Finland used to have one of the highest suicide rates in the world – how the country halved it and saved countless lives

A heavy drinking culture was a strong contributing factor then, he says. “Our suicide rate has gone down at the same rate that our drinking has gone down. So it’s strongly related. And now when, especially the youth, [people] don’t drink that much any more, of course they don’t have that many suicides.”

However, the most vulnerable groups now include young women: suicide attempts among those aged 14 to 25 are increasing. The highest proportion of attempts are still among middle-aged men, but the overall composition has shifted significantly towards females. In the 90s, 80% of all suicides involved males; now, among the under-25s, it is 60%. Sihvola says it could be down to the fact that “stereotypical male-female polarities have been lessened”.

The big fear is method substitution. If women move to more lethal methods their rates of death by suicide will increase a lot.

It's an unsolved problem that's troubling for people working in suicide prevention.

Another reason it's a problem is that women's suicidal distress can be disbelieved -- "you've had multiple attempts but you're still alive, why should I believe you this time?". People need support, and people have different ways of presenting when they need that support but services often have weird stereotypes that they use to allocate support.

With darkness already closing in on the snow- and ice-covered Helsinki streets, despite it still being afternoon, I ask Partonen whether Finland’s geographical position and weather conditions play a role. But, he says, the data suggests these are not factors. “In fact, the numbers of suicides are at their lowest during winter: December, January, February.” It is not clear why, but they tend to peak in spring and early summer. “There can be some environmental impact in the form of temperature, for example, or light exposure. So people know that if they have been depressed for months or even years, usually spring is the hardest time for them.”

The phenomenon, he says, is universal, with similar patterns found in the southern and northern hemispheres, eastern and western culture. “If you are depressed, your brain and body react differently to the increase in exposure to sunlight. It may make you suffer more from insomnia, for example. You become more restless, anxious, so the level of anxiety increases and it may worsen your depression.” The worst outcome of these conditions, for somebody with insufficient coping skills, treatment or support, could then be suicide.

Just a few decades ago, the word “suicide” was also almost unsayable – and unprintable. Soon after it opened in 1972, Mieli’s crisis centre in Helsinki changed its name from “suicide prevention centre” to “crisis prevention centre” because there were objections to publishing the word in the phone book. For many older Finnish people, Sihvola says, “suicide” is still a difficult word to say; as with the word “bear” – as in the animal – there is a sense that saying it will bring it closer.

Unfortunately a similar attitude can still be seen 50 years later. The translation came out a bit clumsy, but I tried condensing it as best I could: An inpatient hospital ("Halikko Hospital", named after the municipality it's in) in Turku is currently being relocated to a new building, closer to the city centre and metropolitan area. The hospital project manager says that the name "psychiatric hospital" would have been "too stigmatizing". So through a poll they settled on.... "Compass Hospital" (Kompassisairaala). "Compass is a neutral name, and doesn't have an association with illnesses of the mind. We want a psychiatric hospital to be like a bank or bureau, that is, a place where you receive service.", he said.

"Some patients are afraid of admitting they've been to the Halikko Hospital because of the stigma associated with the name.[...]In psychiatry, it's important that the name of the hospital is abstract." He also wants to apply similar naming conventions to the names of the individual departments in the hospital, saying "We have psychosis unit, mood disorder unit and addiction department. I've spoken with patient organizations, and these names are seen as quite stigmatizing. They could be something else." When questioned about whether the stigma could eventually reform around the new name, he handwaves it, saying "I think the location will play a big part in this. The new hospital is close to the central hospital, but there are other nearby services like offices and a new hotel."

To me, he is participating in the same type of stigma he claims needs to be avoided. A suicidal person isn't lost and in need of some directions, their mind is ill and needs treatment. Trying to hide these difficult issues behind new names will only enforce the idea that they shouldn't be talked about. With some personal experience of actually being mental ill, to me this feels like downplaying the illness and infantilizing the patient.