Socioeconomic determinants of suicide and the effectiveness of public mental health policies in Brazil

Abstract

Objective: To critically analyze recent scientific evidence on the socioeconomic determinants of suicide and the effectiveness of public mental health policies in Brazil. Methods: Integrative review following the PRISMA protocol, with searches conducted in January 2025 in the PubMed, SciELO, LILACS, and ProQuest databases. Studies published between 2019 and 2024, in Portuguese, English, or Spanish, addressing the relationship between socioeconomic factors and suicide or the evaluation of related public policies were included. Results: The synthesis of 25 studies demonstrated that poverty, income inequality, unemployment, and low education are central determinants for the increased risk of suicide, with heightened vulnerability among young people, indigenous communities, the LGBTQIA+ population, and rural residents. Income transfer policies demonstrated a protective effect, contrasting with the insufficient coverage (≈45%) and weaknesses of the Psychosocial Care Network (RAPS) in early detection by Primary Care. Conclusion: The effectiveness of these policies appears to be constrained by structural barriers and regional inequities, requiring intersectoral integration, expansion of RAPS coverage with equity, and investments in specifically targeted research.