Suicide by patients in contact with drug and alcohol services (CAG Pilot)
Research type
Research Study
Full title
Suicide by patients in contact with drug and alcohol services in the year prior to death
IRAS ID
309878
Contact name
Jennifer Shaw
Contact email
Sponsor organisation
University of Manchester
Duration of Study in the UK
0 years, 9 months, 31 days
Research summary
Alcohol and drug misuse are key risk factors for suicide. There is currently no national study of suicide by people in contact with alcohol and drug services, and following NHS reforms, service provision has become more complex. The National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) proposes an 18-month study investigating deaths by suicide of people under the recent care of alcohol and drug services.
The objectives of this study are:
(1) Estimating the number of people in contact with alcohol and drug services in the year prior to suicide;
(2) Identifying sociodemographic, mental health and substance misuse characteristics that could be a focus of suicide prevention in this group;
(3) Examining suicide risk management in people under the care of alcohol and drug services who have died by suicide.We will undertake this by (1) linking existing drug and alcohol misuse and suicide databases, (2) using existing data for case-control exploration, and (3) collecting and analysing additional clinical data from Serious Incident Reports. This study uses existing data only and will not recruit participants.
Lay summary of study results: What were the main findings?
• 428 people in England and Wales died by suicide within 12 months of contact with drug and
alcohol services during the study period, 8% of all suicide deaths. For England this represented a
rate of 119.2 per 100,000 people in treatment, more than ten times the general population suicide
rate (10.7 per 100,000 population). The majority of those in contact with drug and alcohol services
were men (80%) but the observed rate of suicide in this study was also higher than the overall rate
for men in the general population (16.2 per 100,000 population) or men in mid-life (23.2 per
100,000 population).
• Almost half of people (175, 47%) who died by suicide were unemployed at the time of death and
over a third (140, 34%) lived in the 20% most deprived areas. In England most (283, 81%) resided
in social housing.
• In almost half (48%) of the people who died, the primary substance for which they were seeking
help was alcohol. This group was older than those using other substances. Overall, 40% of people
who died by suicide had a record of more than one problem substance at the start of treatment.
• The majority (349, 82%) of people in contact with drug and alcohol services who died by suicide
had received psychosocial interventions. In total, 108 (25%) had completed treatment with
services prior to death and were reported as being substance free or an occasional user. Just under
half (191, 45%) of people had contact with drug and alcohol services in the month prior to their
death. One hundred and sixty-one people (38%) remained in treatment at the time of death.
• Just under a third (127, 30%) also had contact with mental health services in the previous 12
months. These people had high rates of self-harm (76%), including in the 3 months prior to death
(43%). A fifth of these people had missed their last contact with mental health services, and 14%
were not adherent with prescribed medication.
• We found high rates of social adversity among both people who had died by suicide and living
controls; this included living in social housing and unemployment. More people who died by
suicide (205, 48% vs. 874, 25%) used alcohol as the main substance compared to living controls.
They were more likely to have been in treatment for less than a month, and less likely to have
been receiving treatment for a mental health need than controls (154, 44% vs. 1,234, 78%).
• The length of the serious incident reports and the amount of detail within them were variable.
Where available, the reports identified common themes of (1) socio-economic adversity, (2)
interpersonal problems, (3) physical ill-health, (4) warning signals of recent self-harm and suicidal
ideation/intent, and (5) recent contact with services, both drug and alcohol and mental health
services.
Has the registry been updated to include summary results?: No
If yes - please enter the URL to summary results:
If no – why not?: Study not on registry.
Did you follow your dissemination plan submitted in the IRAS application form (Q A51)?: Yes
If yes, describe or provide URLs to disseminated materials: https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fclick.pstmrk.it%2F3ts%2Fsites.manchester.ac.uk%252Fncish%252Freports%252Fsuicide-by-people-in-contact-with-drug-and-alcohol-services%252F%2FNBTI%2Fbye3AQ%2FAQ%2F50148b39-23ee-4701-a167-8ed6acccabde%2F1%2FZCD1pcUXxm&data=05%7C02%7Csurreyborders.rec%40hra.nhs.uk%7C98392d8dcba84148053e08dcb5f8d0a3%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638585327464651399%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=v9HfGNMX%2BjeE7gjTlAnajuXZx4yh93lI6FeL4mpFgfM%3D&reserved=0
If pending, date when dissemination is expected:
If no, explain why you didn't follow it:
Have participants been informed of the results of the study?: No
If yes, describe and/or provide URLs to materials shared and how they were shared:
If pending, date when feedback is expected:
If no, explain why they haven't: Participants in the study sample are deceased.
Have you enabled sharing of study data with others?: No
If yes, describe or provide URLs to how it has been shared:
If no, explain why sharing hasn't been enabled: Data is highly confidential.
Have you enabled sharing of tissue samples and associated data with others?: No
If yes, describe or provide a URL:
If no, explain why:
Submitted on: 06/08/2024REC name
London - Surrey Borders Research Ethics Committee
REC reference
22/LO/0362
Date of REC Opinion
24 May 2022
REC opinion
Favourable Opinion