Skip to main content
×
×
Home

Are we finally making progress with suicide and self-harm? An overview of the history, epidemiology and evidence for prevention

  • B. D. Kelly (a1)
Abstract

Ireland’s suicide rate is falling, but suicide and self-harm remain substantial societal problems. It is not possible to predict suicide at the level of the individual but good primary care, good mental health care and good social care all likely reduce risk. In terms of targeted interventions, public health measures, such as paracetamol pack size regulations, have the best evidence base to support them. Despite increased public and professional discussion, much remains to be done to provide effective, coordinated support to those at risk of suicide and those bereaved. In 2016, there were up to 300 different groups providing support. Clearly, a coordinated, effective and compassionate approach is needed, linking community and state resources meaningfully with each other. Approaches rooted outside of core mental health services will be vital: addressing alcohol problems and other addictions, reducing homelessness, reforming the criminal justice system and improving social care.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Are we finally making progress with suicide and self-harm? An overview of the history, epidemiology and evidence for prevention
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Are we finally making progress with suicide and self-harm? An overview of the history, epidemiology and evidence for prevention
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Are we finally making progress with suicide and self-harm? An overview of the history, epidemiology and evidence for prevention
      Available formats
      ×
Copyright
Corresponding author
*Address for correspondence: B. D. Kelly, Department of Psychiatry, Trinity Centre for Health Sciences, University of Dublin Trinity College, Tallaght Hospital, Dublin D24 NR0A, Ireland. (Email: brendan.kelly@tcd.ie)
References
Hide All
Beattie, D, Devitt, P (2015). Suicide: A Modern Obsession. Liberties Press: Dublin.
Bennewith, O, Nowers, M, Gunnell, D (2007). Effect of barriers on the Clifton suspension bridge, England, on local patterns of suicide: implications for prevention. British Journal of Psychiatry 190, 266267.
Central Statistics Office (1954). Tuarascáil an Ard-Chláraitheora 1952. Stationery Office: Dublin.
Chan, MK, Bhatti, H, Meader, N, Stockton, S, Evans, J, O’Connor, RC, Kapur, N, Kendall, T (2016). Predicting suicide following self-harm: systematic review of risk factors and risk scales. British Journal of Psychiatry 209, 277283.
College of Psychiatry of Ireland (2010). Antidepressant Medication – Clarification. College of Psychiatry of Ireland: Dublin.
Cooper, J, Kapur, N, Webb, R, Lawlor, M, Guthrie, E, Mackway-Jones, K, Appleby, L (2005). Suicide after deliberate self-harm: a 4-year cohort study. American Journal of Psychiatry 162, 297303.
Corcoran, P, Griffin, E, Arensman, E, Fitzgerald, AP, Perry, IJ (2015). Impact of the economic recession and subsequent austerity on suicide and self-harm in Ireland: an interrupted time series analysis. International Journal of Epidemiology 44, 969977.
Curran, G, Ravindran, A (2014). Lithium for bipolar disorder: a review of the recent literature. Expert Review of Neurotherapeutics 14, 10791098.
Dillon, L, Guiney, C, Farragher, L, McCarthy, A, Long, J (2015). Suicide Prevention: An Evidence Review 2015. Health Research Board: Dublin.
Donohoe, E, Walsh, N, Tracey, JA (2006). Pack-size legislation reduces severity of paracetamol overdoses in Ireland. Irish Journal of Medical Science 175, 4042.
Foley, SR, Kelly, BD (2007). When a patient dies by suicide: incidence, implications and coping strategies. Advances in Psychiatric Treatment 13, 134138.
Griffin, E, Arensman, E, Dillon, CB, Corcoran, P, Williamson, E, Perry, IJ (2016). National Self-Harm Registry Ireland Annual Report 2015. National Suicide Research Foundation: Cork.
Gunnell, D, Harbord, R, Singleton, N, Jenkins, R, Lewis, G (2004). Factors influencing the development and amelioration of suicidal thoughts in the general population: cohort study. British Journal of Psychiatry 185, 385393.
Hawton, K, Bergen, H, Simkin, S, Dodd, S, Pocock, P, Bernal, W, Gunnell, D, Kapur, N (2013). 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 346, f403.
Hawton, K, Townsend, E, Deeks, J, Appleby, L, Gunnell, D, Bennewith, O, Cooper, J (2001). Effects of legislation restricting pack sizes of paracetamol and salicylate on self poisoning in the United Kingdom: before and after study. BMJ 322, 12031207.
Hawton, K, van Heeringen, K (2009). Suicide. Lancet 373, 13721381.
Hawton, K, Witt, KG, Taylor Salisbury, TL, Arensman, E, Gunnell, D, Hazell, P, Townsend, E, van Heeringen, K (2016). Psychosocial interventions for self-harm in adults. Cochrane Database of Systematic Reviews 5, CD012189.
Health Service Executive (HSE) (2011). Responding to Murder Suicide and Suicide Clusters: Guidance Document. Health Service Executive: Dublin.
Healthy Ireland, Department of Health, Health Service Executive (HSE), National Office for Suicide Prevention (NOSP) (2015). Connecting for Life: Ireland’s National Strategy to Reduce Suicide, 2015-2020. Department of Health: Dublin.
Irish Association of Suicidology and the Samaritans (2013). Media Guidelines for Reporting Suicide. Irish Association of Suicidology, Samaritans: Dublin.
Kelly, BD (2016). Hearing Voices: The History of Psychiatry in Ireland. Irish Academic Press: Dublin.
Large, M, Kaneson, M, Myles, N, Myles, H, Gunaratne, P, Ryan, C (2016). Meta-analysis of longitudinal cohort studies of suicide risk assessment among psychiatric patients: heterogeneity in results and lack of improvement over time. PLoS One 11, e0156322.
Malone, KM, Quinlivani, L, McGuinness, S, McNicholas, F, Kelleher, C (2012). Suicide in children over two decades: 1993-2008. Irish Medical Journal 105, 231233.
McMahon, EM, Keeley, H, Cannon, M, Arensman, E, Perry, IJ, Clarke, M, Chambers, D, Corcoran, P (2014). The iceberg of suicide and self-harm in Irish adolescents: a population-based study. Social Psychiatry and Psychiatric Epidemiology 49, 19291935.
Mulder, R, Newton-Howes, G, Coid, JW (2016). The futility of risk prediction in psychiatry. British Journal of Psychiatry 209, 271272.
Murphy, OC, Kelleher, C, Malone, KM (2015). Demographic trends in suicide in the UK and Ireland 1980-2010. Irish Journal of Medical Science 184, 227235.
Murray, D (2016). Is it time to abandon suicide risk assessment? BJPsych Open 2, e1e2.
Murray, D, Devitt, P (2017). Suicide risk assessment doesn’t work. Scientific American, 28 March.
National Office for Suicide Prevention (NOSP) (2014). Annual Report 2013. National Office for Suicide Prevention/Health Service Executive: Dublin.
National Office for Suicide Prevention (NOSP) (2016). Annual Report 2015. National Office for Suicide Prevention/Health Service Executive: Dublin.
Ní Mhaoláin, Á, Kelly, BD, Breen, E, Casey, P (2007). Legal limits for paracetamol sales. Lancet 369, 1346.
Ní Mhaoláin, ÁM, Davoren, M, Kelly, BD, Breen, E, Casey, P (2009). Paracetamol availability in pharmacy and non-pharmacy outlets in Dublin, Ireland. Irish Journal of Medical Science 178, 7982.
Nielssen, O, Wallace, D, Large, M (2017). Pokorny’s complaint: the insoluble problem of the overwhelming number of false positives generated by suicide risk assessment. BJPsych Bulletin 41, 1820.
O’Regan, M (2016). Stigma of mental illness remains, says Fine Gael TD. Irish Times, 27 January.
O’Rourke, M, Garland, MR, McCormick, PA (2002). Ease of access is a principal factor in the frequency of paracetamol overdose. Irish Journal of Medical Science 171, 148150.
Pokorny, AD (1992). Prevention of suicide in psychiatric patients: report of a prospective study. In Assessment and Prediction of Suicide (ed. R. W. Maris, A. L. Berman, J. T. Matlsberger and R. I Yufit), pp. 105129. Guilford Press: New York.
Sheehan, JD (2001). Deliberate self-poisoning in an Irish county hospital. Irish Journal of Medical Science 170, 90.
Turecki, G, Brent, DA (2016). Suicide and suicidal behaviour. Lancet 387, 12271239.
Williams, M (1997). Suicide and Attempted Suicide. Penguin: London.
World Health Organisation (2017). Suicide Data. World Health Organisation: Geneva.
Zalsman, G, Hawton, K, Wasserman, D, van Heeringen, K, Arensman, E, Sarchiapone, M, Carli, V, Höschl, C, Barzilay, R, Balazs, J, Purebl, G, Kahn, JP, Sáiz, PA, Lipsicas, CB, Bobes, J, Cozman, D, Hegerl, U, Zohar, J (2016). Suicide prevention strategies revisited: 10-year systematic review. Lancet Psychiatry 3, 646659.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Irish Journal of Psychological Medicine
  • ISSN: 0790-9667
  • EISSN: 2051-6967
  • URL: /core/journals/irish-journal-of-psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed