Suicide in Trinidad and Tobago: associations with measures of social distress.

Using national statistics for the period 1978-1992, associations were examined between suicide rates and measures of social distress in Trinidad and Tobago. The latter included unemployment, serious crimes, emigration rates and admissions to the country's psychiatric hospital. There was a 319% increase in male suicide rates, from 4.96/100,000 in 1978 to 20.76/100,000 in 1992. Although there were fluctuations in the rate for females, it remained below 8/100,000. Over the 15-year period examined, there was a 51% increase in serious crime while male and female unemployment increased by 89% and 33% respectively. There was a 63% fall in the rate of permanent emigration while male and female admissions to the psychiatric hospital fell by 28% and 19% respectively. There were significant positive associations between male suicide and serious crimes as well as with male and female unemployment (p < 0.01). Male suicide rates were also negatively associated with the male admissions to the psychiatric hospital (p < 0.01). Female suicide rates were positively associated with serious crime and male unemployment (p < 0.01). Although it is not possible to determine whether the observed associations were causal, the results suggest that social distress may be an important contributor to the suicide rate in Trinidad and Tobago, particularly among men. The organisation of preventive strategies for suicidal behaviour must therefore include measures to counter the experience of social distress in this setting.