Following several years of decline, the number of suicides registered in England and Wales began to increase in 2018. Whenever a change in suicide rates occur, the reasons are complex and will rarely be because of one factor alone. Here, Ben Windsor-Shellard explains some of the possible explanations.
Every death from suicide is a tragedy, and behind every statistic is an individual, a family, and a community devastated by their loss. The Lifestyle and Risk Factors team in the ONS constantly monitors incoming suicide registrations, and when the figures appear to change the team works hard to understand why.
The Office for National Statistics (ONS) published two articles looking at possible explanations for changes in suicide rates for deaths registered in England and Wales to the end of 2019. Also published are the latest provisional quarterly suicide registrations in England to the end of September 2020.
Why do suicide rates change?
Changes in suicide rates can generally be explained by two broad factors: a change in the way records are collected, and true changes in the number of deaths caused by suicide due to a complex array of social factors.
The impact of how records are collected on rates of suicide
All unnatural deaths in England and Wales, including suicide, are investigated by coroners, with the cause of death concluded and reported to ONS often many months after the death occurred.
Due to their involvement with certifying the deaths, any change in the approach of coroners will impact suicide death registration statistics. One important recent development was a change in the standard of proof – evidence threshold – used by coroners for suicide.
On 26th July 2018, as a result of a case in the High Court, the standard of proof for suicide was lowered from the criminal standard of ‘beyond all reasonable doubt’ to the civil standard of ‘on the balance of probabilities’.
Published figures show that the recent upward trend in suicide began before this legal change. That said, with inquests held since the standard of proof was lowered, coroners have given increasing numbers of suicide conclusions, and fewer conclusions where they were unable to determine whether the deceased did or did not intend to end their own life.
As both conclusion types are included in suicide registration statistics, the impact of the legal change on suicide registration statistics has likely been minimal.
More recently, rates of registered suicides came down in the second quarter of 2020. As opposed to this reflecting a genuine reduction in suicide, this was most likely due to the impact of the coronavirus pandemic on the coroner’s service in England and Wales creating delays to inquests. Rates in the third quarter of 2020 have returned to previously observed levels, likely reflecting a return to usual business among coroners.
Change in rates of suicide due to complex social factors
Ruling out a change in the way records are collected, the other possible explanation for an increase in suicide is a true change due to a complex number of social factors.
Among young people, adverse childhood experiences, academic pressures, bereavement, self-harm, and exposure to harmful online content, will all be important. For those of working age, factors such as low pay and low job security have been shown to correlated strongly with suicide, and among older people, psychiatric illness, deterioration of physical health and functioning, and social factors have been identified as important.
These figures also show the complexity of trying to understand changes in suicide rates. In England and Wales, changing patterns of suicide by sex, age, the method of suicide most commonly being used, and where people live are all important for understanding the recent observed upward trend in suicide.
The ONS works closely with expert cross-government groups to provide evidence on changes in suicide trends to further understand areas of enquiry.
We will continue to monitor our data over the coming years to further understand the changes in suicide rates including any impact that the coronavirus pandemic may have had. Typically, the length of time for an inquest is around five to six months and so we do not currently know the total number of suicides that occurred during the pandemic.
Where to go for help?
If you are struggling to cope, please call Samaritans for free on 116 123 (UK and ROI), email jo@samaritans.org or visit the Samaritans website to find details of the nearest branch. Samaritans is available round the clock, every single day of the year, providing a safe place for anyone struggling to cope, whoever they are, however they feel, whatever life has done to them.
Other sources of support include Papyrus – a national charity dedicated to the prevention of suicide among young people; The Campaign Against Living Miserably (CALM) works to prevent male suicide and offers support services for any man who is struggling or in crisis; other services and support can be found on the NHS website.
Ben Windsor-Shellard, Head of Lifestyle and Risk Factors Analysis at the ONS