1. Epidemiology of suicide in Scotland Stephen Platt University of Edinburgh Presentation to SG National Suicide Prevention Review Group 3 November 2009

2. 22 * per 100 000 inhabitants aged 15+ years Very high suicide rates: 40,1 (Hungary) –58,0 (Lithuania) High suicide rates: 25,0 (Moldavia) –35,8 (Belarus) Low suicide rates: 3,4 (Albania) –9,9 (Portugal) Data not available Average suicide rates 11,9 (Netherlands) –23,0 (Czech Rep) Suicide in Europe (latest available data)

3. Age-standardised suicide rates, UK, 1991/93-2002/04, males

4. Age-standardised suicide rates, UK, 1991/93-2002/04, females

5. Intentional self harm & undetermined deaths, Scotland, 15+ years, 1970-2007

6. Intentional self harm & undetermined deaths, by age, Scotland, 1986-88 to 2006-08, males

7. Intentional self harm & undetermined deaths, by age, Scotland, 1986-88 to 2006-08, females

8. Age-standardised suicide rates by social class, males aged 20-64 years, 1991-93

9. Male suicide risk: effect of educational level and housing tenure (Lorant et al 2005)

10. European age-standardised rates per 100,000 population: deaths caused by intentional self harm and events of undetermined intent, by deprivation decile (SIMD), Scotland, 2004-08

11. Suicide by local area, UK, 1998-04, men 15+ years

12. Local areas with highest suicide rates, UK, 1998-04, men 15+

13. Suicide by local area, UK, 1998-04, women 15+ years

14. Local areas with highest suicide rates, UK, 1998-04, women 15+

15. Suicide cluster in Glasgow, 1999-2001

16. Suicide cluster in Glasgow Significant geographical cluster of suicide among adults aged 15-44 years was identified in east Glasgow around 1981, 1991 and 2001 censuses All three clusters can be explained by the concentration of socio-economic deprivation in this part of Scotland Possibility that this cluster is caused by contagion (direct/indirect exposure to suicide ‘models’) is dismissed “Scottish suicide prevention strategies should target young adults in east Glasgow” (Exeter D & Boyle P JECH 2007; 61: 731-6)

17. Public health effect of economic crises (1) Stuckler et al (Lancet 2009; 374; 315-23) used multivariate regression to investigate how economic crisis (defined as rapid and significant changes in employment) affected mortality rates over past three decades 26 EU countries Looked at all-cause mortality and 25 separate causes (including suicide and suicide in people aged <65 years)

18. Public health effect of economic crises (2) Every 1% increase in unemployment was associated with 0.8% rise in suicide at ages <65 years (similar rise in homicides, 1.4% decline in RTA deaths; but no significant net effect on all-cause mortality) A more than 3% increase in unemployment was associated with 4.5% increase in suicide at ages <65 years (28% [sic] rise in alcohol abuse; again, no significant net effect on all-cause mortality) Adverse effects on suicide were mitigated when investments in active labour market programmes (were high (>$190 per head)

20. Trends in suicide, Glasgow city, males, 1989-1991 to 2002-04