The facts speak for themselves: in the UK and Ireland approximately 6,300 people take their lives every year, which is more than double the death toll from road traffic accidents and twelve times the number of deaths by homicide. It is estimated that at least 140,000 people attempt suicide each year in England and Wales alone.

There are no quick and easy solutions to the complex problem of suicide in our society today. But perhaps the starting point is to consider the attitudes that we have towards ourselves and those around us. It is possible to change a nation's point of view. By next year's report, we hope to see the start of a shift in attitudes that will ultimately lead to fewer tragic deaths by suicide.  

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Suicide Statistics 1996

This section contains recent information about suicide in the UK and Ireland, an analysis of occupational suicide , and of suicide by age . There are also sections covering attempted suicide , seasonal trends in suicide , and prison suicides , as well as some separate figures for England , Northern Ireland , the Republic of Ireland , Scotland and Wales .

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UK and Ireland

• 5,905 ^* suicides in the UK, 378 ^* suicides in the Republic of Ireland in 1996.
• One suicide every 84 minutes in UK and Ireland.
• 75% of suicides are by males.
• 785 ^* suicides by young people in UK and Ireland - 2 per day.
• Suicide accounts for 20% of all deaths of young people.
• Rising trend in attempted suicide - 50% increase since 1990.
• Suicide attempts by young men have doubled since 1985.
• 26% of the population personally knew someone who died by suicide.

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England

• 4634 suicides in 1996 - 3442 males and 1192 females.
• The English suicide rate was 11.7 per 100,000 population in 1996.
• For males, the suicide rate was 17.8, for females it was 5.8 per 100,000 population.
• There has been a 12% decrease in the suicide rate since 1990 in England.

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Northern Ireland

• 143 suicides in 1996 - 113 males and 29 females.
• The Northern Irish suicide rate was 11.2 per 100,000 population in 1996.
• For males, the suicide rate was 18.4, for females it was 4.4 per 100,000 population.
• There has been a 7% decrease in the suicide rate since 1982 in Northern Ireland.  

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Republic of Ireland

• 378 suicides in 1996 - 310 males and 68 females.
• The Republic of Ireland suicide rate was 13.6 per 100,000 population in 1996.
• For males, the suicide rate was 22.9, for females it was 4.9 per 100,000 population.
• There has been a 24% increase in the suicide rate since 1985 in the Republic of Ireland.  

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Scotland

• 845 suicides in 1996 - 620 males and 225 females.
• The Scottish suicide rate was 20.1 per 100,000 population in 1996.
• For males, the suicide rate was 30.7, for females it was 10.2 per 100,000 population.
• There has been a 12% increase in the suicide rate since 1982 in Scotland.

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Wales

• 283 suicides in 1996 - 228 males and 55 females.
• The Welsh suicide rate was 11.9 per 100,000 population in 1996.
• For males, the suicide rate was 19.8, for females it was 4.5 per 100,000 population.
• There has been an 11% decrease in the suicide rate since 1990 in Wales.

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* Data includes deaths by injury undetermined whether accidental or purposeful.

NB: Suicide statistics are based on ICD codes E950-9 and E980-989, minus E988.8. English and Welsh figures come from Office for National Statistics, DVS3.L 1996 Mortality Statistics - 1996 Boundaries;figures for Northern Ireland come from General Register Office for Northern Ireland, Belfast; figures for the Republic of Ireland are provisional at the time of publishing,  obtained from Central Statistics Office, Cork; and figures for Scotland are obtained from Registrar General for Scotland, Annual Report 1996.

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Suicide and Occupation

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The following analysis has been done by the Office for National Statistics (previously the Office of Population Censuses and Surveys). A full report is available in "Suicide Deaths in England and Wales, 1982-92 : the contribution of occupation and geography", Population Trends, No 80, Summer 1995, by Sue Kelly and John Charlton.

Proportional Mortality Ratio

It is highly relevant, when looking at deaths in different occupations, to look at proportions of deaths from specific causes, eg do alcohol-related diseases count as a major cause of death amongst publicans and bar staff? The statistic used to compare different occupational groups is the Proportional Mortality Ratio, or PMR. This uses the proportion of total deaths due to suicide in a particular group and compares this figure to an average for the overall population. After all the calculations, the figure for the PMR gives an indication of suicide risk in a particular group. The average figure is 100, therefore a PMR of 200 indicates twice the average risk, 50 indicates half the average risk.

The male and female occupations with the highest PMRs from suicide are given below, together with the number of suicide deaths in each group. Suicide figures include undetermined deaths:

Occupation	PMRs		Number of Deaths
	1982-7	1988-92	1982-7	1988-92
Men aged 16-64
Vets	342	361	16	18
Librarian, Information Officer	230	84	21	8
Dental Practitioners	205	194	21	18
Farmers	205	145	310	177
Pharmacists	204	199	24	18
Forestry Workers	182	155	23	27
Medical Practitioners	180	144	80	60
Hotel Porters	176	102	28	15
Chemical Scientists / Engineers	145	156	41	38
University Academic staff	109	152	16	27
Women aged 16-59
Government inspectors	458	365	4	3
Vets	415	387	2	3
Medical Practitioners	347	322	27	25
Pharmacists	270	141	10	9
Physiotherapists	248	99	9	3
Ambulancewomen	234	402	2	3
Other health professionals	220	81	22	7
Literary/Artistic Professions	173	112	16	7
Teachers, higher education	171	74	16	7
Nurses	149	154	286	247

Average PMRs for men aged 16-64 and women aged 16-59 = 100

Occupational data for women are unfortunately not as accurate as those for men because occupation is only recorded on the death certificate for a woman if she was working for most of her life, and for married women, the husband's occupation is recorded.

Farming Suicides

The suicide risk for male farmers decreased over the time period 1982 to 1992, from 2.05 times the average risk to 1.45 times. Still, numbers of farming suicides are high, with farmers accounting for 1% of all male suicides between 1982 and 1992. There were 589 suicides among farmers and farmers' wives between 1982 and 1992, which is on average one farming suicide per week.

Firearms are the favored method of suicide for male farmers, accounting for 38% of the farming suicide deaths. As a proportion of all male suicides, only 5% are carried out using firearms. Farmers' wives use firearms in 10% of all suicides, compared with 1% of all female suicides.

Medical Professions

Nurses are at 1.54 times the average risk of suicide, and accounted for 5% of all female suicides between 1982 and 1992. Medical Practitioners, both male and female, show above average risks for suicide.

Self-poisoning is a more common method of suicide used by men and women in health care professions than in the population as a whole.

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Young People and Suicide

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There are two suicides every day by young people under the age of 25 in the United Kingdom and Republic of Ireland. The rate of suicide amongst young men has undergone an increase since the 1970s but statistics show a downturn in the UK since 1993. The rate has dropped by 18% to 15 per 100,000 but still remains higher than the national suicide rate, of 12 per 100,000. In the Republic of Ireland suicide amongst young men continues to rise and in 1996 was more than double (108% higher than) the rate for 1986.

Attempted suicide amongst young men and young women has been increasing during the 1990s. It is estimated that there are approximately 19,000 suicide attempts by adolescents every year, which is more than one every 30 minutes. Young women aged between 15 and 19 years are the most likely to attempt suicide, usually by overdose, however the rate amongst young men has doubled since 1985. Follow-up studies of teenagers who take overdoses show that up to 11% will kill themselves over the next few years.

Factors linked to suicide and attempted suicide in young people are:

*

Alcohol and drug abuse	Substance abuse is thought to be a highly significant factor in youth suicide. Alcohol and drugs affect thinking and reasoning ability and can act as depressants. They decrease inhibitions, increasing the likelihood of a depressed young person making a suicide attempt. American research has shown that one in three adolescents is intoxicated at the time of an attempt.
Unemployment	There is much debate over the role of unemployment in suicide and causal links have not been established. However the rate of attempted suicide amongst the short-term unemployed has been shown to be 10 times as high as for people in work.
Physical and Sexual Abuse	Young people who suffer, or have suffered, abuse in the past are often at increased risk of suicide or deliberate self-harm.
Custody	Within the prison population as a whole, young prisoners represent the largest group of at-risk individuals, particularly those under 21 who make up a third of the remand population. In 1995, 20% of prison suicides were by people of 21 or under.

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Older People and Suicide

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Suicide rates in older people of both sexes has dropped considerably since the 1950s.

However, older people still have higher rates of suicide across the age groups in the UK. In 1995, 1014 people over the age of 64 took their lives, accounting for 17% of all suicide deaths.

Across the age spectrum, the male suicide rate peaks twice, once at the 25-34 year age group, and then at the 75+ age group. Men of 75 or older have a suicide rate which is 11% higher than the suicide rate for all males of 15 or over. The suicide rate for women is lower and the peaks are less pronounced. However, two peaks do occur, one in those of 45-54 and the other one in women of 75 or over, whose rate is 21% higher than the rate for all women.

This age profile of suicide in the UK is not relevant to all cultures. It does not apply to the Republic of Ireland, where the suicide rate falls after the age of 64 for both men and women. An important factor may be social isolation - in the UK, 38% of people over 64 live alone whereas 24% of Irish older people live alone.

The most common means of suicide in older people are overdose of prescribed and over-the-counter drugs and hanging, which is far more frequent in older men.

Suicide in older people is strongly associated with:

• depression
• physical pain or illness
• living alone
• feelings of hopelessness and guilt

A study of suicide in the over 65s showed that in approximately one third of cases, alcohol had been used to "facilitate" the suicide and 10% of those who killed themselves were addicted to alcohol.

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Attempted Suicide

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Attempted suicide, para suicide and deliberate self harm are all terms which are often used interchangeably. They all describe non-fatal acts of self harm which arise for a variety of different reasons. "Suicidal" people also have varying degrees of the wish to die, and different suicidal acts can involve different degrees of risk to life.

Statistics on attempted suicide are collected by monitoring emergency hospital referrals for deliberate self-poisoning or injury. However, it is likely that many attempts are not referred to hospital and may be managed by GPs, if they come to any medical attention at all. 1

During the 1960s and 1970s there was an increase in attempted suicide in the Western world, mainly through self-poisoning. This was followed by a gradual decline during the 1980s but there has been an increase during the late 1980s and 1990s the United Kingdom now has one of the highest rates of attempted suicide in Europe. 2

Unlike the suicide rate which is highest in men aged between 25 and 44 and older people of both sexes, deliberate self-harm is most common among young women aged 15-19. Recently, however, researchers report a large, sudden increase in suicide attempts by younger men and boys aged 15-24, whose rate has doubled since 1985. 3

In females, the overall trend is also increasing, but this is a more recent development than among men, and the increase is lower. Attempted suicide by young women and girls aged 15-24 increased by 42% between 1992 and 1995. Females now outnumber males by a ratio of 26 : 1.

Relationship problems are the most common, persistent problems of suicide attempters, both adolescent and adult. A common event prior to a suicide attempt is a serious argument with a partner and disturbed family relationships are found in many cases. Problems with a partner appear to be increasingly reported by men, who now mention this more often than women. 3

Factors found to be associated with attempted suicide are. 3

• single marital status (including divorced/widowed)
• unemployment 4
• social deprivation 5
• history of physical or sexual abuse
• alcohol problems
• social isolation

The most commonly used method is self-poisoning, by both men and women, although men are more likely than women to self-injure, usually by cutting. There has been an enormous increase in the use of paracetamol over the past 20 years and it is now the most common drug, involved in nearly half of all adolescent overdoses and 70% of overdoses by children. 3

Repetitions of suicide attempts are common, with approximately 20% of suicide attempters being re-admitted within a year of a previous attempt. Those who have attempted suicide are at greater risk of eventually dying by suicide and the number of repeat attempts made increases the likelihood of eventually dying by suicide. Several studies 6 have shown that approximately one out of every 100 suicide attempters will die by suicide within a year of an attempt, a suicide risk approximately 100 times that of the general population.

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REFERENCES

1 Hawton, K, Fagg, J, (1992), "Trends in deliberate self-poisoning and self-injury in Oxford, 1976-1990", British Medical Journal, 304, 1409-11

2 Hawton, K, Fagg, J, Simkin, S, Mills, J, (1994), "The Epidemiology of Attempted Suicide in the Oxford Area, England (1989-1992)", Crisis, 15:3, 123-35

3 Hawton, K, Fagg, J, Simkin, S, Bale, E and Bond, A, (unpublished) "Attempted Suicide in Oxford 1995", University Department of Psychiatry, Warneford Hospital, Oxford

4 Platt, S, Hawton, K, Kreitman, N, Fagg, J, and Foster, J, (1988), "Recent clinical and epidemiological trends in para suicide in Edinburgh and Oxford: a tale of two cities", Psychological Medicine,18, 405-18

5 Gunnell, DJ, Peters, TJ, Kammerling, RM and Brooks, J, (1995), "Relation between para suicide, suicide, psychiatric admissions , and socioeconomic deprivation", British Medical Journal, 311, 226-30

6 Hawton, K, "Suicide and attempted suicide", in Handbook of Affective Disorders

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Seasonal Trends in Suicide

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Official suicide figures for England and Wales show that traditionally, the highest number of suicides occurs in spring and early summer, most notably March, April, May and June. Recent data (since 1993) also show a peak in January.

It was known as early as 1825 that suicide rates peak in late spring, declining to winter lows and research confirms that there is a similar pattern for certain depressive disorders. The pattern is evident among populations as diverse as those of rural Italy and Zimbabwe.

However, there is still no widely accepted theory as to why this occurs. One school of thought suggests that climate, linked to human biology, is the important factor. It argues that the warm season results in people having more energy which needs an outlet. Another hypothesis is based on social factors, stating that spring is a time of increased activity in general, and suicide is one such activity. The sociological theory implies that rural areas which are more dependent on agriculture as an industry, would show more of a seasonal variation in suicide rates, since agricultural activity is dependent on seasonal factors such as daylight hours and weather.

References:1. Chew, KSY and McCleary, R, 1995, "The Spring Peak in Suicide: A Cross- National Analysis", Social Science Medicine, Vol 40 No 2, pp223-30

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Prison Suicides

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In 1997 there were 70 self-inflicted deaths in prisons in England and Wales, 67 men and 3 women. This figure is a 9% increase on the previous year, a 40% increase since 1990 and a 159% increase since 1983. However, the rateof self-inflicted deaths in prisons in England and Wales is currently 115 per 100,000 population, a slight decrease from 116 per 100,000 in 1996. Nonetheless, the rate of suicide in prisons in England and Wales is currently over six times the total male suicide rate and nearly ten times the rate for both sexes for this region. 39% of those who took their own lives in prison were on remand.