Transcript Priority Groups for Choose Life Overview Children

Priority Groups for Choose Life
Overview
Children (especially looked after
children):
• Deaths of children aged 0-14: < 5 per
year (GROS)
• Highest in males
• No discernable increase / decrease
• BUT child suicide is mercifully rare
Deaths of looked after children
(SWIA):
• 2006-07: Seven children aged 13-16 died of
intentional self harm / undetermined intent – all but
one were boys
• Some of the children were living at home, other were
in residential units
• Most had self harmed in the past and the majority of
the reports received did not specifically discuss the
risk assessment or management process for the
children
• Many of the children in this group had long histories
of disrupted care, patterns of alcohol and substance
misuse amongst parents and relatives and other
family members who had died through violence or
suicide.
Young People (especially young
men):
• Deaths of young people 15-19: between 28 –42 persons per
year (average 35 )
• Most youth suicides are male – ¾ male ratio consistent each
year (and replicated almost everywhere else)
• Significant fall in rate for young men but may be rising again
• Middle age suicide appears to be the dominant age group
• 70% of male suicides are by hanging – strong association with
more lethal means
• Males less likely to seek help until crisis time
People with mental health
problems:
• Across all age groups, genders and in a wide
range of geographical locations
• Several diagnoses of mental illness,
including affective disorders, schizophrenia,
personality disorders and childhood
disorders, and a history of psychiatric
treatment in general have been established
as risk factors for completed suicide.
• In schizophrenia and borderline personality
disorder suicide risk appears to be elevated
around the time of first diagnosis.
• For bipolar disorder and schizophrenia the
elevated risk of suicide is further
exacerbated by other risk factors, such as a
history of suicide attempts, other psychiatric
diagnoses, drug or alcohol misuse, anxiety,
recent bereavement, severity of symptoms
and hopelessness
• NCI – high suicide rate after discharge and
missed first appointment in community
• Falling rate of inpatient suicides due to
improved safety procedures
People who attempt suicide:
• Those who self-harm have a much greater risk of
dying by suicide compared with those who do not
engage in this behaviour
• Association with family history of suicide and many
other risk factors
• Those (hospital in-patients) with a history of severe
self harm are at significantly higher risk of suicide
(Hawton)
• Wider social and other factors are not well
understood i.e. life crisis
• Date on hospital admissions patchy but could serve
as a proxy indicator (rec from Phase One evaluation)
People affected by the aftermath of suicidal
behaviour or completed suicide (and people
who are recently bereaved)
• Family history of suicide appears a
significant risk factor
• Clustering of suicides can raise risk for
some people
• Media reporting is a risk and protective
factor – explicit reporting of means can
lead to contagion effect
• Lack of support services in the
aftermath of suicide for some people
i.e. remote and rural
People who abuse substances:
• Substance misuse increases the risk of suicide attempt and
death by suicide
• 23% of drug related deaths are suicide / undetermined – drd’s
are rising steeply (574 in 2008). Poly drug use is a significant
factor
• Possible ‘cohort’ effect associated with increased death in
middle aged males
• The risk associated with opioid use (disorders) and mixed
intravenous drug use is greater than that for alcohol misuse
• Alcohol a significant risk factor in: a) population suicide and b)
those with alcohol dependency
• The risk of suicide from alcohol misuse is greater among
women than among men
People in prison:
• Prison suicides have decreased via Act
2 Care and other safety procedures
• Increased risk post release may be a
factor for some (as in drug related
deaths)
• SPS keeping a watching brief on prison
suicides
Other Groups:
• People who have recently lost employment /
unemployed: Unemployment is linked to
elevated risk of suicide
• People in isolated or rural communities:
Highest proportional mortality rates for
suicide are found in medical doctors and
farmers, with female doctors having a higher
risk of suicide than male doctors – access to
means may be a significant factor
People who are homeless: Higher risk for
homeless people due to poor physical
and mental health, substance misuse /
dependency and other risk factors
LGBT: High risk group due to sexual
orientation and other factors
Women: No discernable increase but ¼
of all suicides are female – rise in older
women and BME women from Indian /
Asian background
BME :Asylum seekers / isolation /
language barriers and increased mental
illness for some
Older people:
• No discernable rise but suicides of 50+
age group represents 32% of all
suicides in the last 5 years.
• Older male suicides may be associated
with alcohol dependency.
• Older people tend to opt for more
lethal means with far fewer attempted
suicides compared to younger people
Poverty / Inequalities:
• Not a priority group as such but poverty and
deprivation are linked to suicide risk at an
ecological (area) level. Areas with greater
levels of socio-economic disadvantage
(lower SES) have higher suicide rates
• Higher concentration of risk factors in areas
of deprivation and for lower socio-economic
groups?
Lastly:
• People who are not involved or in contact with
helping services (NCI 2/3 not in contact with MH
services in the year before death)
• Risk factors are multiple – including risk times for
some i.e. first diagnosis, recovery from drug /
alcohol dependency; loss of child custody, etc
• Anyone can be at risk of suicide – priority groups are
limited in their ability to identify and target those at
most risk
• Suicide Register may help illuminate other factors