Suicide trends following the Taiwan earthquake of 1999: empirical evidence and policy implications Yang C-H, Xirasagar S, Chung H-C, Huang Y-T, Lin H-C. Suicide trends following the Taiwan earthquake of 1999: empirical evidence and policy implications. Acta Psychiatr Scand 2005: 112: 442–448. Ó 2005 Blackwell Munksgaard. Objective: Mental health impact of severe earthquakes on survivors has attracted considerable attention. Suicide represents a terminal outcome of the spectrum of potential major mental health issues spawned by severe earthquakes. This study used time-series analysis to examine the time trends of increased suicide rates after the Chi–Chi earthquake of 1999 in Taiwan in the affected counties. Method: Adult cause of death data were used to study monthly suicide rates per 100,000 adult population in the study and control counties, during January 1995 to December 2001. Box and Tiao’s event intervention analysis was used to examine changes in monthly suicide rates before and after the Chi–Chi earthquake. Results: During the post-quake period, October 1999 to December 2001, the mean monthly suicide rate in the affected counties was 1.567 per 100,000, compared with the control countiesÕ rate of 1.297 per 100,000. Mean monthly suicide rate among the high-exposure group was 42% higher during the 26 months following the earthquake than the average for the entire observation period. Examined by time trends, the increased suicide rate registered in the first month following the quake began a monthly gradual decline by 0.7/100,000 thereafter, accounting for a total reduction of 98% in quake-related suicides by the end of 10 months. Suicide rates fell to the baseline level after 10 months. Conclusion: We found that the mean monthly suicide rate for earthquake victims was higher while the low-exposure group remained stable and consistent throughout the observation period, indicating that the impact on the high-exposure group was attributable to the earthquake. This indicates the need for providing strengthened psychiatric services during the first year following major disasters. C.-H. Yang 1 , S. Xirasagar 2 , H.-C. Chung 1 , Y.-T. Huang 3 , H.-C. Lin 4 1 National Taipei College of Nursing, Graduate Institute of Health Care Management, Taipei, Taiwan, 2 Department of Health Services Policy and Management, University of South Carolina, Columbia, SC, USA, 3 Institute of Public Health, National Yang- Ming University, Taipei, Taiwan and 4 School of Health Care Administration, Taipei Medical University, Taipei, Taiwan Key words: natural disasters; suicide; Taiwan Herng-Ching Lin, School of Health Care Administration, Taipei Medical University, 250 Wu-Hsing St., Taipei 110, Taiwan. E-mail: henry11111@tmu.edu.tw Accepted for publication June 13, 2005 Significant outcomes • Significant increase in suicide rates among survivors of the Chi–Chi earthquake of Taiwan. • Higher suicide rates were observed over a 10-month period following the disaster. • Possibilities for mobilization of mental health professionals in disaster-affected areas are recommended for a significant time period following a disaster. Limitations • Due to sample size specific age groups or gender particularly vulnerable to suicide among the disaster survivors could not be identified. • Inability to link death statistics data with national statistics for health care utilization and mental health care utilization data. • Lack of data on the number of attempted but incomplete suicide. Acta Psychiatr Scand 2005: 112: 442–448 All rights reserved DOI: 10.1111/j.1600-0447.2005.00603.x Copyright Ó 2005 Blackwell Munksgaard ACTA PSYCHIATRICA SCANDINAVICA 442