Frequently asked questions
How do you define suicide and homicide?
How do you define patient suicides?
How do you collect suicide data?
Obtain information on all general population suicides and deaths of undetermined intent from the Office for National Statistics (ONS) (England, Wales), National Records of Scotland (NRS) and the Northern Ireland Statistics and Research Agency (NISRA).
Identify contact of those individuals with mental health services in the 12 months prior to the incident through administrative contacts at healthcare organisations and if contact is confirmed.
Collect detailed clinical data via questionnaire from the consultant psychiatrist (or other senior professional) caring for the patient. NCISH has the following approvals:
- Approval from the North-West Greater Manchester South Research Ethics Committee (ref: ERP/96/136).
- Approval from the Health Research Authority Confidentiality Advisory Group (HRA-CAG). Section 251 approval permits us to access confidential and identifiable patient information in the interest of improving care. This approval is renewed on an annual basis (PIAG 4-08(d)/2003).
- Approval from the Public Benefit and Privacy Panel for Health and Social Care (PBPP) (eDRIS ref: 1718-0171)
Individual R&D/R&I and Caldicott data sharing agreements with all NHS mental health services providing data.
How do you collect homicide data?
Obtain information on all homicide convictions from the Home Office Homicide Index (England and Wales) and the Management Information Analysis Team at the Scottish Courts and Tribunal Service (Scotland). We have historically obtained data from the Central Business Unit of Northern Ireland Courts and Tribunal Service (Northern Ireland).
Identify contact of those individuals with mental health services in the 12 months prior to the incident through administrative contacts at healthcare organisations – allowing us to record and report on the numbers of homicides by people in contact with mental health services.
How do you define homicide-followed by suicide and how do you collect these data?
How complete is the data you present?
Why is there a delay in the receipt of data from national sources?
Do you only collect case series data?
- carried out record linkage studies to identify patient suicides occurring in primary care;
- interviewed GPs and nurses to identify barriers to accessing secondary services, and difficulties with observation in in-patient settings;
- conducted case control studies to investigate in-patient suicide and suicide in the post-discharge period;
- examined the association between local service delivery and changing suicide rates;
- reviewed mental health care records to investigate the assessment and management of risk prior to suicide or homicide;
- examined suicide in the general population using information from investigations by official bodies, mainly coroners.
Find out more about our projects.
How many of the questionnaires that you send out are returned
What has been the effect of the ICD-10 coding changes to the recording of drug-related deaths?
Why do you report homicide convictions?
Why are there differences between the rates of suicide you calculate and those calculated by other agencies?
- Calculate the number of suicides based on the date of death.
- Collect data on suicide from age 10 years and over.
- Include a small number of deaths occurring outside the country and deaths of people who were not residents of the country. For example, for Wales we include all those deaths that occurred within Wales (residents and non-residents of Wales) and also the deaths of Wales residents who died in other countries.
- Calculate the overall rate of suicide based upon the number in the general population aged 10 years and over.
- Calculate crude suicide rates.
Other agencies sometimes report the rate of suicide:
- Where the number of suicides reported are based on date of registration of death.
- Using deaths from age 15 and over.
- That have been standardised using the European Standard Population.
Can I request data from the NCISH?
Yes. Individuals submitting data, audit teams and commissioners of services are able to access data through bespoke data requests. Currently, data requests must be initiated by the Medical Director of the healthcare organisation. Data requests provide individual trusts with benchmarking data for their trust in the context of the national data. Our annual reports provide some data on a regional basis, where appropriate. Annually, we provide a Safety Scorecard to the Medical Director of each mental health trust in England. This Scorecard provides benchmarking data to support quality improvement. All of our outputs and information about our work programme are available via our website – including PowerPoint data slides for download. We actively engage with clinical, commissioning and policy stakeholders through presentations at professional meetings and training days. We inform the public of our work through events, presentations, print and social media. However, we are bound by the conditions stated in the data sharing agreements we have with our data providers which are intended to safeguard the identifiable clinical information that they share with us and therefore it may not always be possible to respond to a request if it risks breaching these agreements. See our privacy notice for further information.
What happens to the information I provide?
We publish annual reports which include analysis of the most recent year of national data on patient suicides, as well as trends over time. In addition to annual reports, we publish project reports investigating specific patient sub-groups.
We recommend changes to clinical practice and policy to reduce the risk of suicide and improve the safety of mental health patients. We only publish aggregate figures, and we follow Office for National Statistics guidance about small numbers – we don’t publish low counts, and we never share information about an individual.
For more information on how we use the sensitive information that we collect in our research, and the rights you have if you think that we hold information about you as a data subject please refer to our privacy notice.
How do you involve service users, carers and their representative organisations?
Online data collection
All NHS Trusts in England, Health Boards in Scotland and Wales, and Health and Social Care trusts in Northern Ireland moved from the completion of paper NCISH questionnaires to an online system for the collection of questionnaire data by January 2018. The following FAQs provide more information about why this step was taken and how the online data collection site was built.
Why has an online data collection system been built using modern browser technology?
- Use robust and secure technology that is suitable for the public internet because the system cannot be used in the N3 environment.
- Use recommended software that could be supported long term, as the system is hosted on The University of Manchester’s servers.
- Develop a system that is in a familiar format to the user and is easy to use.
- Acknowledging that some NHS units are not as advanced in IT infrastructure upgrades; build in a simple secure solution to enable older systems to work with the online data collection system.
- Ensure the system meets the requirements of the stakeholder and the governance bodies who nationally have to approve it.
- Provide a solution that has no financial cost for relevant software to the end user.