Impact News

Responding to Violence, Suicide, Psychosis and Trauma

Suicide Rates Rise in UK

According to the Office of National Statistics the suicide rate for men aged 45-59 in the UK is now the highest since 1986. Against a trend over the past two decades that has seen suicide rates gradually falling, suicide rates are now rising again for both men and women wih highest suicide rates being among men aged 30-44. According to stephen Platt at Edinburgh University disadvantages midlle aged men face a perfect storm of “unemployment, deprivation, social isolation, changing definitions of what it is to be a man, alcohol misuse, labour market and demographic changes that have had a dramatic effect on their work, relationships and very identity.” Next month the government will award research contracts worth £1.5m to develop new initiatives as part of a “refreshed” suicide prevention strategy.

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Suicide rate masked by coroners’ verdicts

By Martin Beckford, Health Correspondent
07 Oct 2011, Daily Telegraph (http://www.telegraph.co.uk/news/uknews/law-and-order/8811351/Suicide-rate-masked-by-coroners-verdicts.html)

Many more inquests are ending in “narrative verdicts” rather than a ruling that someone killed themselves, often because of caution over their intention.

But it is feared that this may mean up to 6 per cent of suicides being wrongly classified as accidents, which could be “masking the effects of the economic crisis on suicide”.

In an editorial published in the British Medical Journal, Prof David Gunnell at the University of Bristol and colleagues said: “This increased use of narrative verdicts has important effects on the estimation of national suicide rates because these verdicts present coding difficulties for the Office for National Statistics – when suicide intent is unclear such deaths are coded as accidents.”

Official figures show there were 4,648 suicides in England and Wales in 2009, based on the verdicts given by coroners after inquests into unexpected deaths.

But many hangings, overdoses and poisonings are being treated as possible accidents, with coroners ending inquests in narrative verdicts that give an account of how the death occurred in a few sentences.

The number of narrative verdicts has risen from just 111 in 2001 to 3,012 – more than one in 10 inquests – in 2009.

This is despite the fact that suicide is sometimes strongly implied in the verdict, with phrases used such as “deceased took his own life with an accidental overdose”, according to the BMJ study.

If all deaths from hanging and poisoning were classed as suicides rather than given narrative verdicts, the suicide rate would be 6 per cent higher.

This would account for almost a third of the National Suicide Prevention Strategy’s target of reducing suicides by 20 per cent.

But even this figure could be an underestimate because the ONS did not include all common methods of killing oneself.

The academics warn: “As the use of narrative verdicts rises, so too may the underestimation of suicide.

“The consequences of this could be incorrect rate estimates, misleading evaluations of national and local prevention activity, and masking of the effects of the current economic crisis on suicide.

“Furthermore, because coroners vary greatly in their use of narrative verdicts, suicide rates may (falsely) seem to decline in areas served by coroners who make most use of such verdicts.”

But Prof Louis Appleby, chairman of the Government’s National Suicide Prevention Strategy Advisory Group, insisted: “There is nothing new in finding that some probable suicides are omitted from official statistics because of doubts about the person’s intent.

“Coroners used to record verdicts of accident or misadventure in many such cases, now they may record a narrative verdict.

“There is no reason to doubt the fall in suicide in England in the last decade, though of course we should continue to examine how narrative verdicts are used.”

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Rise in number dying by suicide

The number of people dying by suicide every year in the UK has gone up slightly after a decade in which the rate has fallen, according to the latest figures released today.

In 2008, 5,706 people over the age of 15 took their own lives.

This compares with 5,377 in 2007.

This is the first rise in the annual rate since there was a sharp increase between 1997 and 1998.

The figures, published by the Office for National Statistics (ONS), continue to show a marked difference in the number of men and women who die by suicide.

In 2008 there were 17.7 suicides per 100,000 men with 5.4 per 100,000 women.

The group with the highest rates continue to be men aged between 15 and 44. Since 2004 the highest suicide rates among women have been in the 45-74 age group.

The statistics show some variations within England, with the North having the highest rates of male suicide.

But in Wales 2008 saw the lowest rate since 1991 with 266 deaths, although the ONS pointed out the Welsh figures have remained broadly steady in the period from 1991-2008.

Stephen Platt, Samaritans’ trustee and professor of health policy research at the University of Edinburgh, said: “In view of the promising downward trend in suicide in previous years, this could be worrying but it may turn out to be a normal fluctuation.

“However, given the strong research evidence of a link between economic recession and suicide, it is also possible that this is the start of an upward trend in suicide which could continue until there is an improvement in economic conditions.

“Any suicide is one too many and it is vital that we continue to work towards ensuring that fewer people die in this way.

“Samaritans persist in reaching out to those who are at risk of suicide by providing our 24/7 emotional support line and by the work of our 200 branches to support distressed and vulnerable people in their local communities.

“We also work with Government in Westminster and the devolved nations on the national suicide prevention strategies, as well as forming local and national partnerships, such as our new project with Network Rail that aims to reduce suicides on the railways by 20% over the next five years.”

Source: Press Association.

28/01/2010

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Rising unemployment will lead to a rise in suicide rates

Rising unemployment will lead to a rise in suicide rates across Europe unless preventative action is taken, a study says

The stress triggered by job losses could see suicides rise across Europe if governments fail to take preventative action, a new study claims.

Researchers at the London School of Hygiene and Tropical Medicine in London and the University of Oxford examined economic downturns over the past 30 years and concluded that when unemployment rose by 3%, there was a corresponding increase of 4.5% in the number of suicides among people under 65.

In the study published today in medical journal the Lancet, the authors conclude that people who lose their jobs during a recession are at greater risk of suicide – and that for the least well-educated, the risks are even higher.

However, governments can help by providing social security safety nets, and programmes to help people cope with redundancy and get back to work.

Researcher David Stuckler said that while the study found differences between how countries classified and measured suicide, it was possible to look at how governments could reduce the likelihood of suicide during an economic crisis.

“Governments might be able to protect their populations specifically by budgeting for measures that keep people employed. This is a complex issue but we can see what has happened and hopefully use this to work out what to do about it.”

Joe Ferns, deputy director of the Samaritans, welcomed the report. “People who are unemployed are two to three times more likely to die by suicide than people who have jobs, because unemployment can lead to anxiety, depression, lowered self-esteem and feelings of hopelessness – all of which increase the likelihood that someone will think that life is not worth living,” he said.

Dr David Gunnell, a professor of epidemiology at the university of Bristol, cautioned against over-simplifying the link with unemployment. “Suicides are the tip of a much larger iceberg of emotional distress caused by job loss and economic hardship. It is important to appreciate that the causes of suicide are complex and most people who lose their jobs do not end their lives.”

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Changing Suicide Rates

Figures released by the ONS showed that the number of people in the UK committing suicide is continuing to fall and is now at its lowest level in 17 years.

The ONS said that, in 2007, there were 5,377 suicides in adults aged 15 and over, 177 fewer than in 2006 and 940 fewer than in 1991. Three-quarters of the suicides in 2007 were by men – a proportion that has remained fairly constant since 1991.

The suicide rate for men in 2007 was 16.8 per 100,000 people, while the rate for women was five per 100,000. Suicides among men reached a peak in 1998 – 21.1 per 100,000 – but the rate has since fallen. Suicide rates among women have been consistently much lower and have decreased more steadily.

In the early 1990s, the highest suicide rates for men and women were in those aged 75 and over. Rates in this group have since decreased and were among the lowest in 2007.

In recent years, the highest suicide rates in men have been in those aged 15-44, while the highest rates among women have been in the 45-74 age bracket. Suicide rates in women aged 15-44 have consistently been the lowest and fell to 4.2 per 100,000 in 2007.

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The truth behind prison suicides

A fall last year in the number of prisoners taking their own lives is good news, but while we continue to jail mentally ill people the problem will continue, says Erwin James

A young prisoner at Ashield young offenders’ institution.

‘Sixty-one suicides in a year is as unacceptable as 100’, says Erwin James.

“There is never any room for complacency in our work to prevent these deaths,” said justice minister Shahid Malik in response to the fall in the number of people in prison taking their own lives in 2008. The drop from an average of 91 self-inflicted deaths per year over the previous three years to just 61 last year is noteworthy. (In 2007 eight women took their lives in prisons; only one woman took her life in custody last year.)

Staff vigilance has to be one reason for the lower figure. Prison staff rarely receive good press and it is easy to forget the significant number of prison officers who actually enjoy their job for the right reasons, and who care about the vulnerable people they have to supervise. Another reason has to be the army of volunteers who give their time to those who are struggling with their prison situation, particularly the Samaritans.

The Samaritans managed to get a foothold into our prisons after 15-year-old Philip Knight hanged himself in his cell in Swansea prison in 1990. Kathy Biggar, former vice-chairwoman of the “Sams”, and Jim Heyes, the then governor of Swansea jail, came up with the idea of the Listener scheme, whereby groups of prisoners are trained by the Samaritans to provide listening ears for fellow prisoners in distress.

The scheme was so successful that it was expanded throughout the prison system, so that today one key performance indicator (KPI) in every prison in the country is the provision and quality of its Listener scheme. Most prisons now get at least one visit a month from their local Samaritans who give on going support and training to the Listeners and to prison staff if requested. The relationship that has developed between the Samaritans and our prisons is one of the best social initiatives to have emerged over the past 15 years.

So a bit of good news for the prison service at last. But 61 people dead in a year in our prisons by their own hands is as unacceptable as 100. And let’s bear in mind this figure will have little impact on the overall statistics regarding the likelihood of self-inflicted deaths in prison unless it can be sustained for a few years. The suicide rate for men in prison is five times higher than for men in the community. Women in prison are 36 times more likely to take their own lives than women in the community. And a study published in 2003 found that 72% of those who took their own lives in prison had a history of mental disorder (over half had symptoms suggestive of mental disorder at reception into prison).

Four years ago the then minister for prisons, Paul Goggins, reported in a debate that 20% of all prisoners in the UK had four of the five major mental health disorders.

I used to think that suicide in prison was the ultimate means of empowerment. Prison engenders intense feelings of helplessness. Living with limited choices, little control or responsibility, and shouldering the opprobrium of society can make you feel backed into a corner. In those circumstances, it might not seem to be a totally irrational act. Most people who go to prison contemplate suicide, even if only fleetingly. The evidence shows however that the majority of people who carry it through are mentally unwell. Mr Malik made no mention of that fact. The reality is that the only way to sustain a relatively low prison suicide rate is to address our complacency about jailing mentally ill people.

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The facts about suicide are far less alarming than the media portray

Oliver James, The Guardian, Saturday 24 January 2009

A completed suicide casts a long, dark shadow on families. Yet there is much misinformation about who is at risk and how common it is. Many parents will, I hope, find the facts reassuring. The first myth is that suicide is increasing. Actually, it has been falling for many years: from 6,129 cases in 1994 to 5,576 in 2006, with the decline in numbers occurring almost annually.

The second myth is that it is a young person’s plague. Virtually no children under 14 do it (22 a year, albeit 22 too many) and the total for 15-34-year-olds is 1,400. While it may be the second largest cause of death in 15-24-year-olds (car accidents being the highest), that is because hardly any in this age group die. The real increase in suicide has been in the 35-64-year-olds, up 15% from 2,950 to 3,400.

The third and most widely touted myth is that suicide has become an epidemic among young men, totemic of a “crisis in masculinity”. In 1994, there were 1,850 in the 15-34-year-old male age group, dropping steadily year on year down to 1,200 in 2006. In other words, the real story is that suicide by young men has fallen by over one third.

What is true is that, in much of the world, men outnumber women in completed suicide. In this country, it is at least three times more men. However, this is not some biological given – there are many cultures in which women exceed men. One of the most suicidal groups on earth, for example, is rural middle-aged Chinese women.

It is a curiosity of suicide statistics that the gender differences for those who attempt it are almost exactly the reverse of those who complete it: women are much more likely to deliberately self-harm than men. Superficially, the explanation is that men tend to use much more fatal methods, like hanging or jumping off high buildings, whereas women take ineffective overdoses. However, that prompts the question of why, to which there are as yet no satisfactory answers.

In most developed nations, women are twice as likely as men to be depressed. We know from psychological autopsies that the great majority of people who killed themselves were depressed. That makes it all the stranger that relatively fewer women die this way. A possible factor is that men abuse substances much more than women (about twice as much) – women are more likely to visit their GP and accept pills or therapy. It’s possible that the disinhibition of booze or drugs means men are more likely to take extreme measures to end their lives.

But the remarkably reassuring fact is that only one in 50 young people who attempt suicide dies: 24,000 people aged 10-19 attempt it each year, at least three quarters of them female, but fewer than 500 die. Even allowing for a great many pleas for help, you would have thought that a higher proportion than this would end in tragedy.

All in all, if you are a parent the facts about suicide are a great deal less worrying than the tosh you read in many newspapers. Just as we are
encouraged to fantasise about creepy strangers making off with our little
girls when this is so rare that it is not worth giving the time of day to, so with suicide: forget your teenage Smiths fan for whom the GP wants to prescribe antidepressants: if anything, the person you should worry about is any 35-64-year-old man in the household.

For information about suicide go to samaritans.org/your_emotional_health/about_suicide.aspx.

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