Suicide by people in contact with drug and alcohol services in the year prior to death
Alcohol and drug misuse are key risk factors for suicide. There is currently no national study of suicide by people in contact with alcohol and drug services, and following NHS reforms, service provision has become more complex.
We are conducting a new study investigating deaths by suicide of people under the recent care of alcohol and drug services based on a methodology recommended in our feasibility study. We will undertake this by (1) linking existing data, (2) using existing data for case-control exploration, and (3) collecting and analysing clinical data from Serious Incident Reports.
The study is commissioned by the Healthcare Quality Improvement Partnership (HQIP). Further information on the study design and purpose, and how we comply with data protection obligations, can be found in our study summary and information sheet, and in our Data Protection Impact Assessment document.
Pilot real-time data collection of probable suicide deaths
We are establishing a real-time data collection of suspected suicide deaths by people under the recent care of mental health services in England – specifically, in-patients and post-discharge patients who died within 14 days of discharge. This real-time surveillance (RTS) system will focus on patients closest to care and ask for information that we need to know early to support suicide prevention efforts. This includes emerging novel methods, suicide related internet use, possible clusters, problems in care which may be systemic and particular problems that patients face.
On 1st August 2023, we will begin piloting this real-time data collection in eight NHS Trusts in South East England only (see list below). We will be asking clinicians from these pilot trusts to complete an online questionnaire when they become aware of a suspected suicide by a patient under the care of their trust, without waiting for the inquest or for a request from us. This data collection will be extended nationally in 2024 (estimated) following feedback and learning from our pilot.
- Berkshire Healthcare NHS Foundation Trust
- Isle of Wight NHS Trust
- Kent and Medway NHS and Social Care Partnership Trust
- Oxford Health NHS Foundation Trust
- Solent NHS Trust
- Southern Health NHS Foundation Trust
- Surrey and Borders NHS Foundation Trust
- Sussex Partnership NHS Foundation Trust
Suicide in NHS staff: a national data collection to inform prevention
We have been commissioned by NHS England to establish a prospective data collection about suicide by NHS staff, with the aim of preventing future deaths.
Some health service staff may be at an increased risk of suicide, and staff wellbeing is a priority in the context of sustained and growing pressures.
We are taking a stepped approach to establishing this data collection:
- firstly, we are working with Greater Manchester NHS Integrated Care Board to engage with stakeholders and HR representatives across Greater Manchester as our trailblazer site to explore data availability for clinical staff;
- we will expand our engagement to the North-West region, to pilot retrospective data collection on all suicide deaths by NHS healthcare staff over a 5-year period;
- we will expand this data collection nationally, and further develop the data collection to collect information about non-clinical members of NHS staff who die by suicide. By learning from these tragic deaths, our aim is to improve safety and wellbeing for people working within the NHS. This work will run from May 2023 to April 2026.
Reducing suicides: Quality improvement and patient safety
We are working with experts in Quality Improvement at the National Collaborating Centre for Mental Health (NCCMH) to support Sustainability and Transformation Partnerships (STPs) to strengthen their local suicide prevention quality improvement plans. This is part of a nationally recognised suicide reduction priority across Department of Health, NHS England, and an overall Mental Health Five Year Forward View recommendation to reduce the suicide rate by 10% by 2020/21.
Together with NCCMH, we are working with Quality Improvement teams in each STP to:
- review their services against established guidelines and recommendations, and improve the quality of care they offer, using bespoke data provided from the NCISH database, benchmarked against the national average;
- provide expert knowledge of suicide prevention in three priority areas – mental health secondary care, services for self-harm, and middle-aged men;
- identify and help STPs adopt and embed national evidence including NCISH “10 ways to improve patient safety” into local quality improvement plans;
- advise on local data collection and suicide prevention plans.
Read more about this collaboration on NCCMH’s Suicide Prevention National Transformation Programme webpage. The study is commissioned by the Healthcare Quality Improvement Partnership (HQIP).
In May 2019, NCISH were winners of a 2019 Making a Difference award for social responsibility.
Read our March 2020 update on the national suicide prevention programme in this blog, by NCISH researchers Nicola Richards and Cathryn Rodway.
Read a blog on our work with NCCMH to help local areas improve suicide prevention plans, by the NCISH project manager, Dr Pauline Turnbull.
A diverse range of multifaceted, novel projects have been established throughout this programme. See some examples of innovative work being carried out by local areas in the programme.
Collaborations and associated projects
We work collaboratively with national and international academic and health colleagues in the area of suicide prevention research. Our ongoing projects are listed below.
Suicide in former service personnel
*NEW* findings from the first phase of the study published in PLOS Medicine.
We found the overall suicide rate was not greater than in the general population, but risk was 2-3 times higher in male and female veterans aged under 25 than in the same age groups in the general population. Male veterans aged 35 years and older were at reduced risk of suicide. Male sex, Army service, discharge under the age of 35 years, being untrained on discharge, and length of service under 10 years were associated with increased suicide risk. Factors associated with reduced risk included being married, a higher rank and deployment on combat operations.
Read our paper “Suicide after leaving the UK Armed Forces 1996-2018: a cohort study” (PLOS Medicine)
This study, with the Ministry of Defence, aims to investigate suicide amongst those who have left the UK Armed Forces, and to make comparisons with serving personnel and the general population. The study will update our previous work from 2009, which showed although the overall rate of suicide was not greater than that in the general population, the risk of suicide in young men who had left the Armed Forces was 2-3 times higher than in the same age groups in the general population. Since this study was carried out there has been no systematic investigation of suicide in UK veterans.
The purpose of the study is to understand the rate, timing and risk factors for suicide for those who have left the UK Armed Forces between 1996 and 2018. The study will include the linkage of data from the Ministry of Defence on all suicide deaths in serving personnel and all personnel discharged from Armed Forces with NCISH data on general population and mental health patient suicides. It will also include a review of coroner’s records and inquest hearings for a sample of veteran suicide deaths. This study will provide more detail of the factors related to suicide (particularly early and recent vulnerabilities, in-service exposures, difficulties after discharge, living circumstances, and contact with a variety of health and third sector providers) in this population.
The study is funded jointly by the Ministry of Defence and NHS England. Further information on the study design and purpose can be found in our study summary and information sheet, and is also available on the GOV.UK website.
Support for improving community-based care for self-harm
We were commissioned by NHS England and NHS Improvement to support areas in England to improve community-based services and care for people who self-harm. Together with experts from the Manchester Self-Harm Project (MaSH) and NIHR Greater Manchester Patient Safety Translational Research Centre (PSTRC), we supported participating areas by providing:
- Expert knowledge of current self-harm data and research;
- Guidance on national guidelines and recommendations for the care of people who self-harm;
- Advise on methods of data collection to monitor and evaluate the impact of service changes for people who self-harm;
- An online resource to gather useful information in an easily accessible format.
This was part of a national programme funded by NHS England and NHS Improvement linked to establishing new and integrated models of primary and community mental health care across England. Read more about this collaboration here. This work was commissioned by the Healthcare Quality Improvement Partnership (HQIP) and funded by NHS England and NHS Improvement.
Suicide Information Database Cymru (SID-Cymru) and NCISH database linkage study
National academic response to COVID-19 related suicide prevention
Evaluation of the Mersey Care NHS Foundation Trust Zero Suicide initiative
Safety in marginalised groups
The impact of suicide in the UK
A survey-based study conducted in collaboration with the Support after Suicide Partnership (SASP) to better understand the impact of suicide on people’s lives, including the support received.
- Read the study’s report “From grief to hope: the collective voices of people bereaved and affected by suicide in the UK“.
All our research projects
More information on our research projects can be found within the University’s Research Explorer.