Personalised approach to risk: learning event 6
Racial equity, self-harm, and suicide prevention
Wednesday 22 October 2025
On this page:
Recording of the session
Racial equity, self-harm, and suicide prevention
At this learning event, we discussed racial equity consideration for risk assessment in mental health services, and research on ethnicity, suicide and self-harm.
Links and resources
Research and reports
- Ethnicity and suicide in England and Wales: a national linked cohort study (The Lancet Psychiatry, 2024)
This study linked mortality data with Census data to examine suicide rates in England and Wales by ethnicity and migrant and descendant status. The White British majority had the highest rate of suicide, with the exception of individuals who identified as being from a Mixed heritage background, and White Gypsy or Irish Travellers. Migrants had a lower rate of suicide compared to non-migrants. However, descendants from a Mixed ethnicity background were at higher risk than White British individuals.
- Suicide rates by ethnic group among patients in contact with mental health services: an observational cohort study in England and Wales (The Lancet Psychiatry, 2021)
This NCISH study examines suicide rates by ethnicity among mental health patients. Patients from an ethnic minority background had a lower rate of suicide compared to White patients. There were differences between ethnic groups, with higher rates in Black Caribbean patients, and lower rates in South Asian patients.
- Suicide among psychiatric patients who migrated to the UK: a national clinical survey (eClinicalMedicine, 2023)
This NCISH study examines the suicide rate and antecedents of migrants who had been in contact with mental health services, specifically those resident in the UK for less than 5 years, and those seeking permission to stay in the UK. The suicide rate for those seeking to stay appears to be higher than that of the general population. Migrants have specific clinical needs that services should be aware of (such as acute illness, non-adherence to medication, and recent (in the last 3 months) discharge from psychiatric in-patient care).
- Ethnic differences in self-harm, rates, characteristics and service provision: three-city cohort study (British Journal of Psychiatry, 2010)
This paper investigates age- and gender-specific rates of self-harm by ethnic group in three cities in England. Young Black females had the highest rate of self-harm across sites. Individuals from a minority ethnic background were less likely to receive an assessment following self-harm and to re-present with self-harm.
- Self-harm in children and adolescents by ethnic group: an observational cohort study from the Multicentre Study of Self-Harm in England (The Lancet Child & Adolescent Health, 2021)
This study explores self-harm in young people by ethnic group. While rates of self-harm were highest in White children and adolescents, increases in self-harm over the study period were greater in Black, South Asian and non-White groups compared to the White groups. Those from a minority background were less likely to receive a psychosocial assessment and to live in areas of high deprivation.
- Variation by ethnic group in premature mortality risk following self-harm: a multicentre cohort study in England (BMC Psychiatry, 2015)
This study examines self-harm and risk of premature death by ethnicity. South Asian and Black people had a lower risk of death following self-harm compared to White people. The prevalence of common risk factors for premature death was also lower in these two groups.
NHS England guidance and resources
- Culture of care standards for mental health inpatient services
This guidance details the core commitments and standards for the culture of inpatient care. The standards are aligned with three principles of support equality-focused inpatient care: autism-informed, culturally competent and trauma-informed.
- Culturally competent inpatient care
This guidance sets out why culturally competent care is needed in mental health inpatient care, what culturally competent care is and how to deliver it.
- Patient and Carer Race Equality Framework
The Patient and Carer Race Equality Framework (PCREF) outlines the steps that mental health trusts and providers should take to improve experiences of care for racialised and ethnically and culturally diverse communities.
Black Thrive Global resources
- Patient and Carer Race Equality Framework
Further information on the PCREF can be found on the Black Thrive Global website.
This work was completed as part of the Culture of Care Programme. The work was supported by the National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Research Collaboration (GM PSRC) (Grant Reference Number NIHR204295). Leah Quinlivan is fully funded by the NIHR GM PSRC, Pauline Rivart was part funded by the NIHR GM PSRC, and Professor Nav Kapur is part funded by the NIHR GM PSRC. The views expressed on this webpage are those of the authors and not necessarily those of NICE, NIHR, NHS, or the UK Department of Health and Social Care.
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