A major review of how suicides are recorded in Northern Ireland has resulted in a “downward revision” of the figures.
The Northern Ireland Statistics and Research Agency worked with the Northern Ireland Coroner’s Service to look at how at how deaths are defined as suicide and re-assess a number of deaths previously determined as being self-inflicted.
As part of the review Coroner Joe McCrisken studied paperwork including post-mortem results and police reports as well as toxicology reports to determine whether it was appropriate to define a death as a suicide.
The review has determined that a number of deaths previously recorded as having been self-inflicted were not in fact suicides.
Many of the deaths previously recorded as intentional were, the review found, unintentional drugs related deaths. The review finding means that Northern Ireland has now moved from having the highest suicide rate in the UK to being second behind Scotland.
The experts involved in the review were, however, at pains to point out that one intentional death is “one too many”. They added that previous trends still apply, ableit with slightly lower figures - IE that Belfast Health Trust area still has the highest rate of intentional deaths and that those living in the most deprived areas are twice as likely to die by suicide as those in the most affluent areas.
The most up to date figures now show that in 2020 there were 219 suicides registered in Northern Ireland, compared to 263 under the previous reporting regime. Looking at the ‘age-standardised’ suicide rate, it has increased from 12.4 deaths per 100,000 in 2019 to 13.3 deaths per 100,000 in 2020. NISRA warned, however, against reading too much into year to year increases and decreases saying that longer term trends are a better way to determine patterns.
The stat’s show that Belfast Trust had the highest suicide rate at 18.8 deaths per 100,000 in 2020, followed by Southern Trust (14.2 deaths per 100,000) in 2020. Northern Trust had the lowest suicide rate in 2020 at 9.4 deaths per 100,000.
The most deprived areas had a suicide rate that was almost twice that of the least deprived areas in 2020 - with the most deprived areas witnessing 19.7 deaths per 100,000 compared to 10.8 per 100,000 in the least deprived.
The research found that the “main outcome of the review is that the majority of cases previously coded as undetermined intent have been reviewed by a coroner and deemed accidental and recoded as such, which excludes them from the official suicide definition”.
The review “was initiated following a notable fall in suicide numbers among registrations in 2019 (reported in June 2020) which had been subject to increased quality checks of source data compared with previous years”.
NISRA adds: “It was observed that prior to 2019 the number of deaths of undetermined intent had been increasing. This was primarily driven by an increase in the number of drug-related deaths, but was also linked to the information on intent captured via the CSNI [Coroners] system and subsequently the coding of cause of death by NISRA.
“In short, there had not been enough detail available to allow reliable coding of intent with the result that a number of cases between 2015 and 2018 were coded as deaths of undetermined intent and therefore fall within the official definition of suicide as opposed to accidental, which are outside the definition.
“Initially the review involved revisiting the individual cases where the cause of death was drug related and the intent had been coded as undetermined. In the process of reviewing these cases it became apparent that other deaths of undetermined intent should also be reviewed so the work was expanded to include deaths registered in 2020.”
Reacting to the review, Mental Health Champion Siobhan O’Neill said that regardless of the revised figures they still refer to “real people and real lives”.
She added: “The review of Northern Ireland’s suicide statistics today shows that the rates of suicide in NI from 2015 to 2020 are lower than the rates that were published previously. The review involved a closer examination of deaths which led to some deaths being removed from the suicide category and placed in an accidental death category.
“The accurate figures tell us that NI does not have the highest rates of suicide in the UK; the rates here are lower than the rates in Scotland and higher than England, Wales and Republic of Ireland. However the regions use slightly different classification methods so suicide is not measured in the same way in all of these regions.
“I am very conscious that these suicide stories refer to real people and real lives. The toll of suffering that they represent is huge. It is unacceptable and we must do all we can to prevent every single death.
“The Protect Life 2 - Suicide Prevention Strategy contains actions that we know will over time reduce the numbers of people who die by suicide. This Strategy is being implemented but we need more funding (10-26%) so that we can implement this strategy in full.
“Likewise the Mental Health Strategy is really strong and includes actions that will prevent mental illness, which is associated with suicide. This Strategy needs an increase in funding of about 34% to the Department of Health budget."
She continued: “For many of those who hear about this review, it will be a painful reminder about a loved one’s death and they may wonder what this means about the cause of death.
“The review is about numbers in a data file, it does not change the cause of death on a death certificate because that cause of death will explain what led to the person’s death. The coding is a separate process for statistical purposes only.
“It is absolutely vital that we have accurate statistics about causes of death so that we can continue to monitor trends, direct services and implement policies to prevent these deaths.”
If you or someone you know is in distress or despair, call the freephone 24/7 crisis helpline Lifeline on 0808 808 8000.
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