Suicide in NI: Does Northern Ireland have a deepening suicide crisis?

• This claim features a series of small misrepresentations and errors. However, while the number of suicides registered annually in Northern Ireland seems to be pretty stable, that does not in any way suggest this is not a major issue that requires political and civic attention. Every death by suicide is a tragedy.
• For examining trends in suicide rates, NISRA uses a three-year rolling average of registered suicides and this has barely changed in the last four annual reports.
• The latest official suicide statistics for Northern Ireland indicate that in 2023 a total of 221 deaths by suicide were REGISTERED in Northern Ireland.
• However, this does not mean these deaths OCCURRED in 2023 due to the lengthy and complicated process for recording the deaths.
• There was a 9% rise in the number of deaths by suicide registered between  2022 (203) and 2023 (221), but this does not mean there was an increase in the number of suicides that OCCURRED, year on year.
• Guidance from NISRA and research from Westminster cautions against using year-on-year comparisons between figures of registered suicides to illustrate any points or draw any conclusions – instead, they urge people to consider changes over a longer period of time.

[If you, or anyone you know, may be at risk of harm there are people you can talk to. Help is available. In Northern Ireland specifically, please don’t hesitate to contact any or all of the following groups dedicated to helping people who are in or at risk of crisis: Samaritans ; PIPS ; Lighthouse ; PAPYRUS (Prevention of Young Suicide) Aware. In particular, Lifeline is Northern Ireland’s crisis response helpline . Call: 0808 808 8000. Textphone: 18001 0808 808 8000]

In a statement made to the Northern Ireland Assembly on 9 September, SDLP MLA Mark H. Durkan said:

“Tomorrow is World Suicide Prevention Day. It is a day when we reflect and remember the people whose lives were cut short by suicide. Those people are not just statistics; they are sons, daughters, mothers, fathers, brothers, sisters, friends and neighbours. However, the Executive seem to have become desensitised to that fact. In 2023, 221 people died by suicide, which is an 8% increase on the previous year. That is 221 more empty seats at dinner tables and 221 more families who have been shattered forever …

“Suicide prevention is shamefully absent from the Programme for Government. Protect Life 2 and the mental health strategy were launched with great promise yet remain chronically underfunded, under-scrutinised and under-delivered. While we delay, the crisis deepens.”

This fact check looks at the MLA’s claim that “In 2023, 221 people died by suicide, which is an 8% increase on the previous year” and his statement that “the crisis deepens”.

There are several technical problems with this claim, which misrepresents what Northern Ireland’s annual suicide statistics actually record, and also highlights a problematic comparison without providing the full context. However, neither this nor our rating of this fact check diminish the seriousness of suicide as an issue within Northern Ireland or the need to make efforts to address it in politics, within communities, and among family and friends.

According to the latest annual report on suicide statistics by the Northern Ireland Statistics and Research Agency (NISRA), which was published in February of this year and covers 2023, the number of suicides registered in NI in 2023 was 221.

However, this is not the same as saying that 221 suicides occurred in 2023. The process for formally registering local deaths as suicides tends to create a delay between a death occurring and it being registered. For instance, fewer than half of the deaths by suicide registered in 2020 actually took place that year.

The second part of the numerical claim shares the same issue. The number of deaths by suicide registered in 2022 was 203, meaning that there was an 8.87% increase in the number of deaths registered between 2022 and 2023. However, once again this increase covers the number of deaths registered rather than which occurred (while the increase itself is more like 9% than 8%, as cited by the SDLP MLA).

Furthermore, advice from both NISRA – as well as Westminster – indicates that year-on-year comparisons between suicide figures do not necessarily provide evidence of any significant change or illustrate anything about trends over time. Instead, it is suggested that any analysis should take into account longer time frames. NISRA itself includes data on three-year rolling averages to better interrogate any changes over time.

Mr Durkan’s highlight the year-on-year increase in registrations (and said they were occurrences) increase without qualifying it with any mention of this advice. Moreover, recent three-year averages for the number of local suicides registered annually does not support the idea that NI’s suicide crisis is deepening. This figure has remained very consistent in the past four years for which there is data: there was a rolling average of 220.0 in 2020, 220.3 in 2021, 219.7 in 2022 and 220.3 in 2023.

For more information – including details about how deaths by suicide are registered, how this methodology has changed in the last decade, and the usefulness of three-year averages – read on.

• Source

FactCheckNI contacted Mr Durkan about this claim. His office responded to say this statement was based on data provided by NISRA, and pointed us to the latest annual statistical bulletin on this subject – Northern Ireland Suicide Statistics, 2023.

• Latest figures

The latest annual report on NI suicide statistics was published on 5 February this year and covers the period up to and including 2023. It begins with an explanation of what these statistics actually detail:

“Suicide statistics and mortality statistics more generally are published by NISRA as the number of deaths registered within a calendar year, rather than the number of deaths that occurred in that period.”

The way potential suicides in NI are investigated, confirmed and then registered can lead to significant delays between the death occuring and it being registered. This process, and the delays involved, are covered in greater detail at the end of this article.

For now, it is vital to understand that annual suicide figures do not necessarily outline all the deaths by suicide that occurred in that year – instead it is about deaths registered in that year.

Some of the report’s key points include that:

• Since 2015, annual numbers of registered suicides have fluctuated, ranging from 195 in 2016 to 237 in 2021. There were 221 suicide deaths registered in Northern Ireland in 2023. Considering a three-year average trend drawing on post review data (from 2015), the average rose from 204.7 in 2017 to 220.3 in 2021 and has remained at a similar level since then (220.3 in 2023). 
• The age-standardised suicide rate in Northern Ireland was 13.3 deaths per 100,000 population in 2023. This rate has fluctuated since the start of the revised series (2015), ranging from 11.9 per 100,000 in 2016 to 14.3 per 100, 000 in both 2018 and 2021.
• The percentage of suicides in 2023 within Northern Ireland’s most deprived areas (28.5%) was over twice that of the least deprived areas (13.1 per cent). Three quarters of suicides registered in 2023 were men.
• The NI 2023 age-standardised rate of 13.3 suicides per 100,000 population was lower than the rate for Scotland (14.6) but higher than the rate for England and Wales (11.4). It should be noted that comparisons will be affected by differences in data collection and collation processes in the separate jurisdictions. 

Note that Mr Durkan’s claim states that “[in] 2023, 221 people died by suicide, which is an 8% increase on the previous year.” Based on the way the statistics are compiled, this is not quite right. Instead, 221 deaths by suicide were registered in that year. 

This matches the figure cited by Mr Durkan. We will examine whether this represents an 8% rise compared with 2022 in the section below.

The age profile and sex of the people whose deaths by suicide were registered in 2023 are shown in the graph below.

Figure 1 – source: NISRA

• Comparisons over time

How has the number of suicides registered annually changed over time?

Note that, due to changes in what qualifies as a death by suicide made in the past decade combined with a number of subsequent data revisions (more on all of this later), comparisons between data pre- and post-2015 should be treated with real caution.

The table below shows the numbers of deaths by suicide registered in NI in each year since 2015, when data collated in line with current methodology first became available. 

It also includes three-year rolling averages for these figures, which can be useful to provide a better idea of actual trends in suicide data and smooth out variations (explained in a House of Commons Library paper). This might have particular importance given the way deaths by suicide are registered in Northern Ireland and the fact that, in theory at least, a spike in annual figures could be the result of a backlog among the work of coroners meaning that more deaths from previous years were registered in that later year than is usually the case.

We have included three-year rolling average data from 2017 onwards to ensure the three years under consideration all fall within the new methodology. As NISRA states in its latest report:

“Fluctuations year on year are not necessarily an indication of a ‘true’ change and it is important to look at suicide trends over a longer period of time.”

Figure 2 – source: NISRA

The number of deaths by suicide registered in 2023 is 221, which is 8.87% higher than the total registered in 2022. This is similar to the claim by Mr Durkan – he said there was an 8% rise when in fact it is more like 9%.

However, there are two qualifications to bear in mind. The first is the same as has been repeated several times throughout this article – these are not the total number of deaths by suicide that took place in a given year, the are the number of suicides registered.

The number of suicides registered in a given year can be significantly different than the number which occurred. As we outline in more detail towards the end of this article, the median delay between a death occurring in NI and being recorded by a registrar has tended to hover between 100 and 200 days for most of the 2010s.

However, the lengths of delay in individual cases can be much longer than this. For instance, in 2020 a total of 219 deaths by suicide were registered but only 101 – less than half – actually took place in that year. Of the rest, 103 occurred in 2019, 10 occurred in 2018, with the remaining 5 occurring in 2017 or earlier.

And that’s not all. As mentioned already, NISRA itself cautions that year-on-year fluctuations in suicide figures are “not necessarily an indication of a ‘true’ change and it is important to look at suicide trends over a longer period of time.”

• Is the crisis deepening?

Mr Durkan has compared one year’s figures to the next without any longer-term view.

However, as can be seen from the table above (Figure 2), the three-year rolling average for the number of annual suicides registered has barely changed at all over the past four years: 220.0 in 2020, 220.3 in 2021, 219.7 in 2022 and 220.3 in 2023.

The stability of the three-year rolling average can be seen in the following graph from NISRA, which also provides a clear break between pre-2015 data and subsequent statistics collected using the newer methodology (again, more on this later).

Figure 3 – source: NISRA

• Considering a rating

Part of FactCheckNI’s process is the assignment of a rating to the claims we investigate.

Although Mr Durkan cited the correct number (221) in his speech delivered to the Assembly, he did not explain this figure correctly and inferred that the deaths took place in 2023 when they were instead registered in 2023.

It’s an easy mistake to make, but the NISRA report makes the distinction clear, and legislators should cite evidence accurately.

Statistical advice is clear that fluctuations between one year and another should be treated with caution, according to both NISRA and guidance from Westminster, as they do not necessarily show a “true” change.

Using the recommended three-year rolling averages as a better measure of trends over time, the registered number of deaths by suicide has remained remarkably consistent in recent years:  220.0 (three years to 2020), 220.3 (2021), 219.7 (2022) and 220.3 (in the most recent figures up to 2023).

Note how NISRA presents this information on the first page of the report Mr Durkan cited:

Figure 4 – source: NISRA screencap

Based on all the above, we have decided to rate this claim as INACCURATE WITH CONSIDERATION/IT’S COMPLICATED/SOMETHING OR OTHER.

However, this in no way downplays the scale or seriousness of deaths by suicide or mental health as an issue for Northern Ireland. Every death by suicide is a tragedy.

Furthermore, the core purpose of our fact checking is to ensure rigour and accuracy in claims of fact – it is not to judge the people making those claims, or their motives.

For a more in-depth look at how suicide statisics are compiled, how the methodology has changed in the past decade, the effects of all this on data comparisons as well as some information on how best to interpret these figures, read on.

• Occurrence year

NISRA does ultimately publish data about the number of suicides that occur in a given year. However, compiling these figures takes longer than collating information about deaths by suicide that have been registered. NISRA states:

“While annual data based on the date of occurrence are accurate if enough time has lapsed, for more recent years they will be incomplete as more registrations will follow. Most suicide deaths (98 per cent) are registered within three years of the death occurring.”

The following graph compares annual registrations of deaths by suicide with the number of suicides that occurred in each year. However, the latter data is only available up until 2022 and, even then, some more recent years may still be subject to revision.

Figure 6 – source: NISRA

• Statistical classification

To understand all this figures properly, it is necessary to know how deaths become recorded as suicides, and how long this takes.

In Northern Ireland, deaths are recorded as suicides according to criteria from the UK National Statistics definition, which “includes deaths from Self-inflicted Injury for persons aged 10 and over as well as Events of Undetermined Intent for those aged 15 and over.”

FactCheckNI has previously written in detail about these different definitions and how they are applied – for a lengthier explanation, read here.

The process of recording a death as a suicide takes some time. Suspicious deaths are referred to a coroner and a registrar will only record the death as a suicide when they receive a report from the coroner confirming this to be the case.

This means that, in the case of suicides, there is a delay between the death occurring and it being recorded. Annual suicide statistics, such as those outlined above, compile information about deaths recorded as suicide, which means some some deaths by suicide do not appear in data for the year in which the death took place but instead in some later year when the death was recorded by a registrar.

NISRA also provides a User Guide to Suicide Statistics in Northern Ireland which includes a graph showing the median delay between a death by suicide occuring and it being certified by a registrar.

Figure 5 – source: NISRA

As can be seen, the median delay was consistently less than a year since 2001 and under 200 days for the period between 2010 and 2020. However, the delays can vary significantly between different incidents. The user guide notes:

“For example, of the 219 such deaths registered in 2020, 101 actually occurred in 2020, 103 occurred in 2019, 10 occurred in 2018, with the remaining 5 occurring in 2017 or earlier.”

FactCheckNI also asked the Department of Finance (which handles media enquiries for NISRA) about the median delay and they referred us to the user guide above, adding that:

“Latest publicly available figures on registration times for suicides (2020), show that the median time taken to register a suicide death in NI was 174 days.”

This is similar to delays in England where, according to the Office for National Statistics (ONS), “deaths tend to be registered around five to six months after they occurred.”

• Changes in statistics

Within the past decade, changes have been made in what deaths can be classified as suicide in Northern Ireland.

In particular, one of these changes was a re-classification of drug-related deaths from being undetermined – and, therefore, within the boundaries of the definition of suicide – to being accidental (so outside of the definition of suicide).

In 2019, under the new definitions, the number of recorded deaths by suicide (ultimately 197) was a significant fall on the 2018 figure of 309. NISRA says that, in light of this, it decided to “review and revise individual undetermined drug related deaths from 2015 to 2018 …  later extended to include 2020 data as well as some non-drug related cases from 2015-2019.”

That review has since been completed and a report outlining the process and outcomes was published in May 2022. Significant care should be taken when comparing modern data on annual suicides with any statistics from before 2015.

However, the changes may not stop there. As the result of legal case that took place in the High Court in England in July 2018, the legal threshold used by coroners to determine whether a death was caused by suicide has been lowered from the criminal standard of “beyond all reasonable doubt” to the civil standard of “on the balance of probabilities” NISRA says it will monitor and report on the effects of this change but that “it will take time to gather enough data to assess the impact of the change.”

• Talk to someone

Poor mental health can affect anyone.

If you, or anyone you know, may be at risk of harm there are people you can talk to. Help is available.

In Northern Ireland specifically, please don’t hesitate to contact any or all of the following groups dedicated to helping people who are in or at risk of crisis:

Samaritans

PIPS

Lighthouse

PAPYRUS (Prevention of Young Suicide)

Aware

In particular, Lifeline is Northern Ireland’s crisis response helpline

Call: 0808 808 8000

Textphone: 18001 0808 808 8000