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Suicide
Paul Corcoran ([email protected])National Suicide Research Foundation, Ireland
Department of Epidemiology & Public Health, UCC
National Suicide Research Foundation
GoalTo produce a nationally and internationally recognised bodyof reliable knowledge from a multidisciplinary perspective onthe risk and protective factors associated with suicidalbehaviour.
Research focusExtent of the problem of deliberate self harm and suicide aswell as risk and protective factors
Effectiveness of intervention and prevention programmesfor deliberate self harm and suicide
Suicide
Suicide attempts
Deliberate self harm
–Hospital/medically-treated
–Untreated
Suicidal ideation/thoughts/plans
What is suicidal behaviour?
Suicide
Deliberate selfharm
medically treated
‘Hidden’ cases ofdeliberate self harm and
suicidal thoughts
Level 1
Level 2
Level 3
Suicidal behaviour:an ‘iceberg phenomenon’
World HealthOrganization and Irish
Central Statistics OfficeSuicide Data
Surveillance studiesand registries
Community andschool-based
studies
The burden of suicidal behaviour
An estimated one million people die by suicide annuallyworldwide
10-20 million people attempt suicide annually worldwide
Suicide accounts for ~1.5% of all deaths and is the 10th
leading cause of death worldwide
Suicide is the second leading cause of death in 15-34 year-old Europeans
Among 15-44 year-olds worldwide, self-inflicted injuries is thesixth leading cause of disability-adjusted life years
The burden of suicidal behaviour
The burden of suicidal behaviour
Recording of suicide in Ireland
Coroner notified of death by gardai
Post mortem and inquest
Coroner notifies registrar of death after the inquest
Registrar then registers death and notifies the Central Statistics Office(CSO)
CSO send confidential form to relevant garda sub-district
Garda provides opinion as to the cause of death and returns form to CSO
– Suicidal– Homicidal– Accidental– Undetermined
Irish suicide rates, 1960-2010
0
4
8
12
16
20
2419
6019
6219
6419
6619
6819
7019
7219
7419
7619
7819
8019
8219
8419
8619
8819
9019
9219
9419
9619
9820
0020
0220
0420
0620
0820
10
Rat
e pe
r 100
,000
age
-adj
uste
dto
the
Sta
ndar
d E
urop
ean
Pop
. Men
Women
0
100
200
300
400
500
600
700
800
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Num
ber o
f dea
ths
Suicide+UD Suicide Transport accidents
Suicide compared to transport accidentdeaths in Ireland
Is suicide a major cause of death inIreland?
Suicide accounted for 527 (1.8%) of the 28,898 deaths thatwere registered in 2009.
8,58530%
3,69413%
1,156 4%
527, 2%
5,24318%
9,69334%
Circulatory system
Neoplasms
Respiratory system
Digestive system
Suicide
Other
Is suicide a major cause of deathamong young adults in Ireland?
Suicide accounted for 229 (25%) of the 923 deaths of 15-34year-olds that were registered in 2009.
23%
25%13%
6%
8%
13%
1%2%
10%Circulatory systemMalignant neoplasmsRespiratory systemDigestive systemSuicideTransport accidentsAccidental poisoningUndetermined intentOther
Suicide in Ireland and in other EUcountries
0
5
10
15
20
25
30
35Li
thua
nia
Hun
gary
Slo
veni
a
Latv
ia
Finl
and
Bel
gium
Est
onia
Fran
ce
Pol
and
Aus
tria
Cze
ch R
epub
lic
Sw
eden
Bul
garia
Slo
vaki
a
Ger
man
y
Den
mar
k
Por
tuga
l
Rom
ania
Luxe
mbo
urg
Irela
nd
Net
herla
nds
Spa
in
UK
Mal
ta
Italy
Gre
ece
Rat
e pe
r 100
,000
Based on WHO data accessed on 31 March 2011. Data are for 2004-2008 except for Belgium (1999).
Suicide rate of 15-24 year-olds inIreland and in other EU countries
0
5
10
15
20
25
30
35Li
thua
nia
Finl
and
Est
onia
Irela
nd
Luxe
mbo
urg
Bel
gium
Pol
and
Sw
eden
Latv
ia
Slo
veni
a
Cze
ch R
epub
lic
Aus
tria
Slo
vaki
a
Hun
gary
Fran
ce
Ger
man
y
Den
mar
k
Rom
ania
Bul
garia
Net
herla
nds
UK
Spa
in
Por
tuga
l
Mal
ta
Italy
Gre
ece
Rat
e pe
r 100
,000
Based on WHO data accessed on 31 March 2011. Data are for 2004-2008 except for Belgium (1999).
0
15
30
45
60
75
90
105
120
135
150
10-1
4yrs
15-1
9yrs
20-2
4yrs
25-2
9yrs
30-3
4yrs
35-3
9yrs
40-4
4yrs
45-4
9yrs
50-5
4yrs
55-5
9yrs
60-6
4yrs
65-6
9yrs
70-7
4yrs
75-7
9yrs
80-8
4yrs
85yr
s+
Ave
rage
ann
ual r
ate
per 1
00,0
00
MaleFemale
Suicide in Europe by age
0
5
10
15
20
25
30
3510
-14y
rs
15-1
9yrs
20-2
4yrs
25-2
9yrs
30-3
4yrs
35-3
9yrs
40-4
4yrs
45-4
9yrs
50-5
4yrs
55-5
9yrs
60-6
4yrs
65-6
9yrs
70-7
4yrs
75-7
9yrs
80-8
4yrs
85yr
s+
Ave
rage
ann
ual r
ate
per 1
00,0
00 Men
Women
Suicide in Ireland by age, 2004-2009
Method of suicide in Irelandby gender
66%
50%
12%
24%
9% 20%7% 1%6% 5%
0%
20%
40%
60%
80%
100%
Men Women
OtherFirearmsPoisoningDrowningHanging
Based on 2004-2008 data
Method of suicide in Irelandby gender and age
76%61%
53%68%
43%32%
7%
14%22%
12%
25%40%
7%11% 8%
13%26% 20%
5% 6% 12%2% 1% 1%
5% 7% 5% 4% 5% 7%
0%
20%
40%
60%
80%
100%
Men<30yrs
Men30-54yrs
Men55yrs+
Women<30yrs
Women30-54yrs
Women55yrs+
OtherFirearmsPoisoningDrowningHanging
Based on 2004-2008 data
0
25
50
75
100
125
150
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Num
ber o
f sui
cide
dea
ths
Expected
Observed
Monthly variation in suicide, 2006-2008
Monthly variation in suicide, 2006-2008
-20
-15
-10
-5
0
5
10
15
20
25
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
% d
iffer
ence
from
exp
ecte
d
Suicide in Irelandby day of death
0
5
10
15
20
Mon Tue Wed Thu Fri Sat Sun
% o
f dea
ths
Based on 2005-2006 data
Location of suicide deaths in Ireland
Based on 2002 data
At or near home
River/waterway
At sea
Institution
Farm/agri area
Other personsresidenceRoad/roadside
Work site
Other
1717
1616
141414
1313
1312121212
1212
1111111111111111111110
10109
977
19
0 5 10 15 20
Cork City
Leitrim
Cavan
Carlow
Tipperary North
Waterford County
Wexford
Offaly
Cork County
Westmeath
Clare
Tipperary South
Limerick City
Mayo
Roscommon
Galway County
Kerry
Waterford City
Monaghan
Meath
Wicklow
Longford
Limerick County
Kildare
Louth
Laois
Dublin City
Donegal
Sligo
Kilkenny
South Dublin
Galway City
Dun Laoghaire/Rathdown
Fingal
Crude rate per 100,000
Suicide by county/city, 2004-2010
Example of volatile rates:
Carlow 2007: 22 per 100,000
Carlow 2008: 11 per 100,000
Galway county, 8 deaths in 2004
Galway county, 25 deaths in 2005
Suicide in Irelandby marital status and gender
0
10
20
30
40
50
60
70
Single Married Widowed Separated Single Married Widowed Separated
Rat
e pe
r 100
,000
Based on 2002 dataMen Women
Suicide in Irelandby domestic situation and gender
0
10
20
30
40
50
60
70
Alone Withparent(s)
With partner Alone Withparent(s)
With partner
Rat
e pe
r 100
,000
Based on 2002 dataMen Women
Suicide in Irelandby employment status and gender
0
10
20
30
40
50
60
70
80
90
Unemployed Employed Unemployed Employed Home duties
Rat
e pe
r 100
,000
Based on 2002 dataMen Women