Urgent need for suicide prevention among females: Analysis of suicide statistics from 47 prefectures nationwide in Japan

In Japan, the annual number of suicides among males between 1990 and 1997 was around 13,000 to 16,000; it then abruptly increased to over 23,000 in 1998. By 2011, the number was 20,000 or more annually. After 2012, the annual number of suicides fell below 20,000 and has decreased yearly, reaching 13,939 in 2021. There was, however, a slight increase to around 14,000 suicides in 2022 and 2023. ¹ During the same period, the number of suicides among females was 8244 in 1990. It decreased to 7000 annually from 1991 to 1997, and then abruptly increased to 9850 in 1998. The number held steady at around 9000 annually until 2011 (except for 2001, with 8898). From 2012 to 2014, there were around 8000 suicides annually. The number then decreased to 7344 in 2015, and remained at around 6000 from 2016 to 2019, indicating a slight decrease. There were 6091 suicides in 2019, and around 7000 annually from 2020 to 2022, and 6975 in 2023, a slight increase. ¹ In the report entitled ‘An Overview of Suicide in Japan in 2023 and the Status of Implementation of Suicide Prevention’ by the Ministry of Health, Labour and Welfare, the section on ‘Efforts to Promote Research to Help Promote Comprehensive Suicide Prevention Measures’ recommended the need for ‘Studies on Suicide Among Females’, and also featured a section on ‘Efforts to Further Promote Suicide Prevention Among Females’. ² Over the past few years, there has been an emphasis on suicide prevention measures for females in Japan, and we have advocated for such measures to target Japanese females in the future based on suicide trends in different regions.

In Japan, age-adjusted data are published every five years, with the most recent being from 2020. This study researched the suicide mortality rate for each sex for 2015 and 2020 based on numerical data published in the ‘Age-adjusted Mortality Rate by Prefecture and the Mortality Rate by Age Group’.^3,4 We compare the years and discuss the importance of suicide prevention measures among females.

Among males, the national average age-adjusted mortality rate from suicide (per 100,000 population) was 27.0 in 2015 and 22.6 in 2020, indicating a decrease in the rate. Among females, the age-adjusted mortality rate from suicide was 10.6 in 2015 and 10.3 in 2020, which is holding mostly the same or slightly decreased from 2015.

In terms of the age-adjusted mortality rate from suicide (per 100,000 population) by prefecture, the rate in 2020 was the same or increased among males in four prefectures (Fukushima, Kagawa, Kochi, and Oita). Meanwhile, among females, the mortality rate from suicide in 2020 was the same or increased in 21 prefectures (Hokkaido, Aomori, Miyagi, Ibaraki, Chiba, Tokyo, Niigata, Fukui, Yamanashi, Nagano, Shizuoka, Aichi, Mie, Shiga, Osaka, Nara, Hiroshima, Tokushima, Kochi, Fukuoka, and Miyazaki). By age group, the mortality rate was: 4 for those age 70–74; 6 for those age 95 and over; 7 for those age 90–94; 8 for those age 65–69; 9 for those age 55–59; 9 for those age 75–79; 9 for those age 80–84; 10 for those age 45–49; 10 for those age 85–89; 12 for those age 50-–54; 13 for those age 35–39; 13 for those age 40–44; 13 for those age 60–64; 14 for those age 10–14; 14 for those age 30–34; 16 for those age 25–29; 17 for those age 15–19; and 18 for those age 20–24. Thus, the mortality rate from suicide in 2020 generally increased from the rate in 2015 among all females aged 15 to 29. Broadly defined, the suicide rate increased among females ranging in age from 10 to 44.

The most common reasons given for suicide among females were ‘health problems’ and ‘problems at school’ for those age 19 or younger, ‘health problems’, ‘family problems’, and ‘relationship problems’ for those in their 20s, and ‘health problems’ and ‘family problems’ for those in their 30s and 40s. ¹ A higher proportion of females attempt suicide compared to males, so following up with females who have attempted suicide is important. ⁵ Assistance must also continue to be provided to females in dealing with their various problems and worries, and to assist with pregnancy and child rearing. ⁵ Therefore, suicide statistics for Japan as a whole and each prefecture need to be analysed and discussed, and specific suicide prevention measures for females must be devised by medical personnel in collaboration with the police, government, schools, and community.^6–8