Suicide

Paul Corcoran (pcorcoran@ucc.ie)National Suicide Research Foundation, Ireland

Department of Epidemiology & Public Health, UCC

National Suicide Research Foundation

GoalTo produce a nationally and internationally recognised bodyof reliable knowledge from a multidisciplinary perspective onthe risk and protective factors associated with suicidalbehaviour.

Research focusExtent of the problem of deliberate self harm and suicide aswell as risk and protective factors

Effectiveness of intervention and prevention programmesfor deliberate self harm and suicide

Suicide

Suicide attempts

Deliberate self harm

–Hospital/medically-treated

–Untreated

Suicidal ideation/thoughts/plans

What is suicidal behaviour?

Suicide

Deliberate selfharm

medically treated

‘Hidden’ cases ofdeliberate self harm and

suicidal thoughts

Level 1

Level 2

Level 3

Suicidal behaviour:an ‘iceberg phenomenon’

World HealthOrganization and Irish

Central Statistics OfficeSuicide Data

Surveillance studiesand registries

Community andschool-based

studies

The burden of suicidal behaviour

An estimated one million people die by suicide annuallyworldwide

10-20 million people attempt suicide annually worldwide

Suicide accounts for ~1.5% of all deaths and is the 10th

leading cause of death worldwide

Suicide is the second leading cause of death in 15-34 year-old Europeans

Among 15-44 year-olds worldwide, self-inflicted injuries is thesixth leading cause of disability-adjusted life years

The burden of suicidal behaviour

The burden of suicidal behaviour

Recording of suicide in Ireland

Coroner notified of death by gardai

Post mortem and inquest

Coroner notifies registrar of death after the inquest

Registrar then registers death and notifies the Central Statistics Office(CSO)

CSO send confidential form to relevant garda sub-district

Garda provides opinion as to the cause of death and returns form to CSO

– Suicidal– Homicidal– Accidental– Undetermined

Irish suicide rates, 1960-2010

0

4

8

12

16

20

2419

6019

6219

6419

6619

6819

7019

7219

7419

7619

7819

8019

8219

8419

8619

8819

9019

9219

9419

9619

9820

0020

0220

0420

0620

0820

10

Rat

e pe

r 100

,000

age

-adj

uste

dto

the

Sta

ndar

d E

urop

ean

Pop

. Men

Women

0

100

200

300

400

500

600

700

800

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Num

ber o

f dea

ths

Suicide+UD Suicide Transport accidents

Suicide compared to transport accidentdeaths in Ireland

Is suicide a major cause of death inIreland?

Suicide accounted for 527 (1.8%) of the 28,898 deaths thatwere registered in 2009.

8,58530%

3,69413%

1,156 4%

527, 2%

5,24318%

9,69334%

Circulatory system

Neoplasms

Respiratory system

Digestive system

Suicide

Other

Is suicide a major cause of deathamong young adults in Ireland?

Suicide accounted for 229 (25%) of the 923 deaths of 15-34year-olds that were registered in 2009.

23%

25%13%

6%

8%

13%

1%2%

10%Circulatory systemMalignant neoplasmsRespiratory systemDigestive systemSuicideTransport accidentsAccidental poisoningUndetermined intentOther

Suicide in Ireland and in other EUcountries

0

5

10

15

20

25

30

35Li

thua

nia

Hun

gary

Slo

veni

a

Latv

ia

Finl

and

Bel

gium

Est

onia

Fran

ce

Pol

and

Aus

tria

Cze

ch R

epub

lic

Sw

eden

Bul

garia

Slo

vaki

a

Ger

man

y

Den

mar

k

Por

tuga

l

Rom

ania

Luxe

mbo

urg

Irela

nd

Net

herla

nds

Spa

in

UK

Mal

ta

Italy

Gre

ece

Rat

e pe

r 100

,000

Based on WHO data accessed on 31 March 2011. Data are for 2004-2008 except for Belgium (1999).

Suicide rate of 15-24 year-olds inIreland and in other EU countries

0

5

10

15

20

25

30

35Li

thua

nia

Finl

and

Est

onia

Irela

nd

Luxe

mbo

urg

Bel

gium

Pol

and

Sw

eden

Latv

ia

Slo

veni

a

Cze

ch R

epub

lic

Aus

tria

Slo

vaki

a

Hun

gary

Fran

ce

Ger

man

y

Den

mar

k

Rom

ania

Bul

garia

Net

herla

nds

UK

Spa

in

Por

tuga

l

Mal

ta

Italy

Gre

ece

Rat

e pe

r 100

,000

Based on WHO data accessed on 31 March 2011. Data are for 2004-2008 except for Belgium (1999).

0

15

30

45

60

75

90

105

120

135

150

10-1

4yrs

15-1

9yrs

20-2

4yrs

25-2

9yrs

30-3

4yrs

35-3

9yrs

40-4

4yrs

45-4

9yrs

50-5

4yrs

55-5

9yrs

60-6

4yrs

65-6

9yrs

70-7

4yrs

75-7

9yrs

80-8

4yrs

85yr

s+

Ave

rage

ann

ual r

ate

per 1

00,0

00

MaleFemale

Suicide in Europe by age

0

5

10

15

20

25

30

3510

-14y

rs

15-1

9yrs

20-2

4yrs

25-2

9yrs

30-3

4yrs

35-3

9yrs

40-4

4yrs

45-4

9yrs

50-5

4yrs

55-5

9yrs

60-6

4yrs

65-6

9yrs

70-7

4yrs

75-7

9yrs

80-8

4yrs

85yr

s+

Ave

rage

ann

ual r

ate

per 1

00,0

00 Men

Women

Suicide in Ireland by age, 2004-2009

Method of suicide in Irelandby gender

66%

50%

12%

24%

9% 20%7% 1%6% 5%

0%

20%

40%

60%

80%

100%

Men Women

OtherFirearmsPoisoningDrowningHanging

Based on 2004-2008 data

Method of suicide in Irelandby gender and age

76%61%

53%68%

43%32%

7%

14%22%

12%

25%40%

7%11% 8%

13%26% 20%

5% 6% 12%2% 1% 1%

5% 7% 5% 4% 5% 7%

0%

20%

40%

60%

80%

100%

Men<30yrs

Men30-54yrs

Men55yrs+

Women<30yrs

Women30-54yrs

Women55yrs+

OtherFirearmsPoisoningDrowningHanging

Based on 2004-2008 data

0

25

50

75

100

125

150

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Num

ber o

f sui

cide

dea

ths

Expected

Observed

Monthly variation in suicide, 2006-2008

Monthly variation in suicide, 2006-2008

-20

-15

-10

-5

0

5

10

15

20

25

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

% d

iffer

ence

from

exp

ecte

d

Suicide in Irelandby day of death

0

5

10

15

20

Mon Tue Wed Thu Fri Sat Sun

% o

f dea

ths

Based on 2005-2006 data

Location of suicide deaths in Ireland

Based on 2002 data

At or near home

River/waterway

At sea

Institution

Farm/agri area

Other personsresidenceRoad/roadside

Work site

Other

1717

1616

141414

1313

1312121212

1212

1111111111111111111110

10109

977

19

0 5 10 15 20

Cork City

Leitrim

Cavan

Carlow

Tipperary North

Waterford County

Wexford

Offaly

Cork County

Westmeath

Clare

Tipperary South

Limerick City

Mayo

Roscommon

Galway County

Kerry

Waterford City

Monaghan

Meath

Wicklow

Longford

Limerick County

Kildare

Louth

Laois

Dublin City

Donegal

Sligo

Kilkenny

South Dublin

Galway City

Dun Laoghaire/Rathdown

Fingal

Crude rate per 100,000

Suicide by county/city, 2004-2010

Example of volatile rates:

Carlow 2007: 22 per 100,000

Carlow 2008: 11 per 100,000

Galway county, 8 deaths in 2004

Galway county, 25 deaths in 2005

Suicide in Irelandby marital status and gender

0

10

20

30

40

50

60

70

Single Married Widowed Separated Single Married Widowed Separated

Rat

e pe

r 100

,000

Based on 2002 dataMen Women

Suicide in Irelandby domestic situation and gender

0

10

20

30

40

50

60

70

Alone Withparent(s)

With partner Alone Withparent(s)

With partner

Rat

e pe

r 100

,000

Based on 2002 dataMen Women

Suicide in Irelandby employment status and gender

0

10

20

30

40

50

60

70

80

90

Unemployed Employed Unemployed Employed Home duties

Rat

e pe

r 100

,000

Based on 2002 dataMen Women