How was this guide produced?
This guide was informed by the findings of a systematic review of risk factors for suicide in people with depression 1. It was also developed with input from experts in primary and secondary care.
Why is this guide needed?
Suicide is a major health issue and suicide prevention is a government priority. In the UK there are nearly 6000 suicide deaths per year 2 , and nearly 500 further suicides in Ireland 3 . Approximately three-quarters of these occur in men, in whom suicide is the most frequent cause of death in those under 35 years of age. The most common method of suicide is hanging, followed by self-poisoning.
Approximately 90% of people dying by suicide have a psychiatric disorder.
Approximately 90% of people dying by suicide have a psychiatric disorder 4, although this may not have been recognised or treated. Depression is the most common disorder, found in at least 60% of cases. This may be complicated by other mental health issues, especially alcohol misuse and personality disorders.
Clinicians working in a range of settings will encounter depressed people who may be at risk. For example, approximately 50% of those who take their own lives will have seen a general practitioner in the three months before death; 40% in the month beforehand; and around 20% in the week before death 5 . Primary care staff are therefore in a particularly important position in the detection and management of those at risk of suicide. Also, approximately a quarter will have been in contact with mental health services in the year before death 6.
While most clinicians outside of psychiatric specialties will only experience a few suicides during their career, it is crucial that they are vigilant for people who may be at risk. It is important to recognise that the effects of suicide on families can be devastating.
The suicide of a patient can also have a profound effect on professionals involved in their care. Following a suicide they may be helping support the people bereaved by the death, dealing with official requirements (e.g. response to the coroner and other agencies), and at the same time trying to cope with their own emotional responses.