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|Topic title||Suicide (2018)|
|Topic owner||Jane Bethea|
|Topic author(s)||Liz Pierce, Nick Romilly (with acknowledgement to Susan March, Nottinghamshire County Council)|
|Topic quality reviewed||September 2017|
|Topic endorsed by||Suicide Prevention Steering Group September 2017|
|Linked JSNA topics|
|Insight Document ID||64976|
“There is no single reason why people take their own lives. Suicide is a complex and multi-faceted behaviour, resulting from a wide range of psychological, social, economic and cultural risk factors which interact and increase an individual’s level of risk. Socioeconomic disadvantage is a key risk factor for suicidal behaviour” (Samaritans 2017).
Although relatively rare, the impact of suicide is devastating. Suicide can have a lasting harmful impact- economically, psychologically and spiritually on individuals, families, and communities Understanding risk factors for suicidal thoughts, behaviour and self-harm may lead to problems being identified earlier and people being better supported.
Suicide prevention is a public health priority both nationally and locally, with a role for a wide range of statutory and community organisations. The national strategy Preventing Suicide in England was refreshed in 2017 following a detailed Health Select committee process. The strategy now aims to reduce suicide rates by 10%. Nottingham City has a Suicide Prevention Strategy and works in partnership with organisations across the City and County with the aim of reducing levels of suicide.
Local suicide prevention priorities sit alongside initiatives to improve and respond to mental health in children, young people and adults, including work to improve Crisis Care (Crisis care Concordat).
Suicide prevention is concerned with improving population mental health, encouraging help seeking behaviour including mental health treatment and support, understanding those who may be at highest risk, reducing access to means, emergency response and supporting those who are affected and bereaved.
Influences on self-harm and suicidal behaviour differ through the life course, and may include impulsive acts in younger people, reactions to economic or relationship stresses, mental health problems during pregnancy or young adulthood, sense of hopelessness in prison, deaths where intention is not clear in people using alcohol or substances, or reactions to physical ill health or loneliness in older people.
Suicide disproportionately affects men, accounting for around three quarters of all suicides. It remains the biggest killer of men under 49 and the leading cause of death in people aged 15–24.
Groups at higher risk include, men in middle age, people in contact with secondary mental health services, particularly post discharged from inpatient care, people in contact with the criminal justice system, people experiencing social pressures such as financial hardship or after relationship breakdown, those using alcohol or substances, groups experiencing discrimination or abuse e.g. LGBT communities, or some BME communities and those with long term physical health problems
Three times as many men as women take their own life and rates are highest in middle age. There is a socioeconomic gradient to suicide with people in the most deprived communities experiencing far higher rates of suicide.
Latest research into population mental health show that suicidal thoughts at some point in a person’s life are relatively common, and particularly high rates are reported in those in receipt of disability and out of work benefits. Most people do not seek professional help for such thoughts, while many will turn first to family and friends (McManus et al 2016). The research points to increasing concern over the mental health of young women, but points to the group with highest need being middle aged men. Research also identifies protective factors and ways services can be organised to promote safety.
Suicide prevention goes hand in hand with addressing self- harm. People who self-harm are at increased risk of suicide. Self-harm, including attempted suicide, is the single biggest indicator of suicide risk. The UK has high rates of self-harm resulting in over 200,000 hospital attendances per year in England. Approximately 50 per cent of people who have died by suicide have a history of self-harm, and in many cases there has been an episode of self-harm shortly before someone takes their own life.
Suicide rates are reported by the Office for National Statistics and include deaths where there is a Coroner’s conclusion of suicide, and deaths were there was injury or poisoning where the intent was undetermined. Rates of suicide fluctuate. Having been at an all-time low in 2006/7, they rose from 2010 to 2014 and most recent reports show they have decreased again to a rate of 9.5 deaths per 100,000 in 2016. Figures released show that 4,575 people were registered as having died as a result of suicide in England in 2016 (ONS definition 2017b).
In the most recent three year period reported, 85 deaths in Nottingham City were recorded as suicide using the ONS definition, over 78% of whom were men. In 2015/16 there were 886 emergency admissions to hospital for intentional self-harm, and 6.6% of the Nottingham population were in contact with secondary mental health services, which equates to 15,211 people (PHE public health profiles).
The most recent analysis estimates that each suicide costs the economy in England around £1.67 million, although the full costs may be difficult to quantify, with 60 per cent of the cost of each suicide attributed to the impact on the lives of those bereaved by suicide. (HM Gov 2017).