Key findings

  • Suicides disproportionately affected males aged 16-44 years and residents of urban (particularly Greater Belfast) and deprived areas.

After accounting for other factors (such as age and marital status):

  • Poor mental health was associated with higher mortality risk for both sexes.

  • Living alone, for both sexes, and for males, being a child in a lone parent household, were associated with higher mortality risk.

  • Unemployment was associated with increased risk for both sexes. For males, no qualifications or having intermediate level qualifications as the highest level of educational attainment were associated with increased risk. For females, economic inactivity and urban residence were associated with increased risk.

Where to go for help

If you are struggling to cope, please call one of the organisations below. There is help available around the clock, every single day of the year, providing a safe place for anyone struggling to cope, whoever they are, however they feel.

Minding Your Head - Find out more about mental health and the issues that can affect it; early warning signs that a mental health issue may be developing; tips on how to maintain good mental health.

Lifeline - A free 24 hour crisis response helpline for people who are experiencing distress or despair, where trained counsellors will listen and help immediately on the phone and follow up with other support if necessary. Phone 0808 808 8000

Samaritans – A registered charity aimed at providing emotional support to anyone in emotional distress, struggling to cope, or at risk of suicide throughout UK and Ireland, often through their telephone helpline or online chat. Freephone 116 123

Information for the media - There is strong evidence that sensationalist media reports about suicide and the nature of suicide deaths can lead to subsequent additional suicidal behaviours (suicides and suicide attempts) or indeed increase the likelihood of copycat deaths. Media professionals should exercise caution in reporting on suicide, balancing the public’s “right to know” against the risk of causing harm. It is therefore important that those reporting on suicide statistics adhere to the guidelines of safe reporting from the World Health Organisation (WHO), the International Association for Suicide Prevention (IASP) and the Samaritans.

Background

Suicides are a major public health challenge in Northern Ireland, with profound impacts on individuals, families and communities. Males and those under 45 years are disproportionately affected. This study examined personal, household and area characteristics associated with suicides, providing insights beyond Accredited Official Statistics (see reference 1). This brief is part of a series alongside related briefs on drug-related deaths and alcohol-specific deaths. The full report is available on the NISRA-led research website.

Data source

Analysis used the The Northern Ireland Mortality study, linking 2011 Census records to registered deaths from April 2011 to September 2022. The dataset includes 1,649 suicides (64.3% of all registered suicides).

Key strengths of NIMS include:

  1. Nationally representative data enabling comparisons of characteristics between those that died and the general population.
  2. Sufficient sample sizes for detailed subgroup analyses.
  3. Supports modelling to quantify mortality risk across diverse groups.

Characteristics

Characteristics of those who died from suicides compared with the general population aged 16-64 years:

Age and sex:

  • Males accounted for three quarters (75.9%) of suicides among 16-64 year-olds (but comprised 48.9% of the general population aged 16-64 years).
  • Males aged 16-44 years: 74.5% of suicides (but comprised 61.0% of the male population aged 16-64 years).

Marital status:

  • Single individuals: 59.7% of deaths (41.1% of the population).

Education and employment:

  • No qualifications: 33.0% of deaths (21.4% of the population).
  • Economically inactive: 39.8% of deaths (27.8% of the population).
  • Unemployed: 10.8% of deaths (5.5% of the population).

Health factors:

  • Self-reported poor mental health: 24.4% of deaths (7.7% of the population).
  • Self-reported disability: 31.4% of deaths (17.2% of the population).

Housing and living arrangements:

  • Social housing residents: 25.5% of deaths (12.8% of the population).
  • Living alone: 22.5% of deaths (10.6% of the population).
  • Children living in lone parent households: 14.9% of deaths (7.2% of the population).

Geographic patterns:

  • Greater Belfast: 40.2% of deaths (34.0% of the population).
  • Urban areas: 73.0% of deaths (63.8% of the population).
  • 27.8% of deaths were in the 20% most deprived areas.

Who faces the highest risk?

Figure 1 shows Hazard Ratios for suicides by sex, comparing each characteristic with its specific reference group (e.g. married, employed, no disability). Full modelling details are in the main report available at NISRA-led research.

Figure 1: Mortality hazard ratios (with 95% confidence intervals) for suicides, 16-64 years by sex: April 2011 to September 2022

Figure 1 shows which groups had higher risk of suicide for males and females aged 16–64 years in Northern Ireland (April 2011–September 2022).

Figure 1: Note and interpretation

Hazard ratios (HRs) show how much more likely death is for a given group compared to its reference group, after adjusting for other factors. For example, males with poor mental health alone (HR 2.93) were 2.93 times more likely to die by suicide than males without poor mental health, while economically inactive females (HR 1.46) had a 46% increased risk of suicide compared to employed females.

These associations do not imply causation but highlight key patterns for targeting prevention efforts.


Key modelling insights

Health factors:

  • Self-reported poor mental health was strongly associated with higher mortality risk, both when reported alone (HR: 2.93 for males; HR: 4.14 for females) and alongside other conditions (HR: 2.11 for males; HR: 3.33 for females).
  • Self-reported disability was also associated with increased risk (HR: 1.36) for males.

Living arrangements:

  • Living alone (compared with living as part of a couple household) was associated with increased mortality risk (HR: 1.93 for males; HR: 1.99 for females).
  • For males being a child in a lone-parent household was also associated with increased mortality risk (HR: 1.47).

Qualifications

  • For males (compared to being degree-qualified), having no qualifications (HR: 1.90) or having intermediate-level qualifications as the highest level of educational attainment (HR: 1.53) were associated with increased mortality risk.

Employment status:

  • Unemployment was associated with increased mortality (HR: 1.30 for males; HR: 1.89 for females).
  • Economically inactive females had a 46% increased risk compared to employed females.

Urban residence

  • Living in an urban area (compared with rural) was associated with increased risk - 18% for males (not shown in Figure 1) and 28% for females.

Note: all reference groups are listed in Figure 1.

Discussion

This study reinforces established patterns, showing that suicide is more common among males, younger people and urban residents, with a strong association between self-reported poor mental health and suicide risk. The analysis also highlights an association between self-reported disability and suicide risk. Education and employment factors also play a key role: unemployment was associated with higher mortality risk for both sexes, while having no or intermediate qualifications increased risk among males, and economic inactivity increased risk among females. Living alone was associated with increased mortality risk for both sexes, and for males, childhood experience of living in a lone parent household was also associated with higher mortality risk. However, it is important to emphasise that not all individuals in these groups experience loneliness or social isolation. Rather these characteristics highlight areas where targeted support may be beneficial.

Policy context

Northern Ireland’s strategies addressing suicide, self-harm, substance use, mental health and inequalities include:

This research highlights the importance of addressing mental health issues, social isolation, and socio-economic inequalities. Collaboration is ongoing with stakeholders in the Department of Health and in the Public Health Agency to maximise the policy impact of this work.

Further information

Definitions:

  • Economic inactivity: not working or seeking work due to reasons such as long-term illness or caring responsibilities.
  • Unemployment: not working but actively seeking employment.
  • Disability: self-reported health problems or disabilities lasting, or expected to last, at least 12 months and which limit daily activities.
  • Poor mental health: self-reported emotional, psychological or mental health condition (such as depression or schizophrenia).
  • Intermediate qualifications: school-level qualification, other vocational qualification or apprenticeship.
  • Greater Belfast includes residents of the Belfast, Antrim and Newtownabbey, and Lisburn and Castlereagh Local Government Districts (see reference 2) at the baseline in 2011.

Note: see the main report for full definitions.

Acknowledgements

The help provided by the staff of the Northern Ireland Mortality Study (NIMS) and the NILS Research Support Unit is acknowledged. The NIMS is funded by the Health and Social Care Research and Development Division of the Public Health Agency (HSC R&D Division) and NISRA. The NILS-RSU is funded by the Economic & Social Research Council and the Northern Ireland Government. We also thank colleagues in NISRA, the Department of Health and the Public Health Agency who contributed to the development of this brief.

Contact details

Research team John Hughes, Brian Foley, Jana Ross, Carmel Colohan, and Deborah Lyness (all Administrative Research Unit, NISRA)

For further information on this research, please contact

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