Suicides in England and Wales: 2020 registrations

• In 2020, there were 5,224 suicides registered in England and Wales, equivalent to an age-standardised mortality rate of 10.0 deaths per 100,000 people and statistically significantly lower than the 2019 rate of 11.0 deaths per 100,000.

• The decrease is likely to be driven by two factors; a decrease in male suicides at the start of the coronavirus (COVID 19) pandemic, and delays in death registrations because of the pandemic.

• Around three-quarters of registered suicide deaths in 2020 were for men (3,925 deaths; 75.1%), which follows a consistent trend back to the mid-1990s.

• The England and Wales male suicide rate of 15.4 deaths per 100,000 is statistically significantly lower than in 2019 but consistent with rates in earlier years; for females, the rate was 4.9 deaths per 100,000, consistent with the past decade.

• Males and females aged 45 to 49 years had the highest age-specific suicide rate (24.1 male and 7.1 female deaths per 100,000).

• For the fifth consecutive year, London has had the lowest suicide rate of any region of England (7.0 deaths per 100,000), while the highest rate in 2020 was in the North East with 13.3 deaths per 100,000.

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

If you are struggling to cope, please call Samaritans for free on 116 123 (UK and ROI) or contact other sources of support, such as those listed on the NHS’s help for suicidal thoughts webpage. Support 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.

5,224 suicides were registered in 2020 in England and Wales, 8.2% lower than in 2019 (5,691 deaths), and equivalent to an age-standardised mortality rate (ASMR) of 10.0 deaths per 100,000 people. While this was statistically significantly lower than the 2019 ASMR (11.0 deaths per 100,000 people), caution is required in the interpretation of this decrease.

The latest decrease is likely to be because of both registration delays during the coronavirus (COVID-19) pandemic (see Section 6), and a decrease in male suicide at the start of the pandemic.

Males continued to account for three-quarters of suicide deaths registered in 2020 (3,925 registered male deaths compared with 1,299 female deaths), as seen since the mid-1990s. In 2020, the suicide ASMR for males in England and Wales was 15.4 deaths per 100,000 – a statistically significant decrease since 2019 (16.9 deaths per 100,000) but consistent with rates between 2014 and 2018.

For females, there were 4.9 deaths per 100,000 registered in England and Wales in 2020. This is consistent with rates seen for more than a decade.

For suicides registered in 2020, the age-standardised mortality rate (ASMR) in England was 10.0 deaths per 100,000 population (4,912 registered deaths), statistically significantly lower compared with the ASMR in 2019 (10.8 deaths per 100,000).

In Wales, there were 10.3 deaths per 100,000 population in 2020 (285 registered deaths). While lower than the ASMR in 2019 (12.2 deaths per 100,000), the difference was not statistically significant because the relatively smaller number of deaths resulted in more statistical uncertainty. The lower rate in Wales during 2020 may be partly explained by longer death registration delays than previous years (see Section 6).

By English region, the highest ASMR was in the North East (13.3 deaths per 100,000 people), as has been the case in five out of the last 10 preceding years. The North East, Yorkshire and The Humber and the South West regions had statistically significantly higher ASMRs of suicide compared with the overall England ASMR (10.0 per 100,000). The lowest rate in 2020 was in London (7.0 deaths per 100,000 people), which was statistically lower than any English region. While 2020 had the lowest London rate since records started in 1981, the rate was statistically similar to the London rate in previous years.

In 2020, ASMRs in both Yorkshire and The Humber (11.5 per 100,000 people) and the East of England (9.5 per 100,000 people) decreased significantly compared with 2019 (13.8 and 11.6 per 100,000 respectively). These were the only significant changes in English regions, when comparing 2020 with 2019.

ASMRs for males and females tend to follow broadly similar patterns to that of all persons, with further detail in the accompanying datasets.

Figure 2: The North East had the highest suicide rate in 2020

Age-standardised suicide rates for English regions and Wales, deaths registered in 2020

Notes:

1. Figures are for persons usually resident in each area, based on postcode boundaries as of May 2021.

2. See Figure 1 for other relevant notes.

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In 2020, males and females aged 45 to 49 years had the highest age-specific suicide rate at 24.1 per 100,000 male deaths (457 registered deaths) and 7.1 per 100,000 female deaths (138 deaths). Figure 3 shows age-specific suicide rates, for 5 year age groups, for all persons since 1981.

Figure 3: The highest suicide rates were seen among those aged 45 to 49 years

Age-specific suicide rates by five-year age groups, England and Wales, registered between 1981 and 2020

Notes:

1. Age-specific suicide rate per 100,000 population.

2. Unreliable rates, where there were fewer than twenty deaths, have been excluded.

3. See Figure 1 for other relevant notes.

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Since around 2010, males aged 45 to 64 years have had the highest suicide rate

Looking at trends over time in broad age groups, males aged 10 to 24 years have always had the lowest rates. In 2020, the rate in this group was 7.0 deaths per 100,000.

Since 2010, men aged 45 to 64 years have had the highest age-specific suicide rates. In 2020, the rate in this group was 20.0 deaths per 100,000. Males aged 25 to 44 years had the highest suicide rates between 1995 and 2009, whereas males aged 75 years and above had the highest rates at the beginning of our series between 1981 and 1991.

Rates for all age groups were lower in 2020 than 2019, however, those aged 25 to 44 years were the only males to see a statistically significant decrease (from 20.4 to 18.0 deaths per 100,000, when comparing 2019 and 2020, respectively).

In 2020, females aged 10 to 24 years had the lowest age-specific suicide (2.5 death per 100,000 females), while those aged 45 to 64 years had the highest (6.4 deaths per 100,000 females).

The most noticeable change over time for females is the substantial fall in rates among those aged 45 years and over. From 1981 to 2020, the female rate fell by:

• 55.6% for those aged 45 to 64 years
• 79.4% for those aged 65 to 74 years
• 72.0% for those aged 75 years and over

The percentage of suicides caused by hanging, strangulation and suffocation has increased in recent years

The most common method of suicide in England and Wales for both males and females continued to be hanging, strangulation and suffocation (all grouped together). This method accounted for 58.1% of all suicides in 2020 (3,036 out of 5,224 registered deaths). The second most common method continued to be poisoning and accounted for 19.9% of all suicides in 2020 (1,041 out of 5,224 deaths).

Last year’s bulletin on 2019 registrations provides a more detailed description of male and female trends in suicide methods over time. This year, we looked at how suicide method varies by age group, for deaths registered between 2018 and 2020 (Figure 6).

For the period 2018 to 2020, hanging accounted for 77.8% of suicides for people aged 10 to 14 years. The proportion of suicides caused by hanging falls steadily as age increases, with this method accounting for 29.1% of suicides in people aged 90 years and over. Conversely, poisoning accounted for 5.6% of suicides for people aged 10 to 14 years and the proportion increases with age to a peak of 29.7% for people aged 90 years and over.

For three methods of suicide — poisoning, sharp object, and other methods — the highest proportions were seen in people aged 90 years and over.

In England and Wales, all deaths by suicide are certified by a coroner following an inquest and cannot be registered until the inquest is completed. This results in a delay between the date a death occurred and the date of registration. Around half of the deaths reported in this bulletin will have occurred in the previous year.

For suicides, the median registration delay for England was 165 days in 2020 (down from 166 days in 2019) and 214 days for Wales (up from 165 days in 2019). The median registration delay in Wales increased to its highest level since 2001 and was likely explained by disruption to inquests caused by the coronavirus (COVID-19) pandemic. While the median delay in England did not increase in 2020, provisional figures for the first two quarters of 2021 (January to June) show an increase; as such it is possible some suicides that ordinarily would have been registered in 2020, have been registered in 2021 due to the disruption caused by the pandemic.

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 caused by injury or poisoning where the intent was undetermined for those aged 15 years and over. Further information on the definition can be found in the Suicide rates in the UK QMI.

Registration delay

Figures are based on deaths registered in each calendar year, rather than the date on which the death occurs. The difference between these dates is known as the registration delay.

Age-specific mortality rate

Age-specific mortality rate is the total number of deaths per 100,000 people of an age group, used to allow comparisons between specified age groups.

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. Age-standardised mortality rates 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 statistically significant 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.

Statistics on mortality are derived from the information provided when deaths are certified and registered. These statistics are assessed fully compliant with the Code of Practice for Statistics and are therefore designated as National Statistics.

More quality and methodology information on strengths, limitations, appropriate uses, and how the data were created is available in the Mortality statistics in England and Wales QMI, the Suicide rates in the UK QMI and the User guide to mortality statistics.

Populations

Mortality rates are calculated using the number of deaths and mid-year population estimates provided by the Office for National Statistics (ONS) Population Estimates Unit. Population estimates are based on the decennial England and Wales census estimates and use information on births, deaths and migration to estimate the mid-year population in non-census years.

Comparing with other statistics

Scotland and Northern Ireland each produce their own suicide statistics. These statistics are compiled by National Records of Scotland (NRS) and the Northern Ireland Statistics and Research Agency (NISRA), and are comparable to those in this bulletin. Public Health England (PHE), via their Suicide Prevention Profiles, provide data on a wide range of indicators related to suicide including mortality and years of life lost due to suicide.

Monitoring suicide rates is a requirement under the Sustainable Development Goals (SDGs). The statistics in this bulletin will be used to help monitor progress towards these goals. UK data on the SDG indicators can be explored on our SDGs reporting platform.

User-requested data

Special extracts and tabulations of suicide (and other causes of mortality) data for England and Wales are available to order for a charge (subject to legal frameworks, disclosure control, resources and agreement of costs, where appropriate). Email health.data@ons.gov.uk to put in a request or make an enquiry. Our charging policy is also available.

Strengths

We use a robust method for this analysis. Age-standardised rates allow for differences in age structure of populations and therefore allow valid comparisons to be made between the sexes and different occupations.

We only refer to groupings that have at least 20 deaths. For these, reliable age-standardised rates can be calculated, reducing the likelihood of the findings being a result of chance. In our accompanying datasets, rates have been marked as unreliable where there are fewer than 20 deaths, and we have not produced age-specific rates for age groups with fewer than three deaths.

Suicide deaths are compiled using information supplied when a death is registered, which gives complete population coverage. The release uses the National Statistics definition of suicide, which is consistently used by government departments, agencies and the devolved administrations across the UK.

Quality assurance procedures have been undertaken throughout all stages of the analysis to minimise the risk of error.

Limitations

Registration delays

In England and Wales, when someone dies unexpectedly a coroner investigates the circumstances to establish the cause of death. The investigation, referred to as an "inquest", is a process that can take months and in some cases years. The length of time it takes to hold an inquest creates a gap between the date of death and the date of death registration, referred to as a registration delay. For deaths caused by suicide, this generally means that around half of the deaths registered each year will have occurred in the previous year or earlier.

Change in the standard of proof used by coroners in England and Wales

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.

Since the change in the standard of proof, suicide rates have not seen unprecedented increases. Recent increases have been seen among English males and females, but these increases started before the change in the standard of proof. Whenever a change in suicide rates occurs, the reasons are complex and will rarely be because of one factor alone.

See Suicide rates in the UK QMI for more information on strengths and limitations.