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Suicide prevention: The government is unwilling to collect sufficient data - Guardian & Demos

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Suicide prevention: The government is unwilling to collect sufficient data

Demos collected and supplied the evidence on deaths by suicide that the coalition wouldn't because without full information they can't set the best policies

Louise Bazalgette Tuesday 23 August 2011 11.23 BST

It is an uncontroversial observation that the rate of suicide in England continues to be a significant public health challenge. While suicide rates have overall taken a downward trend since the 1990s, the recent period of economic uncertainty has coincided with increases in the rate of suicide in both 2008 and 2009. Figures from 2009 show that 4,390 people aged over 15 died by suicide in England that year, which works out at about one death every two hours.

Suicide therefore remains an important issue for public policy and last month, the coalition government published its new suicide prevention strategy for consultation. The most notable thing about this strategy is that it differs very little from the one published by the Labour Government in 2002. Despite nine years having passed, the same five groups are identified as being at "high risk" of suicide: people using mental health services; people who have previously self-harmed; people involved with the criminal justice system; adult men aged under 50; and particular occupational groups including doctors, nurses, vets and farmers. The strategy explains that these groups are chosen because they are known to have a statistically greater risk of suicide and data is already routinely collected that allows the numbers of people dying through suicide in these groups to be tracked.

The collection of high quality data on suicides is therefore fundamental to the development of good policy on suicide prevention. However, research published today by Demos has found that the data on suicides that is collected at a national level is in fact extremely limited. In particular, there is no national data available at all on the number or rates of people who die by suicide who have chronic or terminal health conditions. This lack of monitoring might be understandable if there was no evidence that physical illness put people at greater risk of suicide. However, a large body of international research, and a smaller number of home-grown studies have linked a variety of serious physical illnesses to a greater risk of suicide, including cancer, motor neurone disease, and people suffering from multiple conditions. It is not therefore a lack of evidence that is driving this policy failure, but a lack of willingness to improve data collection.

Demos recently completed a new research project to fill this evidence gap and identify the proportion of people who die by suicide who had a chronic or terminal illness. We used a variety of research methods including interviews with Coroners, a detailed study of one Coroner's district's suicide inquest records over a period of five years and a Freedom of Information request to all English Primary Care Trusts (PCTs). While this research was hampered by the limited availability of data, we were able to secure interviews with 15 Coroners and 29 out of the 147 PCTs we contacted could provide the requested information.

When we analysed and compared the data provided by the PCTs, we found that on average at least 10% of suicides were by people with either a chronic or terminal illness. The instances of suicide among people with chronic illnesses were higher, with this group making up 10.6% of the sample, while just over 2% of those who died by suicide had a terminal illness. Our study of Norwich Coroner's district's suicide inquest records also corroborated this finding. Twently-five out of the 259 suicides that took place in Norwich over a five year period (just under 10%) involved people with a chronic or terminal illness. Together, the data from PCTs and Norwich Coroner's District indicate that 10% of suicides nationally, or more than 400 of the 4,390 people who died by suicide in 2009 had a terminal or chronic illness.

The anecdotal evidence provided by the Coroners we interviewed also confirmed that serious physical illness was frequently a factor in suicides. However, several of the Coroners we interviewed told us that they do not record any information about physical illness in their inquest records (the main source of information used by PCTs to monitor suicides). This suggests that the data available is likely to under-represent the full extent of the problem.

Demos research indicates that there is currently a lack of willingness – both at a local and national level – to gather the robust evidence of the rates of suicide involving serious physical illness that is needed to design strategies to address this problem. In our report published Tuesday we argue that with increasing numbers of adults with serious illnesses travelling to Switzerland each year to obtain assistance with suicide, and a growing evidence-base demonstrating the relationship between suicide and terminal and chronic illness, we cannot continue our national policy of avoiding this issue.

• Louise Bazalgette, is author of The Truth About Suicide, published by Demos

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