Suicide in Wales Professor Keith Lloyd School of Medicine www.swansea.ac.uk
Definitions Suicide intentionally killing oneself Self harm intentional selfpoisoning or selfinjury, irrespective of the nature of motivation or degree of suicidal intent.
Suicide: Coroner s verdict Suicide should never be presumed, but must always be based upon some evidence that the deceased intended to take his own life. On the other hand, once there is sufficient evidence, it is a matter for the coroner (or jury, if there is one) as to whether or not it was suicide
Hungary* Korea Finland Japan Poland Austria France* Czech Republic Slovak New Zealand' Luxembourg Sw itzerland Iceland Sw eden" United States" Denmark' Canada" Germany Australia* Ireland Norw ay Portugal* Wales Netherlands Spain United Kingdomˆ Italy" Greece 4.4 39.0 36.3 28.9 28.7 25.0 24.1 24.0 22.6 22.0 20.5 20.2 20.0 17.2 17.0 17.0 16.8 16.7 16.3 16.2 15.8 15.1 14.6 14.0 11.1 10.5 9.8 9.3 OECD average = 19.2 0 5 10 15 20 25 30 35 40 45 OECD Age standardised rate per 100,000 males ' 2001, " 2002, * 2003, Wales rate calculated, ˆWales included in UK f igures NB: Suicide in this graph only includes deaths categorised as intentional self poisoning / self injury (X60-X84); unlike all other analyses of suicide in this report it does not include deaths where the intent is undetermined (Y10-Y34). Cultural variations in classification of intent may contrib ute to variation b etween countries.
Korea Japan Hungary* Sw itzerland Finland France* Norw ay Austria Iceland Denmark' New Zealand' Sw eden" Luxembourg Netherlands Germany Canada" Czech Republic Australia* Ireland Poland United States" Portugal* Slovak Spain Wales United Kingdomˆ Italy" Greece 14.4 9.9 8.9 8.6 8.5 7.5 6.9 6.4 6.3 6.3 6.0 6.0 5.5 4.9 4.8 4.6 4.4 4.4 4.2 3.9 3.9 3.8 3.1 3.1 3.1 2.9 2.4 1.0 OECD average = 5.7 0 2 4 6 8 10 12 14 16 OECD Age standardised rate per 100,000 females ' 2001, " 2002, * 2003, Wales rate calculated, ˆWales included in UK f igures NB: Suicide in this graph only includes deaths categorised as intentional self poisoning / self injury (X60-X84); unlike all other analyses of suicide in this report it does not include deaths where the intent is undetermined (Y10-Y34). Cultural variations in classification of intent may contribute to variation between countries.
Male suicide rates, UK nations, 2004-2006 Data sources: ONS (VS), GROS (VE), NISRA (VS) 35 European Age Standardised Rate (per 100,000 population) 30 25 20 15 10 5 UK Rate = 17.5 0 England Wales Northern Ireland Scotland
Female suicide rates, UK nations, 2004-2006 Data sources: ONS (VS); GROS (VE); NISRA (VS) 35 European Age Standardised Rate (per 100,000 population) 30 25 20 15 10 5 UK Rate = 5.7 0 England Wales Northern Ireland Scotland
Proportion of suicides by method, Wales: 1996-1998 and 2004-2006 Data source: ONS (ADDE) 50 1996-1998 2004-2006 45 40 Percentage (%) 35 30 25 20 15 10 5 0 Hanging & suffocation Poisioning Drowning Guns and explosives Sharp object Jumping or lying before moving object Jumping from a high place Other
Age specific suicide rates by sex, Wales: 1996-2006 Data source: Annual Distric Deaths Extract, Mid year estimates (Office for National Statisitcs) Rate per 100,000 population 35 30 25 20 15 10 5 0 Male Female 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Age band Graph: National Public Health Service for Wales
Suicide mortality rates, males, all ages (15 and over), Local Health Boards, 1996-2006 Data source: ONS (ADDE, MYE) 40 35 30 25 20 15 10 5 Welsh average = 21.5 0 The Vale of Glamorgan Monmouthshire Torfaen Cardiff Newport Isle of Anglesey Gwynedd Powys Wrexham Swansea Caerphilly Rhondda Cynon Taff Pembrokeshire Ceredigion Flintshire Blaenau Gwent Bridgend Conwy Carmarthenshire Merthyr Tydfil Denbighshire Neath Port Talbot EASR (per 100,000 population) cc
Suicide rates, females, all ages (15 and over), Local Health Boards, 1996-2006 Data source: ONS (ADDE, MYE) 18 16 14 12 10 8 6 Welsh average = 5.6 4 2 0 EASR (per 100,000 population) cc Newport Blaenau Gwent Caerphilly Wrexham Monmouthshire Isle of Anglesey Flintshire Bridgend Carmarthenshire Torfaen Cardiff Pembrokeshire Neath Port Talbot Rhondda Cynon Taff The Vale of Glamorgan Powys Gwynedd Ceredigion Merthyr Tydfil Denbighshire Swansea Conwy
Self harm emergency admissions (continuous periods of hospital care)*, age specific rates by sex, Wales residents: 1999-2006 Data source: PEDW; ONS (MYE) 700 Male Female 600 500 400 300 200 100 0 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Rate per 100,000 population
Talk To Me The National Suicide and Self Harm Prevention Action Plan for Wales
Why An Action Plan 300 deaths per year as a result of suicide in Wales One in five deaths among men aged between 15 and 24 and almost one in ten deaths in women of that age Deaths by suicide represent over 70% more deaths in people of all ages than in RTAs Only 27% of people are known to mental health services in the year prior to death. 6000 admissions due to self harm are an under representation of actual self harm rate. Needs a broad community based approach.
Strategic Aim To deliver co-ordinated action for improving the mental health and wellbeing of the population of Wales, promoting resilience within individuals and communities and thereby reducing the rate of suicide and self harm in Wales
Talk To Me: Strategic Objectives Objective 1: Promote mental health and wellbeing Objective 2: Deliver early intervention Objective 3: Response to personal crisis Objective 4: Manage the consequences of suicide and self harm Objective 5: Promote learning and research and improve information on suicide and suicide prevention Objective 6: Work with the media to ensure appropriate reporting on mental health and suicide Objective 7: Restrict access to the means of suicide
The Principles of Effective Action 1. Raising public awareness by changing public attitudes and enhancing people s willingness to seek help. 2. Tackling social exclusion through practical intervention. 3. Ensuring that services respond to people who are in need at the point at which they request help. 4. Changing professionals awareness and attitudes through training in order to improve their willingness to provide help at the point at which people request help. 5. Raising awareness and delivering training to professionals who provide services. 6. Promoting research and development into patterns of suicide and self
The Approach National Leadership Local Action Health Promotion focus Multi sectoral Reducing risk factors/increasing protective factors Building individual and community resiliance
Early adopted initiatives Mind Cymru commencing the roll out of Mental Health First Aid. Mind Cymru piloting the roll out of Applied Suicide Intervention Skills Training (ASIST). Establishing the Welsh Mental Health Promotion Network through the Wales Centre for Health. This brings together, informs and equips a broad range of stakeholders to participate in improving the mental health and wellbeing of the people of Wales. Implementing the School-based Counselling Strategy in Wales Involving children and young people in decision making on matters that affect their lives Publication of Working Together to Reduce Harm. The Substance Misuse Strategy for Wales 2008-2018
Next Steps Consultation has concluded Briefing to the Minister on consultation outcome Subject to Ministerial approval develop final iteration of the action plan Implementation