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Suicide deaths

Suicide is a major safety concern for mental health services.

Changes to NHS clinical practice and policy resulting from research undertaken at The University of Manchester from 1996 to date have led to a fall in the number of deaths by suicide nationally.

Professor Louis Appleby and colleagues in The National Confidential Inquiry into Suicide and Homicide (NCISH) set up the first national register of all patient suicides in the UK, and it is now the largest such database internationally.

Using the data from the register, the team - which includes Professor Nav Kapur, Professor Jenny Shaw and Dr Kirsten Windfuhr - was able to establish key facts about suicide in clinical settings, including:

  • a quarter of all people who die by suicide have contact with mental health services in the year before death, and in half of these the last contact is within a week of death;
  • 10% of patient suicide deaths occur during in-patient admission;
  • 20% of patient suicides occur within three months of discharge from hospital, particularly in the first one to three days.

Specific recommendations on the implementation of safety measures were made to health services and have informed clinical practice and suicide prevention policy locally, nationally and internationally.

The team's research underpins section 1 of the National Suicide Prevention Strategy for England, which has reduced suicide in high risk groups.

Their safer mental health services toolkit, launched in 2013, sets out quality and safety standards for healthcare providers, to minimise risk.

Suicide rates among psychiatric in-patients fell by 58% (2001-2010), particularly deaths by hanging (the team advised removing ligature points). Overall patient suicide rates fell by 26% (2004-2011).

Implementing inquiry recommendations may have saved 200 to 300 lives per year and could have saved as much as £450 million in healthcare and societal costs.

“Suicide rates among psychiatric in-patients fell by 58% (2001-2010), particularly deaths by hanging (the team advised removing ligature points). Overall patient suicide rates fell by 26% (2004-2011).

“Implementing inquiry recommendations may have saved 200 to 300 lives per year and could have saved as much as £450 million in healthcare and societal costs.”

Kirsten Windfuhr / Research Fellow