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Analysis of trends in adolescent suicides and accidental deaths in England and Wales, 1972–2011

Published online by Cambridge University Press:  02 January 2018

James Redmore
School of Social and Community Medicine, University of Bristol, Bristol, UK
Ruth Kipping*
School of Social and Community Medicine, University of Bristol, Bristol, UK
Adam Trickey
School of Social and Community Medicine, University of Bristol, Bristol, UK
Margaret T. May
School of Social and Community Medicine, University of Bristol, Bristol, UK
David Gunnell
School of Social and Community Medicine, University of Bristol, Bristol, UK
Ruth Kipping, School of Social & Community Medicine, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK. Email:
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Previous analyses of adolescent suicides in England and Wales have focused on short time periods.


To investigate trends in suicide and accidental deaths in adolescents between 1972 and 2011.


Time trend analysis of rates of suicides and deaths from accidental poisoning and hanging in 10- to 19-year-olds by age, gender and deprivation. Rate ratios were estimated for 1982–1991, 1992–2001 and 2002–2011 with 1972–1981 as comparator.


Suicide rates have remained stable in 10- to 14-year-olds, with strong evidence for a reduction in accidental deaths. In males aged 15–19, suicide rates peaked in 2001 before declining. Suicide by hanging is the most common method of suicide. Rates were higher in males and in 15- to 19-year-olds living in more deprived areas.


Suicide rates in adolescents are at their lowest since the early 1970s with no clear evidence that changes in coroners' practices underlie this trend.

Copyright © Royal College of Psychiatrists, 2016


Declaration of interest

D.G. is a member of the National Suicide Prevention Strategy Advisory Group (England).


1 Wolfe, I, Macfarlane, A, Donkin, A, Marmot, M, Viner, R. Why Children Die: Death in Infants, Children, and Young People in the UK – Part A. Royal College of Paediatrics and Child Health, 2014 ( Scholar
2 Sawyer, SM, Afifi, RA, Bearinger, LH, Blakemore, SJ, Dick, B, Ezeh, AC, et al. Adolescence: a foundation for future health. Lancet 2012; 379: 1630–40.CrossRefGoogle ScholarPubMed
3 McClure, GMG. Changes in suicide in England and Wales, 1960–1997. Br J Psychiatry 2000; 176: 64–7.CrossRefGoogle ScholarPubMed
4 McClure, GMG. Suicide in children and adolescents in England and Wales 1970–1998. Br J Psychiatry 2001; 178: 469–74.CrossRefGoogle ScholarPubMed
5 Windfuhr, K, While, D, Hunt, I, Turnbull, P, Lowe, R, Burns, J, et al. Suicide in juveniles and adolescents in the United Kingdom. J Child Psychol Psychiatry 2008; 49: 1157–67.CrossRefGoogle ScholarPubMed
6 Windfuhr, K, While, D, Hunt, IM, Shaw, J, Appleby, L, Kapur, N. Suicide and accidental deaths in children and adolescents in England and Wales, 2001–2010. Arch Dis Child 2013; 98: 945–50.CrossRefGoogle ScholarPubMed
7 Wheeler, BW, Gunnell, D, Metcalfe, C, Stephens, P, Martin, RM. The population impact on incidence of suicide and non-fatal self harm on regulatory action against the use of selective serotonin reuptake inhibitors in under 18s in the United Kingdom: ecological study. BMJ 2008; 336: 542–5.CrossRefGoogle ScholarPubMed
8 Coope, C, Gunnell, D, Hollingworth, W, Hawton, K, Kapur, N, Fearn, V, et al. Suicide and the 2008 economic recession: who is most at risk? Trends in suicide rates in England and Wales 2001–2011. Soc Sci Med 2014; 117: 7685.CrossRefGoogle ScholarPubMed
9 Biddle, L, Donovan, J, Hawton, K, Kapur, N, Gunnell, D. Suicide and the internet. BMJ 2008; 336: 800–2.CrossRefGoogle ScholarPubMed
10 World Health Organization. Adolescent Development. WHO, no date ( Scholar
11 World Health Organization. International Statistical Classification of Diseases and Related Health Problems (ICD–8). WHO, 1967.Google Scholar
12 World Health Organization. International Statistical Classification of Diseases and Related Health Problems (ICD–9). WHO, 1978.Google Scholar
13 World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. WHO, 1992.Google Scholar
14 Gunnell, D, Bennewith, O, Simkin, S, Cooper, J, Klineberg, E, Rodway, C, et al. Time trends in coroners' use of different verdicts for possible suicides and their impact on officially reported incidence of suicide in England: 1990–2005. Psychol Med 2013; 43: 1415–22.CrossRefGoogle ScholarPubMed
15 Hill, C, Cook, L. Narrative verdicts and their impact on mortality statistics in England and Wales. Health Stat Q 2011; 49: 119.Google Scholar
16 McLennan, D, Barnes, H, Noble, M, Davies, J, Garratt, E, Dibben, E. The English indices of deprivation 2010. Department for Communities and Local Government (DCLG), 2011.Google Scholar
17 Bridge, JA, Greenhouse, JB, Sheftall, AH, Fabio, A, Campo, JV, Kelleher, KJ. Changes in suicide rates by hanging/suffocation and firearms among young persons aged 10 to 24 years in the United States: 1992–2006. J Adolesc Health 2010; 46: 503–5.CrossRefGoogle ScholarPubMed
18 Varnik, A, Kolves, K, van der Feltz-Cornelis, CM, Marusic, A, Oskarsson, H, Palmer, A, et al. Suicide methods in Europe: a gender-specific analysis of countries participating in the “European Alliance Against Depression”. J Epidemiol Community Health 2008; 62: 545–51.CrossRefGoogle Scholar
19 Boyle, P, Exeter, D, Feng, Z, Flowerdew, R. Suicide gap among young adults in Scotland: population study. BMJ 2005; 330: 175–6.CrossRefGoogle ScholarPubMed
20 Office of the First Minister and Deputy First Minister of Northern Ireland. Effect of Deprivation on Teen Suicide Rates in NI, 2015. Northern Ireland Executive, 2015.Google Scholar
21 Hawton, K. Sex and suicide. Gender differences in suicidal behaviour. Br J Psychiatry 2000; 177: 484–5.CrossRefGoogle ScholarPubMed
22 Kaess, M, Parzer, P, Haffner, J, Steen, R, Roos, J, Klett, M, et al. Explaining gender differences in non-fatal suicidal behaviour among adolescents: a population based study. BMC Public Health 2011; 11: 597.CrossRefGoogle ScholarPubMed
23 Hawton, K, Saunders, KE, O'Connor, RC. Self-harm and suicide in adolescents. Lancet 2012 379: 2373–82.CrossRefGoogle ScholarPubMed
24 Mishara, BL. Conceptions of death and suicide in children ages 6–12 and their implications for suicide prevention. Suicide Life Threat Behav 1999; 29: 105–18.Google ScholarPubMed
25 Kolves, K, De Leo, D. Suicide rates in children aged 10–14 years worldwide: changes in the past two decades. Br J Psychiatry 2014; 205: 283–5.CrossRefGoogle ScholarPubMed
26 Wasserman, D, Cheng, Q, Jiang, GX. Global suicide rates among young people aged 15–19 years. World Psychiatry 2005; 4: 114–20.Google Scholar
27 Kelly, S, Bunting, J. Trends in suicide in England and Wales, 1982–96. Popul Trends 1998; 92: 2941.Google Scholar
28 Hawton, K, Bergen, H, Simkin, S, Dodd, S, Pocock, P, Bernal, W, et al. Long term effect of reduced pack sizes of paracetamol on poisoning deaths and liver transplant activity in England and Wales: interrupted time series analyses. BMJ 2013; 346: f403.CrossRefGoogle ScholarPubMed
29 Hawton, K, Bergen, H, Simkin, S, Wells, C, Kapur, N, Gunnell, D. Six-year follow-up of impact of co-proxamol withdrawal in England and Wales on prescribing and deaths: time-series study. PLoS Med 2012; 9: e1001213.CrossRefGoogle ScholarPubMed
30 Hawton, K, Bergen, H, Simkin, S, Cooper, J, Waters, K, Gunnell, D, et al. Toxicity of antidepressants: rates of suicide relative to prescribing and non-fatal overdose. Br J Psychiatry 2010; 196: 354–8.CrossRefGoogle ScholarPubMed
31 Cox, GR, Owens, C, Robinson, J, Nicholas, A, Lockley, A, Williamson, M, et al. Interventions to reduce suicides at suicide hotspots: a systematic review. BMC Public Health 2013; 13: 214.CrossRefGoogle ScholarPubMed
32 Gunnell, D, Bennewith, O, Hawton, K, Simkin, S, Kapur, N. The epidemiology and prevention of suicide by hanging: a systematic review. Int J Epidemiol 2005; 34: 433–42.CrossRefGoogle ScholarPubMed
33 Hills, S, Thomas, R. The UK recession in context — what do three centuries of data tell us? Q Bull 2010; Q4: 277–91.Google Scholar
34 Pearson-Nelson, BJ, Raffalovich, LE, Bjarnason, T. The effects of changes in the World Health Organization's International Classification of Diseases on suicide rates in 71 countries, 1950–1999. Suicide Life Threat Behav 2004; 34: 328–36.CrossRefGoogle ScholarPubMed
35 Busse, H, Harrop, T, Gunnell, D, Kipping, R. Prevalence and associated harm of engagement in self-asphyxia behaviours (‘Choking game’) in young people: a systematic review. Arch Dis Child 2015; 100: 1106–14.Google Scholar
36 Government, HM. Preventing Suicide in England – A Cross-Government Outcomes Strategy to Save Lives. Department of Health, 2012 ( Scholar
37 Wasserman, D, Hoven, CW, Wasserman, C, Wall, M, Eisenberg, R, Hadlaczky, G, et al. School-based suicide prevention programmes: the SEYLE cluster-randomised, controlled trial. Lancet 2015; 385: 1536–44.CrossRefGoogle ScholarPubMed
38 Biddle, L, Donovan, J, Owen-Smith, A, Potokar, J, Longson, D, Hawton, K, et al. Factors influencing the decision to use hanging as a method of suicide: qualitative study. Br J Psychiatry 2010; 197: 320–5.CrossRefGoogle ScholarPubMed
39 The All-Party Parliamentary Group on Suicide and Self-Harm Prevention. Inquiry into Local Suicide Prevention Plans in England. APPG, 2015 ( Scholar
40 Public Health England. Guidance for Developing a Local Suicide Prevention Action Plan. Public Health England, 2014 ( Scholar
41 Fraser, J, Sidebotham, P, Frederick, J, Covington, T, Mitchell, EA. Child death in high-income countries 1. Learning from child death review in the USA, England, Australia, and New Zealand. Lancet 2014; 384: 894903.CrossRefGoogle Scholar
42 Public Health Wales. Thematic Review of Deaths of Children and Young People through Probable Suicide, 2006–2012. Public Health Wales NHS Trust, 2014 ($FILE/PHW%20probable%20suicide%20web.pdf).Google Scholar
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