Data

Data on suicidal ideation, attempts and deaths by suicide

Suicidal ideation

  • From national data, it is estimated that a fifth of adults (20.6%) had thought of taking their own life at some point in their lives (APMS 2014).
  • Nationally, key risk factors were living alone, out of work, receiving benefits (two-thirds of Employment and Support Allowance (ESA) recipients had suicidal thoughts (66.4%) and approaching half (43.2%) had made a suicide attempt at some point).
  • There was no local data for estimating the prevalence of suicidal ideation in C&P as a whole, although from local Liaison Psychiatry data, a high proportion of A&E attendances for self-injurious behaviour related to suicidal ideation.

National data

From the 2014 APMS, a fifth of adults (20.6%) reported that they had ever thought of taking their own life and 5.4% of UK population aged 16-74 reported suicidal thoughts in the past year (29). This was also more common in women than men (Figure 20). Using 2023/24 population estimates for Cambridgeshire and Peterborough, which include approximately 668,000 residents aged 15 to 74, and applying the APMS prevalence estimate of 20.6%, it is estimated that around 138,000 adults may experience suicidal thoughts.

Figure 20: Suicidal thoughts ever, by age and sex. Source: APMS, 2014 (29)

Some groups in the population were more likely than others to report these thoughts and behaviours, such as those who lived alone or were out of work (29). Benefit status identified people at particularly high risk: two-thirds of Employment and Support Allowance (ESA) recipients had suicidal thoughts (66.4%) and approaching half (43.2%) had made a suicide attempt at some point (29). Rates did not differ significantly by ethnic group after age-standardising the data.

First Response Service Data

As with self-harm, the FRS also assesses callers for suicide risk during the triage process:

  • About 60% of calls are assessed as presenting a self-reported suicide risk (over 5500 calls in 2023 and over 5800 calls in 2024), a rate that has been largely stable since mid-2021.
  • The highest rate of calls for suicide risk is among young adults, particularly females (ages 17-25). While rates of self-harm risk decrease over age, suicide risk remains consistent over all working ages (Figure 21).
  • There appears to be seasonality in calls observed between 2021 and so far into 2024, both for risk of self-harm and suicide, with there being significantly more calls June-Dec than Jan-May.

Figure 21: First Response calls triaged for suicide risk by age and sex. Source: First Response Service, CPFT

Suicide attempts

Key findings

  • From national data, it is estimated that one adult in fifteen (6.7%) had made a suicide attempt at some point in their life (APMS 2014).
  • Despite men being more likely than women to die from suicide, women were more likely to report having ever attempted suicide.
  • Locally, the rate of Section 136 orders in C&P has significantly decreased. Females aged 10-19 are 3.5 times more likely to be placed under Section 136 compared to males, diverging from the national trend. Moreover, the gender disparity has widened over time, with females constituting an increasingly larger proportion of Section 136 cases.

National survey data

Nationally from the 2014 APMS, one adult in fifteen (6.7%) had ever made a suicide attempt at some point and 0.7% had attempted in the last year. Using 2023/24 population estimates for Cambridgeshire and Peterborough, which include approximately 668,000 residents aged 15 to 74, and applying this prevalence estimate , it is estimated that around 45,000 adults may have attempted suicide in C&P at some point in their life and around 5,000 adults in the last year.

Despite men being more likely than women to die from suicide, women were more likely to report an attempt (Figure 22) (29,37). This gender difference is thought to be due the choice of more lethal methods by men (hanging as opposed to cutting or poisoning) (7).

Figure 22: Suicide attempts ever, by age and sex. Source: APMS, 2014 (29)

Overall, half of people who attempted suicide sought help after their most recent attempt (50.1%) (29). About a quarter sought help from a GP, a quarter went to a hospital or specialist medical or psychiatric service, and a fifth tried to get help from friends or family (29). Men and women were equally likely to seek help after a suicide attempt (29).

Local Hospital data

See above section on hospital data on self-harm as self-harm and suicide attempts are both routinely coded as ‘self-injurious behaviour’.

Police data

Section 136 orders (s136) are a type of Short-Term Detention Order used by the police to move a person in a community setting in a mental health crisis to a ‘place of safety’ (38). For this needs assessment, local s136 data for 2019-2024 was provided by Cambridgeshire Constabulary. The reasons for placing someone under s136 primarily included overdose, self-harm, and suicide attempts. However, these reasons were not always distinctly coded and often overlapped (e.g., “self-harm and suicidal”), or the intentions were unclear (e.g., “attempt to jump from bridge” without specifying suicidal or self-harm intent). Key findings:

  • The rate of s136 orders has significantly declined in C&P since 2021/22 (Figure 23). This is consistent with national s136 trends (Figure 24). In C&P, Cambridge City consistently has the highest s136 rate 2018/19-2023/44. Possible reasons for the decline in s136 orders locally, as provided by Cambridgeshire Constabulary, include:
  • The use of Mental Health Joint Response Vehicles
  • S136 follow-up support by Lifeline
  • Project focusing on high demand/high risk patients, involving partnership working to put management/police response plans in placed to reduce demand.
  • Weekly partnership meetings to discuss s136 gaps in services in a timely manner.

In addition, the current ICB crisis pathway review is identifying alternatives to section 136 or step-down options in the community.

Figure 23:  C&P s136 by local authority, crude rate per 100,000, 2018/19-2023/44. Source: Cambridgeshire Constabulary

Figure 24: England and C&P  s136 rate per 100,000, 2021/22-2023/24. Source: Mental Health Act Statistics, NHS Digital (38)

  • Age and gender distribution. In Cambridgeshire and Peterborough, there are significant gender differences in the use of Section 136 orders between 2019 and 2024 (Figure 25). Females aged 10-19 were 3.5 times more likely to be placed under s136 compared to their male counterparts, while females in their 20s were 2.5 times more likely to be placed under s136 compared to males in their 20s. This is in stark contrast to national trends where males were more likely to be placed under s136 than females (28 uses vs 24.5 uses per 100,000 population) in 2023-24 (Figure 24). In addition, the C&P s136 gender split has become more pronounced over time (Figure 26).

Figure 25: C&P number of s136 by age and gender, 2019-2024. Source: Cambridgeshire Constabulary

Figure 26: C&P  s136 by gender, 2019-2024. Source: Cambridgeshire Constabulary

  • Ethnicity. Nationally, amongst broad ethnic groups, people of Mixed ethnicity were most likely to be placed under s136 (37.7 uses per 100,000 population) and the lowest rate was for Asian or Asian British people (14.0 uses per 100,000 population) (38).

Fire and Rescue data

Cambridgeshire Fire & Rescue Service is rarely called to incidents related to self-harm but is regularly contacted by partner agencies for suicide attempts. These incidents typically involve threats to jump from heights or into water. Since only the location of the incident is recorded, it is unclear whether the individuals involved are C&P residents or from outside the area, though most are likely local residents. Recording of demographic information such as ethnicity, age, and sex is incomplete—of 201 incidents recorded between 2019/20 and 2023/24, sex was recorded for 122 individuals, age for 77, and ethnicity for only 58. As a result, demographic details have not been included here.

Key findings:

  • Over the last five years, there has been a 114% increase in the rate of attempted suicide-related callouts per 100,000 people in C&P (Figure 27). From 2019/20 to 2023/24, C&P consistently reported statistically higher rates of attempted suicide Fire & Rescue callouts than England, with a notably sharp increase in 2023/24. However, the data sources for England and C&P differ, potentially affecting comparability due to variations in incident recording and categorisation.  Note: statistical significance for the rate differences was assessed using a Z-test, where Z-values exceeding 1.96 indicate a statistically significant difference at the 95% confidence level, i.e., that the differences between rates are unlikely to arise by random chance.

Figure 27: Cambridgeshire Fire & Rescue Service callouts related to attempted suicide, compared to England, 2019/20-2023/24. Source: Cambridgeshire Fire & Rescue Service

  • Call-out rates vary across C&P areas, with Peterborough consistently reporting the highest rates from 2019/20 to 2023/24 (Figure 28). However, these figures should be interpreted with caution due to the small numbers involved, with annual callouts ranging from 0 to a maximum of 27 per local authority.

Figure 28: Cambridgeshire Fire & Rescue Service callouts related to attempted suicide by district, rates per 100,000, 2019/20-2023/24.

Deaths by suicide

Key findings

  • In England, male suicide rate (17.4 deaths per 100,000) is three times higher than female suicide rate (5.7 deaths per 100,000).
  • Nationally, suicides rates are significantly higher amongst disabled, unemployed, and single people.
  • In 2022, there were 65 local suicide deaths, a crude rate of 8.21 per 100,000 people, aligning with the England average. This rate remained consistent from the previous year, 2021, with 65 deaths (8.21 crude rate), and was slightly higher in 2020 with 70 deaths (8.84 crude rate).
  • In terms of healthcare contact, local audit data showed that in the month prior to their suicide around a third saw their GP and around a quarter were in contact with mental health services. Around three quarters (73%) saw their GP in the six months prior to their suicide.
  • From the local suicide audit, key suicide risk factors are:
    • Demographic risk factors – Lived alone, were separated, or unemployed.
    • Mental Health – the majority (60%) had a formal mental health diagnosis; depression and anxiety were the most common diagnoses.
    • Social and Economic factors – relationship breakdowns, work, and financial issues.
    • 45% had a history of self-harm.
    • 44% involved drugs or alcohol.
    • 28% reported ongoing physical health issues
    • 15% had adverse childhood experiences
    • 15% had contact with the criminal justice system.
    • 10% involved domestic abuse
    • 10% were believed to be neurodivergent (including autism and ADHD)
    • 5% involved bereavement

National suicide data

The Office for National Statistics (ONS) provides data on registered deaths from suicide in England and Wales (37,39). Key findings from the most recent reports include:

  • In 2023, the age-standardised mortality rate in England was 11.2 deaths per 100,000 people, the highest rate of suicides since 1999 (Figure 29).

Figure 29: Age-standardised suicide rates by sex, England and Wales, 1981-2023. Source: ONS

  • In 2023, the suicide rate for males (17.4 deaths per 100,000) was 3 times higher than for females (5.7 deaths per 100,000). The age-specific suicide rate was highest for males aged 45 to 49 years and for females aged 50 to 54 years.
  • In 2023, the most common method of suicide continued to be hanging, strangulation and suffocation (58.8%), followed by poisoning (19.8%). The proportion of suicides caused by hanging has increased over time.
  • Between 2011 and 2021, the highest suicide rates were in disabled people, those who have never worked or are in long-term unemployment or are single (never been married or in a civil partnership) (39). For ethnicity, rates were highest in the White and Mixed/Multiple ethnic groups and lowest in Arab group. For religious affiliation, the lowest rates of suicide were in the Muslim group and the highest rates were in Buddhists and “Other” religious groups, compared with all other religious groups and those who reported no religion (39). Veterans aged 25-44 had higher age-specific suicide rates compared with the general population of that age (40).
  • Nationally, suicide rates tend to increase with greater level of deprivation (Figure 30).

Figure 30: England suicide rate by deprivation decile. Source: Fingertips

Local suicide audit

Between June and September 2024, the C&P Suicide Prevention Manager conducted a local suicide audit based on completed Coroner’s Inquests. This audit provides critical insights for local strategies, service improvements, and supporting professionals in suicide prevention. While many individuals received appropriate and compassionate care, the audit underscores the complexity of each case and the profound impact on loved ones and the community. Cases from 2022 were included in a three-year average, comparing 2019–2021 to 2020–2022 data.

Key finding from the 2022 suicide audit are summarised below.

Overall cases

In 2022, 65 deaths were recorded as suspected suicides in Cambridgeshire and Peterborough, with a crude rate of 8.21 per 100,000 people (Figure 31). The overall number of cases for 2019-2021 is 205 and for 2020-2022 is 200. For comparison, the C&P age-standardised mortality rate from suicide and injury of undetermined intent from ONS data is higher, around 10 per 100,000 people in the last 5 years, but has been similar to England average (Figure 32).

Figure 31: C&P Number and crude rate of suicides by Year of Death. Source: Local suicide audit

Figure 32: Suicide rate (Persons, 10+ yrs), age standardised rate per 100,000, Cambridgeshire and Peterborough compared to England. Source: Fingertips

Geographical variation

Differences in suicide rates between districts are not statistically significant (Figure 33).

 

Figure 33: Suicide rate (Persons, 10+ yrs) by C&P districts, age standardised rate per 100,000. Source: Fingertips

Demographic factors

  • Age and gender variation: Most suicides were in men (generally twice the rate of females), particularly those aged 40-59 (Figure 34), consistent with national data above. Data on transgender and gender-nonconforming individuals were unavailable.

Figure 34: Suicide rate by age and gender. Source: Local Suicide audit.

  • Place of birth: Suicide rates were highest amongst individuals born in the EU (10.73 per 100,000), followed by those born in the United Kingdom (7.31 per 100,000). As with the previous audit, those born in Lithuania had a higher suicide rate than those born in any other country.
  • Other demographic factors: Those who lived alone had 5 times higher suicide rate than those living with others. Those who were separated and those who were unemployed also had higher suicide rates compared with other marital or employment status. This is consistent with national data above. Unlike the national data where people with a disability had higher suicide rates, disability was not investigated in the local suicide audit.

Mental health diagnoses

Mental health diagnosis if recorded in any of the following inquest files: post-mortem and toxicology reports, police statements, GP records, family statements, notes left by the deceased and, where applicable, statements from mental health and drug and alcohol services. The majority of people who died from suicide had a formal mental health diagnosis (60%), and ‘mental health issues’ were noted in most of the cases (68%) (Figure 35). Depression and anxiety were by far the most common diagnosis (Figure 36).

Figure 35: Mental Health diagnosis status prior to suicide

Figure 36: Diagnosis of Mental Health Issues prior to Suicide (all cases)

Contact with health services

  • Contact with health services: Primary care was the most common contact for people prior to suicide, with around three quarters (73%) of cases (2020-2022) having seen their GP within six months of their death, and around a quarter having been seen in the month prior to their death (Figure 37). Out of those with mental health issues, 74% were known to CPFT although the majority (60%) were no longer on the active caseload. The majority of people who were in contact with CPFT had contact in the month prior to their suicide (Figure 38). This was around a quarter of all cases. The most accessed CPFT services were First Response Service, followed by Liaison psychiatry (Figure 39).

Figure 37: Last contact with primary care prior to suicide (all cases)

Figure 38: Most recent contact with CPFT before death (all cases known to CPFT)

Figure 39: Contact with CPFT prior to death by suicide (all cases known to CPFT)

  • Suicidality Disclosure: Of those that had contact with primary or secondary care within the past 12 months, their records noted that level of suicidality had been asked by professionals in the majority of cases. In just under half of cases, families appeared to be aware of a greater level of suicidality than had been disclosed to professionals. Therefore, it is important to engage with family members to understand their perception of potential risk to their loved one (NICE QS189; NICE NG225).
  • Insights from loved ones: concerns over care were raised in 20% cases. Most common concerns were treatment by staff, lack of available support and queries over quality of care.

Risk factors

  • History of self–harm and suicide attempts: 45% had a history of self-harm, with 89% of these cases involving at least one prior suicide attempt. The majority of incidents happened within a year from suicide. Regarding the number of attempts, 44% had attempted only once prior to taking their life, 44% had attempted 2-4 times before taking their life, 6% had attempted over 5 times before taking their life.
  • Overall risk factors prior to suicide: Suicide often resulted from a combination of mental health, social, and economic factors. Whilst mental health remains the most common risk factor, social, adverse experiences and economic risk factors were also very common (Figures 40-41). From the social risk factors, the most common was relationship breakdown, but there was considerable variety in how this contributed to suicide risk – some people had experienced the breakdown in the relationship within hours or days of their attempt, others were grieving the loss of a significant relationship several years after it ended. From economic risk factors, most common were issues with work or finances. From adverse experiences, Adverse Childhood Experiences were noted in 15% of cases; common experiences amongst this cohort were childhood sexual abuse, child poverty and exposure to domestic abuse in the home. Domestic abuse was a feature in 10% of cases. This related to both current and historic abuse. Bereavement by suicide was noted in 7.5% of cases.

Figure 40: Overall risk factors

  • Alcohol and drug use: Drugs or alcohol were involved in 44% of cases, with prescription drugs more common than illicit substances. However, deaths by illicit drugs are often recorded as accidental in nature and therefore some potential suicides may be included in drug-related death figures only. Around 15% of people had an identified alcohol use issue and around 13% had a drug dependence issue. Of these, around 55% were known to substance use services – typically Change Grow Live, but some people accessed Alcoholics Anonymous and other support offers.
  • Physical health: 28% of cases mentioned an ongoing physical health issue that potentially contributed towards death by suicide, with pain being a particularly common presentation (either a chronic pain condition, such as fibromyalgia or endometriosis, or general references to pain or injuries contributing to a reduced quality in life).
  • Criminal Justice: 15% had contact with the criminal justice system; one-third of these had previously served prison sentences.

Figure 41: Breakdown of risk factors prior to suicide (excluding mental health)

The local audit aligns with most priority groups identified in the 2023 National Suicide Prevention Strategy (see table 1). However, pregnant women, new mothers, and individuals with gambling issues were underrepresented, likely due to limited data rather than lower local risk. The national strategy also highlights the need for deeper understanding of mental health and suicide trends in groups such as Gypsy, Roma, and Traveller (GRT) communities. This is particularly relevant in the East of England, where a notable number of deaths have occurred within this population.

Recommendations

The audit made several recommendations both for commissioners and services.

For Commissioners:

  • Deliver targeted follow-up support for individuals who have attempted suicide.
  • Enhance access to information and resources for those facing relationship breakdowns.
  • Actively involve individuals with lived experience, including carers, in service planning.

For services:

  • Record whether self-harm incidents involve suicidal intent.
  • Facilitate direct referrals to drug and alcohol services when self-referral does not occur.
  • Provide mental health support alongside life-changing physical health diagnoses.
  • Collaborate with domestic abuse services to offer suicide prevention support to victims.
  • Engage families, where appropriate, to understand how suicidal ideation manifests outside professional settings.

Bereavement services data

Lifecraft offers local suicide bereavement support to anyone aged 17+, with the number of individuals supported increasing from 42 in 2019/20 to 121 in 2023/24. Over the past three years, the most common relationships to the deceased were spouse/partner, parent, and adult child. Data on age and gender is not recorded.