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Jun 22 • 10 tweets • 4 min read
Been asked for data sources re my #suicideprevention talk at #RCPsychIC. Mainly @ONS & my research unit @NCISH_UK - link to our website.

Short 🧵 on our research findings.

sites.manchester.ac.uk/ncish/
First, important reminder that graphs & data represent real lives lost, families devastated.
Our national study of suicide in CYP, almost 600 deaths over 3 yrs, based on data from inquests & other official sources.

Shows rapid rate rise in late teens & important stresses such as bullying, suicide bereavement & exams.

cambridge.org/core/journals/…
From same study, focus on online risk. 1/4 of CYP dying by suicide were known to have used internet in “suicide-related” way.

Public concern is on social media but more common was searching for info on methods. Need to tackle these dangerous sites.

cambridge.org/core/journals/…
Our national study of suicide in middle-aged men. Highlights financial probs & alcohol. Our assumption that men don’t seek help is simplistic - 2/3 had contact with services in previous 3m, 1/3 in final week.

sites.manchester.ac.uk/ncish/reports/…
Our annual report for 2022. Around 1600 MH patients/yr die by suicide in UK. Data on suicides in & soon after IP care. Max risk is on day 3 post-discharge.

sites.manchester.ac.uk/ncish/
We tracked patient suicide rates against changes in MH services. Best evidence for prevention included safer wards, early follow up on discharge, crisis teams, outreach, incident review. Became our “10 ways to improve safety” message.

thelancet.com/journals/lanps…
Study of suicide risk assessment tools. We found 156 in use nationally, many self-designed. Poor validity & prediction, should be replaced by more personalised model of care.

thelancet.com/pdfs/journals/…
We tracked suicide in the early pandemic by “real time surveillance”- recording suspected suicides as they happened. Despite much concern & many claims, we found no rise.

Economic protections, social cohesion, stronger services & communities?

sciencedirect.com/science/articl…
Message of my talk at #RCPsychIC22:

Need to learn from positive evidence of pandemic but also pre-pandemic trends: CYP, ethnic minorities, domestic violence, gambling & online.

Suicide is preventable but pattern of risk is changing & we need to be constantly vigilant.

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More from @ProfLAppleby

louis appleby Profile picture
May 4
Discussion on Twitter this week of suicide rate in doctors, after widely-reposted tweet claiming rate in this country to be several times higher than in general population.

This is untrue in England (UK data not available).

It’s worth looking at the figures.

Short 🧵 & TW.
First, a reminder that suicide statistics are real people, lives cut short, preventable deaths not prevented.

No figure, high or low, is acceptable.
Key source of data is @ONS. 5yrs ago they reported on suicide in occupations.

Jobs at high risk tended to be low pay, low skill.

Risk in medics was not high. In male doctors, it was low (SMR 63). In females, average for general population (SMR 101).

ons.gov.uk/peoplepopulati…
Read 13 tweets
louis appleby Profile picture
Apr 8
Latest suicide figures for England are just published, giving us rates for the final 3 months of 2021, based on deaths registered post-inquest. Headline message: no change from previous years. But there’s something troubling there too.

Short 🧵 & TW.
First thing to say, always, is that these figures are not dry data. They are real lives tragically lost, preventable deaths, devastated families. We should never forget this.
Most important thing about figs for final quarter of 2021 is they complete the data for the whole year. They show 2021 suicide rate (10.5 per 100,000 people) was similar to pre-Covid years but higher than 2020 when the inquest system was disrupted. ons.gov.uk/peoplepopulati…
Read 9 tweets
louis appleby Profile picture
Feb 26
Often asked for advice on managing a suicide cluster.

Clusters - where there is a link between deaths - are not unusual.

They cause understandable anxiety in those handling them who may be taking urgent actions on limited information.

Short🧵 & TW.
Links between deaths vary. They may be direct & causal, when one tragedy triggers another. Or indirect via shared circumstances or method.

Clusters occur more in young people & settings like schools & universities but also mental health units. The connections may also be online.
Faced with a series of deaths, it’s easy to waste time checking whether they meet the cluster definition. My rule is that by the time you’re asking, it’s a cluster.

In fact, part of handling a cluster is prevention, recognising that the first death has the potential to spread.
Read 10 tweets
louis appleby Profile picture
Jul 11, 2021
It’s become common to see an academic dropping off Twitter to escape abuse.

It starts with a tweet or media appearance commenting on evidence from their field of study. Someone takes exception to their message, outrage spreads. Their timeline becomes a torrent of hostility.
This is hardly unique to researchers. Twitter is a bear pit.

Public engagement is part of the academic job. Funders expect it. A #publichealth crisis demands it. Yet we have calls for Covid scientists to #resign. One expert’s bio says simply: I block.
How did it come to this?
I should mention my own brush with the Twitter pile-on, though it was comparatively minor. In November my research group released the first pandemic suicide figs for England. Against expectations, we found no rise. The findings were later published here: thelancet.com/journals/lanep…
Read 21 tweets
louis appleby Profile picture
Jan 4, 2021
In 2021 #suicideprevention will remain vital to the #Covid response, so this is a good time to sum up what we know re the impact on suicide. Simple answer is that several countries have now reported no rise. But the picture is more complex, as always with suicide stats. /thread
First, it’s important to stress that graphs & data represent real lives tragically lost. No suicide rate, whether high or low, rising or falling, is acceptable. Even before Covid there were over 6000 deaths by suicide per year in the UK.
From the start of the pandemic there was concern that suicide rates would rise. In April we set out a prevention plan covering groups at risk, #mentalhealth care & economic protections (lead author David Gunnell @SASHBristol):

thelancet.com/journals/lanps…
Read 14 tweets
louis appleby Profile picture
Nov 14, 2020
Suicide in several countries, inc England, didn’t rise after lockdown - see @bmj_latest this wk. Yet many studies have shown poorer mental health. How do we square these findings? Answer matters to #SuicidePrevention in next phase of the pandemic. /Thread

bmj.com/content/371/bm…
I should stress it’s not unusual for rates of mental ill-health & suicide to diverge. Most surveys of anxiety or depression find higher rates in women but suicide is 3x more common in men.
It’s not hard to see why the 1st, stricter lockdown impacted on mental health: fear of catching virus, isolation, loss of usual supports, disruption to services, domestic violence, alcohol, trauma & bereavement. An @ONS study found loneliness to be main driver of anxiety.
Read 13 tweets

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