Quarterly suicide death registrations in England: 2001 to 2018 registrations and Quarter 1 (Jan to Mar) to Quarter 4 (Oct to Dec) 2019 provisional data

• Provisional data show there were 11.3 suicide deaths per 100,000 people in Quarter 4 (Oct to Dec) 2019 in England, equivalent to 1,413 deaths registered.

• In Quarter 4 2019, there were 17.0 deaths per 100,000 males (1,042 deaths registered) and 5.9 suicide deaths per 100,000 females (371 deaths registered).

• The suicide rate in Quarter 4 2019 (11.3 deaths per 100,000 persons) is the highest observed since the same period in 2001, when the rate was 11.4 deaths per 100,000 people.

• In Quarter 4 2019, the South East saw a significant increase in suicide death registrations (12.8 deaths per 100,000 people) compared with the same period in each year since 2016.

In England and Wales, when someone dies unexpectedly, a coroner investigates the circumstances to establish the cause of death. In July 2018, the standard of proof used by coroners to determine whether a death was caused by suicide was lowered to the “civil standard” – balance of probabilities – where previously a “criminal standard” was applied – beyond all reasonable doubt.

It is likely that lowering the standard of proof will result in an increased number of deaths recorded as suicide, possibly creating a discontinuity in our time series.

Whenever a change in suicide rates occurs, the reasons are complex and will rarely be because of one factor alone. However, it is likely that the change in the standard of proof may be contributing to the increased number of deaths recorded as suicide since July 2018. The Office for National Statistics (ONS) will monitor and report the impact of this change when more evidence is available.

If you are a journalist covering a suicide-related issue, please consider following the Samaritans’ media guidelines on the reporting of suicide, owing to the potentially damaging consequences of irresponsible reporting. In particular, the guidelines advise on terminology and include links to sources of support for anyone affected by the themes in the article, such as Samaritans.

If you are struggling to cope, please call Samaritans for free on 116 123 (UK and Ireland), email jo@samaritans.org or visit the Samaritans website to find details of the nearest branch. Samaritans is available round the clock, every single day of the year, providing a safe place for anyone struggling to cope, whoever they are, however they feel, whatever life has done to them.

Suicide

This release is based on the National Statistics definition of suicide: this includes all deaths from intentional self-harm for persons aged 10 years and over and deaths where the intent was undetermined for those aged 15 years and over. For further information on the definition used, please see our annual release.

Year of registration

Figures are based on deaths registered in each calendar year, rather than the date on which the death occurs.

Registration delay

The registration delay refers to the time lag between the date of death (that is, when the death occurred) and the date the death was registered. For further information on the impact of registration delays, see Section 7.

Age-standardised mortality rate

Age-standardised mortality rate in this bulletin refers to a weighted average of the age-specific mortality rates per 100,000 people and standardised to the 2013 European Standard Population. They allow for differences in the age structure of populations and therefore allow valid comparisons to be made between geographic areas, the sexes and over time.

Statistical significance

The term “significant” refers to changes or differences based on unrounded figures. Significance has been determined using the 95% confidence intervals, where instances of non-overlapping confidence intervals between figures indicate the difference is unlikely to have arisen from random fluctuation.

Figures are for deaths registered, rather than deaths occurring in each quarter. In England, deaths caused by suicide are investigated by coroners; the investigation, known as an “inquest”, can take months and sometimes years. The amount of time it takes to complete an inquest creates what is known as a “registration delay”, which is a lag between the date of death and the date of death registration. For deaths caused by suicide, this generally means that around half of the deaths registered in a given year will have occurred in the previous year or earlier.

As such, publishing suicide figures based on death registration year means that many deaths appear in the statistics of a year that is later than the year in which the death occurred. Despite registration delays, publication of suicide statistics by registration year enables figures to be published in a timely manner. The alternative would be to publish statistics based on the year in which the death occurred. However, this would delay publication, cause repeated revisions to historical data and be inconsistent with other published mortality figures. Additionally, data provided in our annual release (Suicide occurrences, England and Wales) show that when you compare rates based on registration year and rates based on the date of death, these follow the same pattern of peaks and troughs over time.

Quarterly age-standardised rates

Age-standardised mortality rates are calculated using the number of deaths and mid-year population estimates provided by our Population Estimates Unit. Mid-year population estimates were used for Quarter 2 (Apr to June) 2001 to 2018 rate calculations, while the latest 2018-based Office for National Statistics (ONS) population projections were used for the Quarter 3 (July to Sept) 2018 to Quarter 4 (Oct to Dec) 2019 age-standardised rates. Recent quarterly rates of suicide by region use 2016-based ONS population projections as updated subnational projections were not available at the time of analysis.

For more information on age-standardisation, please see the Suicide rates in the UK QMI.

Calculation of mortality rates for quarterly deaths requires adjustments to be made to annual population estimates in order to calculate rates that are comparable with annual rates.

We calculate an annual population centered on the mid-point of the quarter using two years’ worth of population estimates or projections. This is then multiplied by the proportion of the number of days within a quarter of the total number of days within that year. The output is used as the population denominator in calculations of age-standardised and age-specific morality rates.

Quarter 4 2019 population:

Where:

• m is the number of days from 1 July 2019 (the start of the mid-year for the population estimate) to the mid-point of the relevant quarter, inclusive

• N is the number of days in the quarter, for example, Quarter 4 2019

• M is the number of days in 2019

• (i) is the age group

Quality and methodology

More quality and methodology information on strengths, limitations, appropriate uses, and how the data were created, including the change in the standard of proof, is available in the Suicide rates in the UK QMI. It is also explained in this article: New standard of proof for suicide at inquests in England and Wales.

This release aims to monitor suicide death registrations in England, based on the best available provisional data.

Quarterly data for 2019 are provisional and may be subject to changes once annual death registrations are complete. For example, some deaths may be registered but the underlying cause of death has not yet been coded. Data for 2019 will be finalised in the annual Suicides in the UK release in 2020.

Quarterly age-standardised rates are included to aid interpretation, such as whether changes by quarter in a given registration year are statistically meaningful. This is especially important when interpreting low numbers of deaths, which are prone to random fluctuation and volatility over time.

Numbers of suicides by quarter are often small, particularly where males and females are analysed separately, as demonstrated by the relatively wide confidence intervals. For this reason, any comparisons should be interpreted with caution and particular attention should be paid to overlapping confidence intervals where differences are then not statistically significant.

Since the beginning of our time series in 2001, the number of suicide registrations in Quarter 1 (Jan to Mar) tend to be lower than those observed in any of the other quarters, something that should be kept in mind when making comparisons. Further guidance on how to interpret the data included in this release is available in the “Table interpretation” tab of the accompanying dataset.