Suicide following missed contact and/or non-adherence with medication
On this page:
- Number of mental health patients who died by suicide following missed contact and/or non-adherence with medication in the UK and Jersey
- Characteristics of mental health patients who died by suicide after missed service contact
- Characteristics of mental health patients who died by suicide and were non-adherent with medication
Number of mental health patients who died by suicide following missed contact and/or non-adherence with medication in the UK and Jersey
An estimated 3,817 patients who died by suicide had missed their final contact with mental health services, accounting for 22% of all patient suicides, an average of 347 deaths per year. There were an estimated 1,998 patients who were non-adherent with drug treatment in the month before their death, representing 12% of all patient suicides, an average of 182 deaths per year.
5,220 patients had missed their last contact and/or were non-adherent to medication, accounting for 29% of all patient suicides, an average of 475 deaths per year. 593 patients fell into both categories – having missed their last contact and being non-adherent – making up 3% of all patient suicides, an average of 54 deaths per year.
The overall number of patients who died by suicide and had missed contact with services has decreased over the report period but we are projecting an increase in 2022; the number of patients who were non-adherent with drug treatment has been relatively stable and we project a fall in 2022.
Patient data unavailable in Jersey in 2019-2022.
Characteristics of mental health patients who died by suicide after missed service contact (UK and Jersey, 2012-2022)
Socio-demographic characteristics
A higher proportion of patients who died by suicide and had missed their last service contact were men compared to other patients who had not missed their last contact (2,560, 67% v. 8,115, 65%). 45 (1%) were aged under 18 and 330 (9%) were aged 18-24. Overall, they were younger, with more aged under 25 (375, 10% v. 1,098, 9%) and aged 25-44 (1,586, 44% v. 4,340, 35%). More were single (1,697, 51% v. 5,035, 43%), unemployed (1,877, 57% v. 5,022, 44%) and living alone (1,883, 56% v. 5,317, 45%) than other patients. See additional data and downloads for further information.
Clinical characteristics
The most common primary diagnosis among patients who missed their last contact was affective disorder (bipolar disorder and depression; 1,239, 35%). A higher proportion had a primary diagnosis of alcohol (328, 9% v. 753, 6%) and drug (266, 8% v. 550, 5%) dependence/misuse and personality disorder (446, 13% v. 1,244, 10%) compared to other patients. More had a comorbid (i.e. additional) diagnosis (2,104, 60% v. 6,443, 53%) and a long (>5 years) history of illness (1,808, 57% v. 5,794, 54%).
67%
male
54%
aged under 45
57%
unemployed
60%
additional mental illness
65%
history of self-harm
69%
history of alcohol and/or drug misuse
Behavioural characteristics
A history of self-harm (2,236, 65% v. 7,143, 60%), violence (771, 24% v. 1,945, 17%) and alcohol and/or drug misuse (2,397, 69% v. 6,341, 54%) was more common among those who missed their last contact than other patients. More had experienced financial problems (541, 22% v. 1,415, 15%) and had previously been in prison (491, 15% v. 1,033, 9%).
Community/Compulsory Treatment Orders and Assertive Outreach
There were 39 (1%) patients who missed their last contact with services who were subject to a Community/Compulsory Treatment Order (CTO) at the time of death. 72 (2%) patients with missed contact were under the care of an assertive outreach service.
Follow-up from services
Services had attempted to re-engage the majority (3,332, 94%) of patients following missed contact. This was mostly a follow-up via telephone (59%) or letter (57%) to arrange another appointment; in half (50%) the GP was also informed and in 28% the patient’s family was contacted. In 18% the patient was discharged from follow-up.
Follow-up by services following missed last contact of mental health patients who died by suicide (UK and Jersey, 2012-2022)
Characteristics of mental health patients who died by suicide and were non-adherent with medication (UK and Jersey, 2012-2022)
Socio-demographic characteristics
Patients who died by suicide and had been non-adherent to medication were younger than other patients (median age 44yrs v. 46yrs), with more aged 25-44 (766, 40% v. 4,951, 36%). 18 (1%) were aged under 18 and 179 (9%) were aged 18-24. A similar proportion were male (1,298, 65% v. 8,926, 65%) and from an ethnic minority group (158, 9% v. 921, 7%) but they were more likely to be single (942, 52% v. 5,741, 44%) and unemployed (937, 52% v. 5,878, 46%).
See additional data and downloads for further information.
Clinical characteristics
A higher proportion had severe mental illness (schizophrenia or affective disorders) (1,180, 63% v. 7,439, 55%) and a comorbid (i.e. additional) psychiatric disorder (1,154, 62% v. 7,219, 54%).
40%
aged 25 – 44
52%
single
52%
unemployed
63%
severe mental illness
46%
history of drug misuse
62%
additional mental illness
Treatment and care
There were 18 (1%) patients who had been non-adherent with drug treatment and were subject to a Community/Compulsory Treatment Order (CTO) at the time of death and 36 (2%) patients under the care of an assertive outreach service. Overall, more patients who were non-adherent with drug treatment had been detained under the Mental Health Act (MHA) at their last admission compared to other patients (457, 26% v. 1,856, 15%).
Behavioural characteristics
Previous violence (383, 22% v. 2,258, 18%) and drug misuse (832, 46% v. 4,612, 35%) were common, and more had recently (<3 months) experienced serious financial problems (278, 19% v. 1,649, 16%). Both immediate (1,191, 72% v. 9,708, 82%) and long-term risk (707, 45% v. 6,462, 57%) were less likely to be viewed as not present or low compared to other patients.
Medication and reasons for non-adherence
Those non-adherent were more often receiving oral antipsychotics (860, 47% v. 4,722, 35%). The most common reasons reported by clinicians for non-adherence were the patient’s lack of insight into their mental ill health (460, 31%), medication side-effects (225, 15%) and the patient finding no positive effect from the treatment (192, 13%).
Method of suicide
Overall, they were more likely to die by jumping/multiple injuries (314, 17% v. 1,826, 13%) and less likely to die by self-poisoning (327, 17% v. 3,055, 22%).
Community/Compulsory Treatment Orders and Assertive Outreach
Of the patients who died by suicide and had either missed last contact and/or were non-adherent with medication, 52 (1%) were subject to a Community/Compulsory Treatment Order (CTO) and 94 (2%) were under the care of an assertive outreach service at the time of death.
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