An unspoken truth
Cases of British people with serious terminal and chronic illnesses, such as Motor Neurone Disease or Multiple Sclerosis, who have travelled abroad to Switzerland to seek assistance with suicide have grabbed public attention recently. However, despite a growing awareness of the issue of assisted suicides among people who are terminally or chronically ill, UK public policy has focused very little on the relationship between physical illness and ‘unassisted’ suicides.
A growing body of research conducted both in the UK and abroad has demonstrated an increased risk of suicide among people diagnosed with cancer and other diseases including Motor Neurone Disease and HIV. However, no national data is currently collected on the role of serious physical illness as a risk factor for suicide to allow for monitoring. As a result, little is known about the extent of the issue.
To fill this evidence gap and inform the Coalition Government’s new suicide prevention strategy, Demos has conducted new research with Coroners and PCTs. The report on our findings, The Truth about Suicide, is published today. To inform this research, Demos sent Freedom of Information requests to all Primary Care Trusts (PCTs) in England and invited all Chief Coroners to take part in an interview.
In total, 29 out of 147 PCTs were able to provide the requested data and 15 Coroners agreed to be interviewed. In addition to this, the Coroner for Norwich District allowed Demos researchers to conduct a detailed study of all of their suicide inquest records over the previous five years, to identify those cases of suicide that involved a person with a chronic or terminal illness.
Across the 29 PCTs that responded to our information request, we found that on average, 10.6 per cent of suicides each year involved a person with a chronic illness and 2.1 per cent of suicides involved a person with a terminal illness. As some people who died by suicide had both a terminal and a chronic illness, and have been included in both categories, we have kept these totals separate to avoid double-counting.
Our more detailed study of Norwich Coroner’s District’s suicide inquest records found that out of the 259 suicides that took place in this district over a period of five years (May 2006 – December 2010), 25 of these suicides involved a person with either a chronic or terminal illness, or just under 10 per cent.
On the basis of these findings, we estimate that at least 10 per cent of the suicides that take place in England each year involve a person with either a chronic or a terminal illness. This is a conservative estimate, particularly as our interviews revealed that some coroners choose not to record any information about physical illness in their suicide inquest reports, increasing the likelihood that this issue is officially under-reported. 4,390 suicides were recorded in England in 2009 (the most recent year for which data is currently available). Therefore our evidence indicates that in at least 439 individual cases, chronic or terminal illness will have been a factor in the suicide.
The Coalition Government’s new Suicide Prevention Strategy, which was published for consultation last month, identifies five ‘high risk’ groups that its suicide prevention efforts are particularly targeted at. These include people using mental health services, people who have previously self-harmed and people in contact with the criminal justice system. Notably, this last group amounts to just 80 people each year, less than a fifth of the number of people who die by suicide and have chronic and terminal illnesses.
Therefore, in our report published today, we argue that it is time for the Government to re-evaluate how it collects data on people who die by suicide and to develop more robust methods for monitoring this vulnerable group of people. Until we understand the true causes of suicide, we will have very little chance of developing an effective policy response to this extremely important public health issue.