There’s been a pattern lately of journalists asking HoL opponents of the #AssistedDyingBill if they are trying to amend or wreck it. Are they so opposed in principle that no version would be acceptable?

It’s a reasonable question for many of us. Here is my answer.

Short 🧵 When the debate started in earnest, I did not support AD but was prepared to accept that public opinion might make it happen in some form.

It was important not to dismiss - or seem to dismiss - the moving stories of terrible end-of-life care.

Hope for 2026: a lower suicide rate.

England’s rate has been unchanged since 2018 - no rise despite a pandemic, a recession & huge pressure on NHS.

2026 needs to be the year the rate falls, as it did in 2000s when rates were the lowest on record.

What will that take? 🧵 Suicide is not one thing, the patterns & causes are numerous, people’s lives are complex.

Suicide prevention too is not one thing. But some elements are literally vital:

When I post reservations on #AssistedDying, the response from its supporters is always the same: choice.

As if nothing more needs to be said. I’ve heard the same from Parliamentarians.

It’s a good argument, individual choice matters, but does it outweigh everything else?

1/6 Choice is influenced by

•mood, not just clinical depression but anxiety & loss of hope

•mental capacity

•what people around us think - not just coercion but despair.

New real-time suicide figures have recently been released, taking us to July 2025.

A few points to notice.

1. July figure is up, most likely random variation, but worth watching. 2. General trend is pretty flat, though there’s a possible fall in late 2023.

Many people have been facing economic pressures but we aren’t so far seeing an effect on suicide rates.

High profile suicide story of the week, the launch of a national suicide prevention network by the Prince of Wales.

Why does this matter & is there a reason to be wary?

bbc.co.uk/news/articles/… It matters first because there are over 7000 suicides/yr in the UK.

Suicide is the leading cause of death in adults under 35.

Families devastated, society diminished, preventable deaths not prevented.

New national suicide figures have been released by @ONS. It’s the big release of the year, taking us to 2024.

But this year it’s more important for what it says about the trend over several years.

Remember last year’s headlines about “the highest rate this century”?

🧵 & TW. First, your regular reminder that no suicide rate is acceptable. In 2024, 5717 suicides were registered in England.

Suicide remains the leading cause of death in adults under 35, men & women.

New schools guidance covers #suicideprevention for the first time.

It’s a tribute to bereaved parents who have campaigned for schools to do more about the tragic figs - over 100 <18s die by suicide/year in England.

But its language is cautious. “Mandatory” isn’t mentioned.

🧵 The emphasis is on schools making their own decisions.

Schools should “consider how to safely address” suicide prevention. Recognising that this starts with mental wellbeing more generally.

That tackling common childhood stresses like loneliness & bullying are part of it.

The vote was lost - not a surprise.

A majority of 55 is down to 23, a net switch of 16 people, only 2.5% of MPs despite so much debate & challenge.

Suggests most had made their minds up by the previous vote, despite protestations of looking for greater assurance.

Short 🧵 You could turn it round & say only 12 more MPs switching sides would have tipped the vote the other way.

A narrow margin for an issue of such enormity.

Raising questions of how a different Commons might have voted. What were the effects of age or sex or time as an MP?

Much comment on mental health of boys & influence of social media after #Adolescence.

Suicide prevention gives one perspective on this. In 2023 there were 161 suicides in males <20 in E&W.

1/5 teenage males who die by suicide have used internet in way that is suicide-related. Suicide rates in teenage males rose in the early 2010s but the risk remains lower than in other age groups.

Rates were at their lowest around 2006, then rose but have been stable since 2018.

The #AssistedDying debate has shown a lack of understanding of suicide.

An offensive word, acc to some proponents of AD.

An action of healthy people, it was said in Parliament this wk.

AD is a form of #suicideprevention, said a witness from Australia.

Short 🧵 There are now over 6000 suicides/ yr in the UK. No group is immune but causes vary.

Suicide is not one thing. Which is why #suicideprevention is not one thing.

#SuicidePrevention v #AssistedDying

It’s striking how little opposition there has ever been to the necessity of suicide prevention.

Of protecting people at their lowest point, helping them find something worth living for, however bleak life looks. 🧵 We rally round people in crisis, sit through the night with friends, look out for distressed strangers.

We volunteer for helplines, do our best for families facing unbearable loss.

It is a profound human commitment.

Last week we saw a new Mental Health Bill whose main purpose is to prevent suicide.

Now we have the Assisted Dying Bill, to help people - in defined circumstances - take their own lives.

🧵 Not the same, but treading same difficult ground where individual choice meets social responsibility.

Legally distinct but in practice not always so far apart.

New national suicide figures are published today in a series of reports.

Headline message from @ONS is a rise in 2023, the highest rate since 1999.

But, taken together, the reports tell a more complex story. Short 🧵 First, an important reminder that these figures represent real lives lost.

No suicide rate is acceptable.

In 2023, over 6000 suicides were registered in England & Wales.

We shouldn’t be reluctant to study homicide and mental illness. It’s an important, if difficult, topic.

Equally, in doing so, we should be sensitive to stigma.

How can research tread this line? A few examples. Short 🧵 First, it’s essential to acknowledge the distress any equivocation causes to victims’ families, those who have been through the most heartbreaking loss.

We owe it to them to be honest about the risks.

Much discussion about benefits of outreach teams in mental health.

And promises to “learn the lessons” from the Nottingham tragedy - a phrase that infuriates families.

But the real question is why we unlearned past lessons & what this tells us about future safety. 🧵 First, an acknowledgment of how painful this public discussion must be for the families of the people who died.

We owe it to them to be honest about the decisions, policy & culture that have got us to this point & the need to change.

It’s a week since the Govt published my report on suicide in young people with gender dysphoria.

What did the reaction tell us about the necessary dialogue with the public on issues of evidence? 🧵 First, a reminder of the wider #suicideprevention task, beyond the focus of my report & the specific suicide claim it addressed.

Young people distressed over gender may be at risk.

And we are likely to see a rise in their number, reflecting a broader social trend.

People have raised clarifying q’s about my review of suicides in young gender dysphoria patients.

And there have been a number of - let’s call them misunderstandings.

A short summary then, tracking from aim to data source to conclusions.🧵 First though, a reminder that in my research unit we always start with.

The numbers we are examining are real lives lost.

No suicide figure, high or low, rising or falling, is acceptable.

My conclusions so far? Start with the fundamental issue.

Young people with gender dysphoria face bullying, family conflict, isolation - risk factors for suicide. The risk is real.

It is also complex. Single causes are unusual.

Depression/anxiety are common. Also treatable. 2/It’s right to point out that young people’s experience of health care may reduce risk. Applies not to one treatment but a whole system.

Non-judgemental attitudes, skilled staff in primary care & CAMHS.

Support while waiting or in a crisis.

Guidance to schools on suicide prevention in the RSHE curriculum was published this week.

It’s an illustration of how we go from a campaign by bereaved parents to Govt policy.

But what does suicide prevention in the curriculum mean? Which children? Are there risks?

🧵 & TW There is no more distressing subject in suicide prevention than the deaths of young people.

It challenges who we are as a society that such tragedies occur.

@ONS records around 100 suicides/year in under 18s. Rates have risen in the last 15 years, though not since 2018.

I’ve been looking in more detail at the 2023 suicide figures from ONS, published this week.

They showed a 6% rise, giving us the highest national rate since 1999.

In fact, the detailed picture - by age, sex & where people live - is not simple.

Short 🧵 & TW

https://twitter.com/ons/status/1775803319111327931

First, an essential reminder that no suicide rate is acceptable. Whether figures are rising or falling, they are too high.

These are preventable deaths not prevented.

Key stat in today’s suicide update from @ONS is about young people.

Suicide rates in young age groups rose steadily from c.2010. They have been a top prevention priority.

New figs confirm a different trend. Rates since 2018 are stable - not falling but the rise has stopped. Why did suicide rise in young people? Some point to ⬆️ depression, income inequality, social media.

Our study of <20s highlighted cumulative risks (graph shows escalating rates in late teens): abuse, bereavement, bullying, self-harm.

Did these factors explain an increase?