whose hungry children now lack shelter seems unlikely to begin her engagement with a clinician by saying "Doctor, my priority today is to discuss my concealed drink problem". We already know that alcohol and unemployment interact3Alcohol ConcernBriefing 5: suicide & alcohol misuse.http://www.alcoholconcern.org.uk/servlets/doc/613Google Scholar and heavy drinking precedes much fatal self harm. Andreas Lundin and Tomas Hemmingsson's prescient Comment1Lundin A Hemmingsson T Unemployment and suicide.Lancet. 2009; 374: 270-271Summary Full Text Full Text PDF PubMed Scopus (37) Google Scholar stresses the "moderating effect of unemployment benefits" on suicide. Does this make the present punitive approach of the UK benefits system towards people with alcohol problems5Caan W Benefits and alcoholics: feasibility study.BMJ. 2009; 338: 1162Crossref Scopus (4) Google Scholar seem a little imprudent? I am a founder member of the UK Public Health Association special interest group for alcohol and violence.