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Trends in national suicide rates for Scotland and for England & Wales, 1960–2008

  • Pearl L. H. Mok (a1), Navneet Kapur (a1), Kirsten Windfuhr (a1), Alastair H. Leyland (a2), Louis Appleby (a3), Stephen Platt (a4) and Roger T. Webb (a5)...

Suicide rates in Scotland have increased markedly relative to those in England in recent decades.


To compare changing patterns of suicide risk in Scotland with those in England & Wales, 1960–2008.


For Scotland and for England & Wales separately, we obtained national data on suicide counts and population estimates. Gender-specific, directly age-standardised rates were calculated.


We identified three distinct temporal phases: 1960–1967, when suicide rates in England & Wales were initially higher than in Scotland, but then converged; 1968–1991, when male suicide rates in Scotland rose slightly faster than in England & Wales; and 1992–2008, when there was a marked divergence in national trends. Much of the recent divergence in rates is attributable to the rise in suicide among young men and deaths by hanging in Scotland. Introduction of the ‘undetermined intent’ category in 1968 had a significant impact on suicide statistics across Great Britain, but especially so in Scotland.


Differences in temporal patterns in suicide risk between the countries are complex. Reversal of the divergent trends may require a change in the perception of hanging as a ‘painless' method of suicide.

Corresponding author
Dr Roger Webb, Centre for Suicide Prevention, University of Manchester, Room 2.311, Jean McFarlane Building, Oxford Road, Manchester M13 9PL, UK. Email:
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We thank the Chief Scientist Office of the Scottish Government for funding this study.

Declaration of interest


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Trends in national suicide rates for Scotland and for England & Wales, 1960–2008

  • Pearl L. H. Mok (a1), Navneet Kapur (a1), Kirsten Windfuhr (a1), Alastair H. Leyland (a2), Louis Appleby (a3), Stephen Platt (a4) and Roger T. Webb (a5)...
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Suicide in Wales

Timothy N Evans, Consultant Psychiatrist
17 March 2012

The paper by Mok et al(1) makes for interesting reading but is something of a blunt instrument in the presentation of the figures.

By combining figures for England and Wales it overlooks the fact thatthe suicide rate for men in Wales is significantly higher than in England with a peak between 20-39 years of age. For women in Wales the rate is a little higher than the English average. Within Wales the rate varies considerably with higher rates in areas of high social deprivation(2).

The figures for Wales are not as high as those for Scotland and Northern Ireland but have been of sufficient concern for the Welsh Government to launch its suicide prevention campaign "Talk to Me"(3) in 2008 which is full of good intentions but lacks some detail as to real life implementation. The impact of this is yet to be evaluated but it is not likely to have been helped by recent economic problems. The association between social adversity and suicide is easy to identify but harder to change.

Also of interest is the high incidence of drowning in Scotland. Of note is the fact that Scotland accounts for 90% of the standing freshwaterof Great Britain and water makes up 2-3% of the land area of Scotland compared to 0.5% in England(4). Similarly in the Republic of Ireland drowning accounts for approximately a fifth of male suicides(5). Whilst itmay be simplistic to equate methods of suicide with geographical proximityit is interesting to speculate on an individual's relationship with their culture, landscape, and history which may have a bearing on attitudes to suicide and methods chosen. Drowning, for example, could be more easily explained away as accidental in cultures where everyday use of water for recreation or work is more commonplace thereby avoiding a pronouncement ofsuicide and its associated stigma.

Whilst there are some common, well replicated associations with completed suicide as discussed in this paper, broad statistics tend to hide subtle variations within regions and it is examination of these differences that can inform suicide prevention strategies that are relevant, practical, acceptable and beneficial for a given community.

1 Pearl L H Mok, Navneet Kapur, Kirsten Windfuhr, Alastair H Leyland,Louis Apppleby, Stephen Platt and Roger T Webb. Trends in national suiciderates for Scotland and for England and Wales, 1960-2008.

2 National Public Health Service for Wales. Suicide in Wales: data tosupport implementation of the national action plan to reduce suicide and self harm in Wales. Welsh Assembly Government.

3 Talk to Me. A national action plan to reduce suicide and self harm in Wales 2008-2013. Welsh Assembly Government,

4 Scottish National Heritage. Land uses change in Scotland.

5 J Connelly. Suicide by drowning in Ireland. World Conference on Drowning Prevention 2007.

Timothy N Evans, Consultant psychiatrist, Cefn Coed Hospital , Swansea. Email

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Conflict of interest: None declared

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