Deciphering the bidirectional relationships between the density of psychiatrists and suicide rates across genders

Background: Much uncertainty exists regarding whether a greater density of psychiatrists mitigates suicide rates, and whether such effects are bidirectional and the same for males and females.
Methods: We collected publicly available data from 39 OECD countries from 2010 to 2021. The mutual relationships between the density of psychiatrists, as an indicator of available mental health services, and male or female suicide rates were examined by following a longitudinal cross-lagged panel design with fixed-effects panel models. Interaction terms with GDP per capita and grouped regressions were conducted to further investigate whether these links varied with the economy and culture.
Results: The results indicated that the density of psychiatrists could be related to subsequent female suicide rates (β = −7.331, 95 % CI [-13.730, −0.932]) after controlling for the autoregressive effects of suicide rates and GDP per capita, and vice versa (β = 0.001, 95 % CI [0.000, 0.002]). None of the interaction terms were significant, and these associations were only evident in Europe. Furthermore, no bidirectional relationship was established in males.
Conclusions: The relationships between female suicide rates and the density of psychiatrists as an indicator of mental health services highlighted that greater availability mitigated female suicide rates, and female suicide rates positively influenced the availability of mental health services in return. These effects remained stable across economies and only existed in Europe. Importantly, greater availability of mental health services seemed not to correlate with reduced suicide rates among males, who as a group account for most deaths.
© 2025 Published by Elsevier Ltd.