There is more to Sweden than flat pack furniture, the invention of dynamite and meat balls. A 2025 Churchill Fellowship allowed me to explore the way Sweden has responded to the epidemic in mental health referrals and, in particular, made progress in suicide prevention.
During the 1960’s Sweden had the highest number of suicides in the developed world and even ten years later, the rate of deaths was about 20 per 100,000 of the population. Sweden developed a range of initiatives and in 2025 the government captured these in the National Strategy for Mental Health and Suicide Prevention. The number of deaths has gradually come down to about 12.3 per 100,000 population and, according to the 2025 World Population Review, Sweden is now 57th in the international table of suicides. Amongst relatively new developments, discussed here, are the “suicide ambulance” service, established in 2015 and Hjalplinjen, a state-run helpline set up in 2024.
Sweden traditionally enjoyed a stable government, with the Social Democrats holding power from 1932-1976. Since then, Sweden has alternated between Social Democratic led governments and non-socialist centre right coalitions, with still a high level of state-run services. There is not the same tradition, as there is in the UK, of charities delivering services (although some exist). What Sweden has retained is high levels of spending on state benefits, pensions and workers’ rights. But the success in bringing down suicide rates and addressing mental health is the result of a number of initiatives.
The 2025 Strategy was important in bringing together a range of strategies and organisations. It’s a ten-year plan, which has been agreed by all parties, in the hope it will outlast changes in government. Ambitiously the Strategy embraces twenty-seven agencies and as well as working at national, regional and municipal levels (through health and social welfare) includes business, civil society, the research community and decision makers. Agencies involved include bodies as diverse as insurance, transport, housing and the police. Its purpose is threefold (1) a whole society approach (2) a focus on promotion and prevention through joint work on mental health and (3) the improvement of services for people living with mental illness or disabilities.
A cornerstone of Sweden’s’ response to suicide and mental illness is a school-based programme for young people of 13-17 in which they learn about and explore the topic of mental health. A previous internet and media based mental health programme (Supreme) developed in Sweden, amongst seven European countries between 2010 and 2013 aimed to improve mental health and well-being by harnessing technology in the belief that conditions like depression and anxiety will persist, without support, and in some cases lead to suicide.
Research is an important part of the strategy and Sweden’s university community have invested heavily in programmes; whether this is in suicide and depression amongst elderly people, ways of reducing suicide on the transport network and focused studies looking at specific communities, such as the Sami, in northern Sweden, where suicide rates have traditionally been high, as their lifestyle becomes eroded.
But what distinguishes Sweden’s mental health services is the mix of state and not for profit services; and this needs untangling. Amidst state services are Pam-Enheten and Hjalplinjen. Pam-Enheten has been widely reported, offering a mobile mental health service with ambulances covering the populations of Stockholm, Gothenburg and Malmo. The mental health ambulances are equipped with paramedics, psychiatric nurses and essential medical resources, ready to focus on acute mental illness. The specially designed ambulances can access medical records and backup from psychiatrists and will, when needed, refer directly to psychiatric hospitals. The service has attracted international interest.
Hjalplijen is a relatively new state funded helpline, set up to assist suicide prevention, alongside two existing helplines for drug and alcohol abuse. Calls are scheduled to last approximately thirty minutes and are run by social workers and psychologists who can also book callers in to offer a brief course of therapy. What is noticeable in this and other Swedish services is the reliance on AI – not to provide direct help, but in a supportive role. So, while callers are waiting, they may be offered access to other websites and organisations that may be able to offer help.
Sweden has also diversified its helplines. Whereas Samaritan volunteers in the UK may experience callers from across society and in different situations, including people in prison or the armed services and people experiencing loneliness or those contemplating suicide, the Swedish not for profit organisation MIND (not state run) has dedicated lines for young people (16-25) to discuss “what feels difficult in life”, an “Age Line” for older people and a “Parent Line” for those who have concerns about parenting or child development.
Sweden’s 2025 Strategy has provided a blueprint for joined up mental health and suicide prevention services. It begins with strong research, a commitment to engaging with children, the harnessing of AI and distinct and separate helplines. Three lessons, in particular, emerge for the UK from what Sweden has achieved. The first is the need for an overarching strategy with a wide range of statutory, voluntary and commercial organisations. The second is the necessity for more specialist helplines, run by professional staff. And, thirdly, the emphasis on early intervention for children and young people. What is beyond doubt is Sweden’s determination to tackle mental health and suicide prevention. There is a recognition that suicide will not be eradicated but to paraphrase playwright Samuel Beckett, the aim is to keep trying, fail again, try again and fail better.
The Samaritans are available 24 hours a day on 116 123 (free to call from within the UK and Ireland) to provide confidential emotional support for people who are experiencing feelings of distress, despair or suicidal thoughts.
Find more helplines here.
