Four in ten young women in Spain have had suicidal thoughts, study finds

40.8% of the young women taking part in the PROSIA-Y study have had suicidal thoughts at some point, compared with 24.8% of the men. Yet completed suicide among 15 to 29-year-olds in Spain is roughly twice as high in men (5.5 per 100,000) as in women (2.6 per 100,000), according to a study by the University of Málaga.

There is a paradox in the numbers that is hard to swallow. Young women think more about taking their own lives, attempt it more often, self-harm more. And yet young men kill themselves twice as often. Both facts are true. Neither cancels the other out. And understanding why they coexist is probably the most useful question that can be asked today about youth mental health.

## What the PROSIA-Y study data actually say

The **PROSIA-Y** project, led by the **Parc Sanitari Sant Joan de Déu** with support from the Social Observatory of Fundación "la Caixa", presented its findings at the event *Women and mental health: Invisible wounds, visible voices*. The sample: **4,182 young people**. The numbers, broken down by sens, show differences that cannot be explained by chance.

**40.8%** of young women say they have had suicidal thoughts at some point, compared with **24.8%** of men. That is a gap of **16 percentage points**. In suicide attempts, the gap persists: **17.1%** versus **6.6%**. And in self-harm without suicidal intent, **37.9%** versus **15.4%**. Researcher **Regina Villa**, of the Parc Sanitari Sant Joan de Déu, summed it up like this: studying sens differences makes visible part of youth suicidal behaviour that overall figures do not show.

That sentence carries more weight than it seems. Because the overall suicide figures, the ones that make headlines, the ones recorded by Spain's statistics institute **INE** by age and sens, tell a different story. And that story matters too.

## The other side: completed suicides are twice as common in men

The official **INE** data allow suicides to be consulted by age and sens, including the **15 to 29** age group. There the pattern reverses. A study by the **University of Málaga** cites rates of approximately **5.5 per 100,000** in young men versus **2.6 per 100,000** in young women. Twice as high, rounding up.

This is not a Spanish anomaly. It happens in almost every country with reliable data. And the most widely accepted explanation is not that boys suffer more, but that they choose more lethal methods, seek help less and reach the health system later or never. Ideation and attempts are more frequent among women. Completed death is more frequent among men. They are two faces of the same poorly served problem.

Whoever looks only at the first row of the table misses the second. Whoever looks only at the second misses the first. The full picture needs both.

## Why young women's distress is seen less than it should be

The *Women and mental health* event focused on something that goes beyond counting heads. Psychiatrist **Judith Usall**, president of the International Association for Women's Mental Health and a researcher at the Parc Sanitari Sant Joan de Déu, pointed out that androcentrism in research has taken the male experience as the norm. That has concrete consequences: systematic assessment of the menstrual cycle, pregnancy or menopause is conspicuously absent from many studies on mental disorders, even though these processes influence symptoms and response to treatments.

Child and adolescent psychiatrist **Marta Pardo**, of Hospital SJD Barcelona, pointed to another consequence. Disorders such as **ADHD** or **ASD** can go unnoticed in girls because for years diagnostic models were built from predominantly male patterns. Research conducted in Catalonia with more than two million young people found that girls received roughly twice as many new diagnoses of depression and anxiety as boys, and almost **nine times more** diagnoses of eating disorders.

It is not that they suddenly fall ill more. It is that for a long time they were not examined with the right lens.

## The trauma that goes unasked

Clinical psychologist **Vanessa Narváez**, of the Consorci Sanitari de Terrassa, issued an uncomfortable warning: many women arrive at mental health services with symptoms of anxiety, depression or post-traumatic stress without the context of violence behind them being properly explored. There is a risk of treating the consequence and not the cause. Of seeing the disorder and not the situation that triggered it.

The event converged on an idea that sounds simple but is not: asking what is wrong with a woman is often not enough if you do not also ask what has peine to her. **Macarena Herrera**, an activist with the Federación VEUS and a peer-to-peer reference in women's groups at the Parc Sanitari Sant Joan de Déu, insisted on incorporating patients' voices into recovery processes. Not as decoration, but as part of the treatment.

None of this invalidates the fact that young men die by suicide more often. It complements it. The health system has to know how to read both realities at once, because one without the other leaves someone out. And those left out, in mental health, do not always get a second chance.

## Key points

- **40.8%** of the young women in the PROSIA-Y study (4,182 participants) have had suicidal thoughts at some point, compared with **24.8%** of the men.
- Suicide attempts affect **17.1%** of them and **6.6%** of the men; self-harm without suicidal intent, **37.9%** versus **15.4%**.
- Completed suicide among **15 to 29-year-olds** in Spain is roughly twice as high in men (**5.5 per 100,000**) as in women (**2.6 per 100,000**), according to a study by the University of Málaga.
- Research in Catalonia with more than two million young people found almost **nine times more** diagnoses of eating disorders in girls than in boys.
- The PROSIA-Y project is led by the **Parc Sanitari Sant Joan de Déu** with support from the Social Observatory of Fundación "la Caixa".