Suicide in mental health patients in the UK between 2005 and 2021: study of methods and clinical characteristics to inform prevention.

Background: Tackling methods of suicide and limiting access to lethal means remain priority areas of suicide prevention strategies. Although mental health services are a key setting for suicide prevention, no recent studies have explored methods used by mental health patients.

Aims: To investigate associations between main suicide methods and social, behavioural and clinical characteristics in patients with mental illness to inform prevention and improve patient safety.

Method: Data were collected as part of the National Confidential Inquiry into Suicide and Safety in Mental Health. We examined the main suicide methods of 26 766 patients in the UK who died within 12 months of contact with mental health services during 2005-2021. Associations between suicide methods and patient characteristics were investigated using chi-square tests and univariate and multivariate logistic regression.

Results: Suicide methods were associated with particular patient characteristics: hanging was associated with a short illness history, recent self-harm and depression; self-poisoning with substance misuse, personality disorder and previous self-harm; and both jumping and drowning with ethnic minority groups, schizophrenia and in-patient status.

Conclusions: A method-specific focus may contribute to suicide prevention in clinical settings. Hanging deaths outside of wards may be difficult to prevent but our study suggests patients with recent self-harm or in the early stages of their illness may be more at risk. Patients with complex clinical histories at risk of suicide by self-poisoning may benefit from integrated treatment with substance use services. Environmental control initiatives are likely to be most effective for those at risk of jumping or drowning.