Deaths from suicide that occurred in England and Wales: April to December 2020

• 3,828 suicides occurred between April and December 2020 in England and Wales, equivalent to an age-standardised mortality rate of 9.8 deaths per 100,000 people; this is statistically significantly lower than the same period in 2019 and 2018, but statistically similar to 2017.

• The male suicide rate (14.8 deaths per 100,000 males) was statistically significantly lower than in the same period between 2018 and 2019, whereas the female rate (5.0 deaths per 100,000 females) showed no statistically significant change.

• Between April and December 2020, age-specific suicide rates in England and Wales statistically significantly decreased for those aged 30 to 39 years from the same period in 2019.

• Coroners' investigations result in suicide registration delays and were further disrupted by the coronavirus (COVID-19) pandemic; while our provisional data for 2020 suicides will be underestimates, late registrations will not fully explain the decrease because most suicides for this period will now be registered.

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 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 Help for suicidal thoughts webpages. 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, and whatever life has done to them.

This article provides an analysis of suicides, based on official death registrations, that occurred at the beginning of the coronavirus (COVID-19) pandemic (April to December 2020). It is an update to our Deaths from suicide that occurred in England and Wales: April to July 2020 article. We use the National Statistics definition of suicide in this article; see the Glossary for more information. Unlike our annual Suicides in England and Wales bulletin, this is based on the date the death occurred.

There is concern over how the coronavirus pandemic has affected well-being and suicide risk (for more information, see the Samaritans One year on: data on COVID-19 report). We aim to contribute to existing evidence and to inform decision-making and policy monitoring of suicide prevention in England and Wales, based on the best available provisional data.

Until now, it has not been feasible to provide insights into suicides that occurred during the coronavirus pandemic period because of death registration delays. In the past five years, median death registration delays from suicide have been no more than 166 days in England and 165 days in Wales, as shown in our Suicides in England and Wales: 2020 registrations bulletin. We focus on deaths between April and December 2020, for deaths registered up to 5 March 2022, the most complete period.

Most suicides in this period will now be registered, even when allowing for disruption to coroners' inquests. The coronavirus pandemic's impact on suicide registrations was relatively short-term (see Section 4), as shown in our latest Quarterly suicide death registrations in England bulletin. We have restricted this analysis to the end of December 2020 because data in subsequent months are not sufficiently complete.

There were 3,828 suicides between April and December 2020 in England and Wales. This was 9.2% less than the corresponding 2019 period when there were 4,215 suicides, and 4.7% less than the five-year average of 4,016 suicides.

Around three-quarters of suicide deaths between April and December 2020 were among males (2,832 deaths, 74.0%).

There is no evidence that the number of suicides increased between April and December 2020 during the coronavirus (COVID-19) pandemic

Between April and December 2020, the age-standardised suicide rate was 9.8 deaths per 100,000 people. This was statistically significantly lower than the same period between 2018 and 2019. However, the April to December 2020 suicide rate was not significantly different to 2017.

The lower suicide rate for April to December 2020 was primarily driven by a decrease in male suicides. Male suicide rates were significantly lower during this period (14.8 deaths per 100,000 males) compared with the same periods between 2018 and 2019. Female rates during the same 2020 period (5.0 deaths per 100,000 females) showed no statistically significant changes.

By English region, rates decreased significantly in April to December 2020 in the East of England, compared with the same period between 2017 and 2018. Rates also decreased significantly in London, compared with the same period between 2015 and 2018.

Figures for constituent countries of England and Wales and English regions are available in our accompanying dataset.

Monthly rates from May to December 2020 are fairly consistent with pre-coronavirus pandemic years

We've previously commented on estimates between April and July in our Deaths from suicide that occurred in England and Wales: April to July 2020 article, noting the significant reduction in suicide rates in April 2020 compared with April 2019 and 2018. Rates were lower in each month from September to December 2020 compared with the corresponding month in 2019. However, none of these were statistically significant.

Some of the reduction in suicides, particularly in the final months of 2020, will be explained by death registration delays. However, more than a year on, this should have minimal impact on interpretation (see Section 4).

Suicide rates decreased in most age groups in England and Wales, with a significant reduction in those aged 30 to 39 years between April and December; the rate decreased from 13.9 deaths per 100,000 people in 2019 to 11.0 deaths per 100,000 in 2020. The increase in the rate for those aged 60 to 69 years was not significant.

Males followed a similar trend to all persons; since April to December 2019, the only statistically significant change in age-specific rates was a decrease in those aged 30 to 39 years.

The rate for females aged 10 to 19 years and aged 60 to 69 years increased compared with 2019, but these were not significant. An increase in suicide among young females was observed in our COVID-19 vaccination and mortality in young people during the coronavirus pandemic article.

Suicide by method

Hanging, suffocation and strangulation (all grouped together) continued to be the most common suicide method, accounting for 59.1% of all suicides between April to December 2020. Hanging, suffocation and strangulation saw the only statistically significant increase in proportion compared with April to December 2015 (from 55.8% of all suicides).

Poisoning was the second most common method, accounting for 20.0% of all suicides. Recently, proportions have not seen any statistically significant changes.

Jumping or lying in front of a moving object was the only method to see a statistically significant decrease in April to December 2020 (3.1%) compared with the same period in 2015 (5.0%).

Late registrations are unlikely to fully explain the decrease

The Office for National Statistics (ONS) only knows about a death once it has been registered. 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. For deaths occurring between April and December 2020:

• 37.1% were registered in 2020

• 61.6% were registered in 2021

• 1.3% were registered in 2022

To assess the impact of late registrations of suicide deaths, we provide additional analysis in our accompanying dataset on suicides registered up to one year and two years after occurrence. Between 2001 and 2019, most suicides were registered within a year of occurrence (between 85.4% and 96.0% of deaths), with most remaining suicides registered in the following year. As such, late registrations are unlikely to affect the interpretation of the results in this article, even when allowing for disruption to coroners' inquests caused by the coronavirus (COVID-19) pandemic.

Our findings are consistent with figures from The Lancet's research paper on real-time suicide surveillance in England, which covered a population of around 13 million people; there was no increase in suicide in the seven months following the first national lockdown in 2020. Similarly, The Lancet found that suicide numbers remained largely unchanged or declined in the early months of the coronavirus pandemic compared with the expected levels. More information is available in The Lancet’s article on international research sourced from 16 high-income and five upper-middle-income countries.

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 our Suicide rates in the UK quality and methodology information article.

Registration delay

In England and Wales, all deaths caused by suicide are certified by a coroner following an inquest and cannot be registered until the inquest is completed. This process can take months, and in some cases, years. The 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".

Age-specific mortality rate

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 (ASMR)

A weighted average of the age-specific mortality rates (ASMRs) per 100,000 people and standardised to the 2013 European Standard Population. ASMRs allow for differences in the age structure of populations and therefore allow valid comparisons to be made over time and between geographic areas and sexes. We have adjusted the monthly ASMRs to allow for comparisons with annual rates. For more information see Section 8: Data sources and quality.

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.

Data source

Statistics on mortality are derived from the information provided when deaths are certified and registered.

The release uses the National Statistics definition of suicide, which is consistently used by government departments, agencies, and the devolved administrations across the UK.

More quality and methodology information on strengths, limitations, appropriate uses, and how the data were created is available in:

• our Mortality statistics in England and Wales QMI article

• our Suicide rates in the UK QMI article

• our User guide to mortality statistics

Monthly mortality rates

To calculate monthly mortality rates that are comparable with annual rates, adjustments must be made to annual population estimates to account for the time period covered. The population denominator for April to December is the sum of those individual months. Find more detail on how this is calculated in Section 2 of our Coronavirus and mortality in England and Wales methodology article.

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). Such requests or enquiries should be made via email to health.data@ons.gov.uk. Our charging policy is also available.

Strengths

• Monthly age-standardised mortality rates allow for differences in the age structure of populations and therefore allow valid comparisons to be made over time and between geographic areas and sexes.

• 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.

• Suicide deaths are compiled using information supplied when a death is registered, which gives complete population coverage.

Limitations

• Provisional death occurrences data are used for 2020 in this article, so they are subject to change. This enables timely analysis to be completed to monitor trends.

• Mortality data give complete population coverage. They ensure the estimates are of high precision and representative of the underlying population at risk. However, because of registration delays, death occurrence data are always somewhat incomplete.