Suicide prevention: Policy and strategy

[Note: This briefing is no longer being updated. It has been replaced by a series of briefings on suicide prevention, available here: Suicide prevention - House of Commons Library.]

Warning: This briefing discusses suicide and self-harm, which some readers may find distressing.

Suicide rates in the UK

In 2022, England had the lowest rate of suicide in the UK. The age-standardised mortality rates across the UK in 2022 were:

• 10.5 deaths per 100,000 people in England
• 12.5 deaths per 100,000 people in Wales
• 14.1 deaths per 100,000 people in Scotland
• 12.3 deaths per 100,000 people in Northern Ireland

Long-term trends in suicide have varied in different parts of the UK:

• The suicide rate in England declined between 1981 and 2022. Most of this fall occurred before 2000.
  • The NHS five year forward view for mental health (2016) included a commitment to reduce the rate of suicides in England by 10% by 2020 compared to 2015 levels. The NHS Long Term plan (2019) suggested this target would be met but there has been no statistically significant change in the rate of suicides in England since 2015.
• Since the 1980s there has been a general downward trend in Wales, although over the past decade rates of suicide have increased.
• The suicide rate in Scotland has been consistently higher than in any other part of the UK. Since 2002, the rate of suicide has generally decreased, although there has been a slight increase in recent years.
• There has been little change in the rate of suicide in Northern Ireland since 2015. Figures before this are not comparable.

Suicide prevention strategies in the UK England

In September 2023, the Government published a five-year cross-sector strategy for suicide prevention in England alongside an action plan with intended timelines for delivery.

The three aims of the new strategy are to:

• reduce the suicide rate over the next five years with initial reductions within half this time or sooner,
• improve support for people who have self-harmed, and
• improve support for people bereaved by suicide.

In 2022, the Department for Health and Social Care held a call for evidence and a consultation on a Mental health and wellbeing plan, intended to inform a new mental health strategy and a separate suicide prevention strategy for England. In January 2023, it was announced that mental health would be incorporated into a new Major conditions strategy, instead of a stand-alone plan.

In the 2023 Spring Budget, the Government announced a £10 million grant fund for suicide prevention voluntary, community and social enterprise organisations across 2023 to 2025.

Scotland

The current strategy in Scotland, Creating hope together: Suicide prevention strategy 2022 to 2032, was published in 2022. A Suicide prevention action plan 2022 to 2025 was published alongside.

Wales

The latest strategy in Wales, Talk to me 2: Suicide and self harm prevention strategy for Wales 2015-2022, was published in 2015. A review of the strategy was published in 2023.

Northern Ireland

The current strategy in Northern Ireland, Protect life 2: Strategy for preventing suicide and self harm in Northern Ireland 2019-2024, was published in 2019. It includes an aim to reduce the suicide rate in Northern Ireland by 10% by 2024. In September 2023, it was announced the strategy has been extended to the end of 2027.

Suicide prevention in different policy areas (England)

Suicide prevention requires action across many areas of policy that are devolved in the UK, such as health and education. A summary of suicide prevention actions in different policy areas in England is set out below. Information on Scotland, Wales and Northern Ireland can be found in the relevant briefing sections.

Healthcare

The NHS Long term plan and subsequent Mental health implementation plan commit to achieving 100% coverage of crisis care via NHS 111 by 2023/24. In 2021 the Government announced £150 million of funding for crisis mental health facilities and patient safety in mental health units. In January 2023, it was announced £7 million of the funding would be allocated to new mental health ambulances. £143 million would go towards 150 new projects, including schemes providing alternatives to A&E.

The Government has said a national investigation of mental health in-patient services will look at how service providers learn from deaths and translate learning into improvement. The NHS Mental Health Safety Improvement Programme includes a focus on suicide prevention and reduction for mental health inpatients.

In the 2023 Spring Budget, the Government announced a £10 million grant fund for suicide prevention for voluntary, community and social enterprise sector organisations across 2023 to 2025.

The 2023 suicide prevention strategy includes targeted actions to support people who have self-harmed, people who are in contact with mental health services, autistic people and pregnant women and new mothers. It also highlights severe physical health conditions as a risk factor for suicide and sets out actions to improve signposting and suicide prevention support in primary care.

The Government plans to publish a new Major Conditions Strategy in 2024, that will consider both mental health and physical health and their interaction.

Education

Since September 2020, health education has been a statutory part of the curriculum in primary and secondary schools in England. The Government has

published statutory guidance on relationships and sex education and health education, including recognising and discussing mental health concerns. The 2023 suicide prevention strategy says suicide prevention will be considered as part of an ongoing review of the curriculum.

The Government is supporting mental health in educational settings by offering funding to train a Senior Mental Health Lead in each school and college and rolling out Mental Health Support Teams in schools.

The 2023 suicide prevention strategy also commits to a national review of higher education student suicides and the publication of a plan to improve student mental health by the higher education mental health implementation taskforce in 2024. There have been calls for universities to have a statutory duty of care towards students, but the Government has said this duty already exists in common law.

Employment

The Department for Work and Pensions (DWP) and the Department for Health and Social Care have worked together through the joint Work and Health Unit to explore how more people living with mental health problems can be supported to find or stay in work. One such scheme is the Access to Work Mental Health Support Service, which provides support to manage mental health at work. This may include a tailored plan to help someone get or stay in a job, or one-to-one sessions with a mental health professional.

In November 2023 the Government announced its Back to Work Plan, which aims to help up to 1.1 million people with long-term health conditions, disabilities or long-term unemployment look for and stay in work. This includes 100,000 more spaces for the Individual Placement and Support programme which aims to help people with severe mental illness find and keep jobs and an expansion of NHS Talking Therapies.

The 2023 suicide prevention strategy calls on employers to have adequate and appropriate support in place for employees, such as people trained in mental health first aid, mental health support and suicide prevention awareness. It also called on employers in occupations with higher rates of suicide to take targeted action to support employees.

Social security

The DWP reviews cases where it is alleged the department’s actions are linked to the death of a benefit claimant or have caused 'serious harm', including attempted suicide. Stakeholders have expressed concerns the process and number of reviews "don’t reflect anything like the real scale of harm". The DWP says it has taken a number of steps to improve how it responds to "those who live complex lives".

In April 2022, the Equality and Human Rights Commission (EHRC) said it was taking action to require the DWP to improve its treatment of customers with mental health impairments and learning disabilities. The EHRC and DWP said they are drawing up a legally binding agreement, committing the DWP to an action plan to meet the needs of these groups. The agreement is yet to be announced.

Major proposals to reform benefits for disabled people were set out in the Government’s Health and Disability White Paper, published alongside the Spring Budget on 15 March 2023. In Autumn 2023 the DWP held a consultation on making changes to the Work Capability Assessment, in advance of its long-term plan to abolish it entirely. In November 2023, welfare rights and anti-poverty organisations wrote to the Government to express “deep concern” about the proposed changes.

The 2023 suicide prevention strategy says that by 2025, the DWP will procure an alert service to identify people who raise suicidal thoughts when using DWP helplines and services. The DWP will also strengthen staff guidance and training.

Transport

The Department for Transport convenes a variety of regular meetings and groups on suicide prevention, such as a suicide prevention awareness group bringing together agencies within the sector to work together to reduce transport-related suicides. The British Transport Police (BTP) also work to prevent suicides through actions such as capturing real time data and training rail industry partners.

The rail industry has its own suicide prevention programme, in partnership with the Samaritans and the BTP. National Highways (formerly called Highways England) published a Suicide prevention strategy in 2022.

The 2023 suicide prevention strategy includes actions across the railways and roads to provide guidance and training on suicide prevention interventions and bereavement support.

Prisons

The Prison Service Instruction (PSI) Safer Custody, issued by HM Prison and Probation Service to all prisons in England and Wales, details actions which must be taken by prisons to try to reduce incidents of self-harm and deaths in custody

The Ministry of Justice has developed safety training for staff which includes suicide and self-harm prevention, a suicide prevention learning tool developed in partnership with the Samaritans, and guidance distributed nationally on supporting someone who is self-harming.

The September 2023 suicide prevention strategy notes that the Ministry of Justice has committed to funding the Samaritans’ Listeners Scheme to March 2025, will continue to roll out suicide and self-harm prevention training for prison staff and is planning to reduce access to means of suicide in cells, focusing on the highest-priority prisons.

Media

The way suicide is covered in the media can impact suicide rates. Depictions of methods and excessive reporting can lead to imitational behaviour. Press, media outlets and broadcasters should follow guidance on reporting deaths by suicide set out by their regulators.

There are growing concerns around the impact of social media on young people's mental health, particularly in relation to self-harm and suicide. The Online Safety Act 2023 aims to increase user safety and improve users’ ability to keep themselves safe online.

Under the Act, all regulated services must protect users from illegal content, such as suicide and self-harm content, that reaches the criminal threshold. There are additional duties for services likely to be accessed by children. The largest services must also introduce optional tools for adults to limit their exposure to legal content that encourages, promotes or provides instructions for suicide or self-harm.

Armed forces

The Armed Forces published a Suicide prevention strategy and action plan in April 2023. It was prompted in part by an upward trend in death by suicide in the armed forces. The Ministry of Defence made suicide prevention one of its priority themes in the Defence People Health and Wellbeing Strategy - 2022 to 2027, along with wellbeing and resilience.

The provision of veterans’ healthcare is primarily the responsibility of the NHS. In March 2021 the Government launched the Operation Courage service, creating a single point to access mental health services for veterans.

Coroners’ conclusions

In England and Wales, deaths which appear to have been caused by suicide are investigated by a coroner as set out in Part 1 of the Coroners and Justice Act 2009.

The level of certainty for a conclusion of suicide is the same as the civil standard of proof, that is, the balance of probabilities. This is a lower threshold than the standard of proof applied in the criminal courts – which is being sure, or “beyond all reasonable doubt”.

On 7 June 2022, The Lord Bishop of St Albans introduced into the House of Lords the Coroners (Determination of Suicide) Bill, a Private Member’s Bill that would require a coroner to record an opinion as to the relevant causative factors in a suicide after the conclusion of an inquest. The Government said it would not be able to support the Bill as it would lead to an inappropriate extension to the coroner's jurisdiction.

The 2023 suicide prevention strategy emphasises the role of sharing information to prevent future deaths, particularly in relation to the role of online suicide and self-harm content.