Skip to main content Accessibility help
×
Hostname: page-component-68c7f8b79f-fnvtc Total loading time: 0 Render date: 2025-12-21T20:58:28.639Z Has data issue: false hasContentIssue false

Chapter 5 - Using Evidence in Suicide Prevention

from Section 2 - Specific Challenges in Preventing Suicide

Published online by Cambridge University Press:  18 December 2025

Rob Poole
Affiliation:
Bangor University
Murad M. Khan
Affiliation:
Aga Khan University
Catherine A. Robinson
Affiliation:
University of Manchester
Get access

Summary

Evidence is essential to suicide prevention. Delay until the evidence base is complete is not possible, so cautious advice must be given to policy makers on imperfect evidence. This means recognising uncertainty, including the risk that the advice may cause more harm than good. Evaluation during implementation is critical but frequently neglected. The UK has a system of nationwide statistics, supplemented by a National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) into all apparently suicidal deaths during or after mental health care. In addition, there are recently devised real-time statistics of suspicious deaths. There is a system of self-harm registers, independent of official systems. These systems have generated unusually good information on suicidal deaths and self-harm, leading to tangible improvements. However, like all evidence, it is still imperfect.

Information

Type
Chapter
Information
Preventing Suicide
An Evidence-Based Approach
, pp. 49 - 62
Publisher: Cambridge University Press
Print publication year: 2026

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Ward, SP. Thalidomide and congenital abnormalities. BMJ. 1962; 2(5305): 646–7.10.1136/bmj.2.5305.646CrossRefGoogle ScholarPubMed
Rose, S, Bisson, J, Wessely, S. A systematic review of single-session psychological interventions (‘debriefing’) following trauma. Psychother Psychosom 2003; 72(4): 176–84.CrossRefGoogle ScholarPubMed
Benne, Gunnell Dwith O, Simkin, S, Cooper, J, Klineberg, E, Rodway, C, Sutton, L, Steeg, S, Wells, C, Hawton, K, Kapur, N. Time trends in coroners’ use of different verdicts for possible suicides and their impact on officially reported incidence of suicide in England: 1990–2005. Psychological Medicine. 2013; 43(7): 1415–22.Google Scholar
Gunnell, D, Hawton, K, Kapur, N. Coroners’ verdicts and suicide statistics in England and Wales. BMJ. 2011; 343: d6030.10.1136/bmj.d6030CrossRefGoogle ScholarPubMed
Hawton, K, Bergen, H, Cooper, J, Turnbull, P, Waters, K, Ness, J, Kapur, N. Suicide following self-harm: Findings from the multicentre study of self-harm in England, 2000–2012. Journal of Affective Disorders. 2015; 175: 147–51.10.1016/j.jad.2014.12.062CrossRefGoogle ScholarPubMed
National Confidential Inquiry into Suicide and Safety in Mental Health. Annual Report: England, Northern Ireland, Scotland and Wales. University of Manchester. 2021. https://sites.manchester.ac.uk/ncish/reports/annual-report-2021-england-northern-ireland-scotland-and-wales/.Google Scholar
Office for Health and Disparities Near to Real Time Suspected Suicide Surveillance (NRTSSS) for England. Statistical Report: NRTSSS for England for a 15-Month Period to August 2023. 2024. www.gov.uk/government/statistics/near-to-real-time-suspected-suicide-surveillance-nrtsss-for-england/statistical-report-near-to-real-time-suspected-suicide-surveillance-nrtsss-for-england-for-the-15-months-to-august-2023.Google Scholar
Appleby, L, Richards, N, Ibrahim, S, Turnbull, P, Rodway, C, Kapur, N. Suicide in England in the COVID-19 pandemic: Early observational data from real time surveillance. Lancet Regional Health – Europe. 2021; 4: 100110.10.1016/j.lanepe.2021.100110CrossRefGoogle ScholarPubMed
Hunt, IM, Windfuhr, K, Shaw, J, Appleby, L, Kapur, N. Ligature points and ligature types used by psychiatric inpatients who die by hanging: a national study. Crisis. 2012; 33(2): 8794.CrossRefGoogle ScholarPubMed
Kapur, N, Hunt, IM, Windfuhr, K, Rodway, C, Webb, R, Rahman, MS, Shaw, J, Appleby, L. Psychiatric in-patient care and suicide in England, 1997 to 2008: A longitudinal study. Psychological Medicine. 2013; 43(1): 6171.CrossRefGoogle ScholarPubMed
Rose, SC, Bisson, J, Churchill, R, Wessely, S. Psychological debriefing for preventing post-traumatic stress disorder (PTSD). Cochrane Database of Systematic Reviews. 2002; 2: CD000560.Google Scholar
Dror, IE. Cognitive and human factors in expert decision making: Six fallacies and the eight sources of bias. Analytical Chemistry. 2020; 92(12): 79988004.10.1021/acs.analchem.0c00704CrossRefGoogle ScholarPubMed
Price, A, McCormack, R, Wiseman, T, Hotopf, M. Concepts of mental capacity for patients requesting assisted suicide: A qualitative analysis of expert evidence presented to the Commission on Assisted Dying. BMC Med Ethics. 2014; 15: 32.10.1186/1472-6939-15-32CrossRefGoogle Scholar
Poole, R, Higgo, R. Clinical Skills in Psychiatric Treatment. Cambridge: Cambridge University Press; 2008.10.1017/CBO9780511544217CrossRefGoogle Scholar
Priebe, S, Bhatti, N, Barnicot, K, Bremner, S, Gaglia, A, Katsakou, C, Molosankwe, I, McCrone, P, Zinkler, M. Effectiveness and cost-effectiveness of dialectical behaviour therapy for self-harming patients with personality disorder: A pragmatic randomised controlled trial. Psychother Psychosom. 2012; 81(6): 356–65.10.1159/000338897CrossRefGoogle ScholarPubMed
McHugo, GJ, Drake, RE, Whitley, R, Bond, GR, Campbell, K, Rapp, CA, Goldman, HH, Lutz, WJ, Finnerty, MT. Fidelity outcomes in the national implementing evidence-based practices project. Psychiatric Services. 2007; 58: 1279–84.10.1176/ps.2007.58.10.1279CrossRefGoogle ScholarPubMed
Jain, D, Sharma, R, Reddy, S. Surgery checklist: Barriers to universal acceptance. J Anaesthesiol Clin Pharmacol. 2018. 34(1); 710.10.4103/joacp.JOACP_307_16CrossRefGoogle ScholarPubMed
Andreotti, ET, Ipuchima, JR, Cazella, SC, Beria, P, Bortoncello, CF, Silveira, RC, Ferrão, YA. Instruments to assess suicide risk: A systematic review. Trends Psychiatry Psychother. 2020 Jul–Sep; 42(3): 276–81.10.1590/2237-6089-2019-0092CrossRefGoogle ScholarPubMed
Hawton, K, Bergen, H, Cooper, J, Turnbull, P, Waters, K, Ness, J, Kapur, N. Suicide following self-harm: Findings from the Multicentre Study of Self-Harm in England, 2000–2012. Journal of Affective Disorder. 2015; 175: 147–51.CrossRefGoogle ScholarPubMed
National Confidential Inquiry into Suicide and Safety in Mental Health. The Assessment of Clinical Risk in Mental Health Services. Manchester: University of Manchester; 2018. https://sites.manchester.ac.uk/ncish/reports/the-assessment-of-clinical-risk-in-mental-health-services/.Google Scholar
Hawton, K, Bergen, H, Simkin, S, Dodd, S, Pocock, P, Bernal, W, Gunnell, D, Kapur, N. 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. 2013; 346: f403.CrossRefGoogle ScholarPubMed
Lee, YY, Chisholm, D, Eddleston, M, Gunnell, D, Fleischmann, A, Konradsen, F, Bertram, MY, Mihalopoulos, C, Brown, R, Santomauro, DF, Schess, J, van Ommeren, M. The cost-effectiveness of banning highly hazardous pesticides to prevent suicides due to pesticide self-ingestion across 14 countries: An economic modelling study. Lancet Glob Health. 2021; 9: e291300.10.1016/S2214-109X(20)30493-9CrossRefGoogle ScholarPubMed
Rhee, P, Prabhakaran, K, Joseph, B, Simely, A, Okumura, K, Klein, J, Policastro, A, Lombardo, G, Latifi, R. Firearm deaths are increasing and endemic in the USA: It is a problem of suicides and not homicides. World J Surg. 2021; 45: 1323–9.CrossRefGoogle Scholar
Homant, RJ, Kennedy, DB. Suicide by police: A proposed typology of law enforcement officer‐assisted suicide. Policing: An International Journal. 2024; 23(3): 339–55.Google Scholar
Wilson, JF. Finland pioneers international suicide prevention. Ann Intern Med. 2004; 140: 853–6.CrossRefGoogle ScholarPubMed
Jiang, H, Niu, L, Hahne, J, Hu, M, Fang, J, Shen, M, Xiao, S. Changing of suicide rates in China, 2002–2015. Journal of Affective Disorders. 2018; 240: 165–70. www.sciencedirect.com/science/article/pii/S0165032718303768.10.1016/j.jad.2018.07.043CrossRefGoogle Scholar

Accessibility standard: Unknown

Why this information is here

This section outlines the accessibility features of this content - including support for screen readers, full keyboard navigation and high-contrast display options. This may not be relevant for you.

Accessibility Information

Accessibility compliance for the PDF of this book is currently unknown and may be updated in the future.

Save book to Kindle

To save this book 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 saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved 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.

Available formats
×

Save book to Dropbox

To save content items to your account, please 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 account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please 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 account. Find out more about saving content to Google Drive.

Available formats
×