The association between suicide rates and mental health service availability: a scoping review

It is uncertain if increasing mental health service availability results in decreased suicide rates. The aim of this scoping study is to systematically examine the literature on the relationship between mental health service availability and suicide rates. A scoping review was undertaken of studies published in English from 1 October 2006 to 1 October 2025 using PubMed, PsycINFO and Cochrane library to identify primary studies. Results from the thirty-two studies were very heterogeneous, with studies reporting negative association (i.e. greater health service availability is associated with decreased suicide rates), positive association as well as no association. There was a slightly greater number of positive (38%) than negative (32%) correlations, and almost a third (30%) found no correlation in studies examining relationships between service availability and population suicide rates. The majority of studies (68%) were cross-sectional in design limiting inferences about causality and making findings susceptible to reverse causality. While there are evidence-based interventions delivered by mental health services for reducing suicidality, heterogeneous findings along with the significant proportion of null findings suggest the need for longitudinal observational designs to confirm causal links between mental health services and suicide behaviour. Greater service availability does not consistently correlate with lower suicide rates, challenging the assumption that expanding mental health provision alone is sufficient for prevention. High-quality, longitudinal observational designs are needed to confirm causal links between mental health services and suicidality.