This is a sub-category of deaths due to suicide and includes all intentional and undetermined deaths by means of hanging, as well as strangulation and suffocation.

For both males and females, Edinburgh and Glasgow have the highest SMRs, followed by London.

Hanging is one of the most commonly used methods of suicide and its incidence has increased in the last 30 years, particularly among males under the age of 65 (Gunnell et al, 2005). This may possibly be explained in part by the substitution of hanging in place of other methods, such as gassing (see Map 32), which have become less prevalent in recent years.

The most commonly used ligatures are ropes, belts and electric flex, and the most commonly used ligature points are beams, banisters, hooks, door knobs and trees. In around half of cases the person is not fully suspended – the ligature point is below head level (for example, sitting on the floor and using a door knob).

Nine out of ten hangings occur in the community, the other 10% inside institutions such as prisons or hospitals. About seven out of ten of those who attempt to hang themselves are successful; the majority of those who reach hospital alive survive (Gunnell et al, 2005). Those who survive hanging may be left with severe neurological problems.

Among older females, suicide by means of suffocation using a plastic bag accounts for around a third of deaths in this category, as deaths by asphyxiation are included here.

Prevention of suicide by this method is difficult due to the widespread availability of ligatures and ligature points in the community.

Men who are in prison are five times more likely to commit suicide than men in the general population and prison suicide rates have been increasing over the past quarter of a century (Fazel et al, 2005).

Fazel, S., Benning, R. and Danesh, J. (2005) ‘Suicides in male prisoners in England and Wales, 1978-2003’, Lancet, no 366, pp 1301-2.

Gunnell, D., Benewith, O., Hawton, K., Simkin, S. and Kapur, N. (2005)

‘The epidemiology and prevention of suicide by hanging: a systematic review’, International Journal of Epidemiology, vol 34, no 2, pp 433-42.

Ian Curtis of Joy Division hanged himself in 1980. Convicted murderers Harold Shipman and Fred West hanged themselves while in prison.