Background
Suicides by people in contact with mental health services are arguably the most preventable. Between 2010 and 2021, over a quarter (26%) of all suicides in the general population were accounted for by individuals in contact with mental health services. Improving services by enhancing the level of support they provide may help make a stronger positive impact on the mental health of an individual and reduce the number of these tragic events.
Most patients who die by suicide have a history of self-harm and are more likely to suffer from alcohol and drug misuse. They are also more likely to have undergone economic adversity (loss of job, benefits or housing). The first Cross-Government Suicide Prevention Workplan in 2019 included a zero-suicide ambition for mental health inpatients, with a view to expanding to include all mental health service users, alongside the national ambition to reduce the total number of suicides by 10% by 2020/21. A follow-up report, Preventing suicide in England: Fifth progress report, published in 2021, underscores the aim to reduce the number of suicides. The latter was superseded by the 5-year strategy plan Suicide prevention strategy for England: 2023 to 2028, published in 2023, which outlines the objectives of reducing suicide rates, improving support for people who have self-harmed and improving support for people bereaved by suicide. The actions set out by the strategy for people who have been in contact with mental health services include good-quality follow-up support within 72 hours of being discharged and a safety planning working group involving experts and people with personal experience.
If you are somebody who has been bereaved or affected by suicide, resources and help are available on the National Suicide Prevention Alliance website.
Number of patient suicides by UK country
While the number of suicides in Scotland, Wales and Northern Ireland have not changed significantly between 2006 and 2021, there has been an uptick in suicides in England over the same period, increasing by 15% from 1,124 in 2006 to 1,297 in 2021. In Scotland, there were 230 suicides in 2021 by people who had been in contact with mental health services in the previous 12 months, and in Wales there were 70. The latest data available for Northern Ireland is 2019, when 18 suicides were recorded from people who had been in contact with mental health services (for more details, please see ‘About this data’). Despite the onset of the Covid-19 pandemic in 2020, which led to economic and social adversity (risk factors for suicide), the number of suicides did not increase overall or in vulnerable groups such as those aged 25 or below or those aged 75 and above.
Data for all UK countries in 2021 (except Northern Ireland) is based on projected estimates. See ‘About this data’ for more information.
Rate of patient suicides by gender
Rates of patient suicide, which take into account the rising number of people receiving mental health care, show a pattern of decline over time. Between 2006 and 2021, the total patient suicide rate decreased from 98 per 100,000 mental health service users to a projected 41 per 100,000 service users.
The rate of suicide in mental health service users is over twice as high in men compared with women. However, the male rate of suicide in 2021 has seen a greater percentage drop from the 2006 figure (59%) when compared with that of females (54%).
Decreases in the rate of patient suicide may reflect increasing use of mental health services as opposed to improved quality of care. Between 2015 and 2016, the rate decreased from 69 to 51 per 100,000 service users. The number of suicides by people in contact with mental health services in the previous 12 months remained similar, however the number of mental health service users increased from 1,828,428 in 2015 to 2,434,913 in 2016. In fact, the number of mental health service users has shown a steady increase in the last five years, while the rate of patient suicide has not wavered much.
Data for 2021 is projected because the figures are incomplete; please see ‘About this data’ for more information.
About this data
The National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) suicide rates differ from Office for National Statistics (ONS) rates because they base their figures on date of death rather than the date when the death was registered. In addition, the figures include people aged 10–14 and are not age-standardised, i.e. they are not adjusted to reflect differences in the age of the population. Currently, patient data is unavailable for Northern Ireland for 2020 and 2021 as the NCISH has not received the patient questionnaire data for those years yet, but these findings will be presented in future reports.
Data completion is lower in the most recent year reported, reflecting the time required to receive and process the data. For 2021, the total number of patient cases was projected based on the number of unreturned NCISH questionnaires and the accuracy of the previous year’s estimates. For more information, please see the NCISH Annual Report 2024.
The Mental Health Services Data Set (MHSDS) was used to calculate rates of suicide by sex. Changes in the methodology mean that rates pre- and post-2011 are not comparable with each other.