Preventing suicide in community and custodial settings

Context

The UK suicide rate was 10.4 deaths per 100,000 population in 2016 (see the Office for National Statistics suicides in the UK: 2016 registrations). Suicide is more than 3 times as common in men as in women. People aged 40 to 44 had the highest suicide rate at 15.3 per 100,000. This age group also had the highest rate among men, at 24.1 per 100,000. For women, 50- to 54‑year‑olds had the highest rate of 8.3 per 100,000.

Overall, the financial cost of someone of working age dying by suicide in the UK is more than £1.6 million (Evaluation of the first phase of Choose Life: the national strategy and action plan to prevent suicide in Scotland Scottish Executive Social Research).

The risk of suicide in the UK prison population is considerably higher than among the general population. The 3-year average rate of self-inflicted deaths by people in prison in England was 69 per 100,000 between 2009 and 2011; approximately 80% received a suicide or open verdict at inquest. There were 62 'apparent suicides following police custody' during 2013/14 in England and 119 deaths by suicide in prison in England and Wales in 2016.

Suicide and self-harm are major public health problems, with someone who self-harms being at increased risk of suicide (see the Department of Health and Social Care's Chief Medical Officer annual report 2013: public mental health priorities). Approximately three-quarters of people who die by suicide have not had recent contact with mental health services at the time of their death. However, many may have seen their GP in the year before they died and others may have been seen in A&E or another setting.

People at risk of dying by suicide may come into contact with a wide range of professionals and others. The Department of Health and Social Care's suicide prevention strategy for England and the House of Commons report on the government's suicide prevention strategy highlight the potential role of the community in preventing suicide. For example, people can make contact with suicide prevention services through helplines and support groups (offered by charities such as Samaritans), or they can speak to a GP.

This guideline covers people of all ages but focuses particularly on groups with high suicide risk.

It also looks at interventions for people who are, or have been in custodial settings, and those in contact with any branch of the criminal justice system.

Suicide prevention in mental health settings is not covered by this guideline. For further information on preventing suicide in mental health services see the reports from the University of Manchester's National Confidential Inquiry into Suicide and Safety in Mental Health.