Factors associated with the recent decline in suicide rates in the elderly in England and Wales, 1985-1998

Elderly suicide rates have declined in recent years in several countries including England and Wales. This study examined the association between a trend of decline in age-specific suicide rates in the elderly in England and Wales and changes in various health and social factors for the period 1985 to 1998. Data on age-specific suicide rates was ascertained from the annual mortality statistics for the years 1985 to 1998. Data on the various health and social variables was ascertained from both the Statistics Division at the Department of Health and the Health and Personal Social Services Statistics, the yearly publications of the Department of Health from 1985 to 1998. The main findings of this study were (i) a significant negative correlation between the number of general practitioners and all categories of wholetime-equivalent (WTE) hospital medical staff and suicide rates for each of the four five-year age bands for males and females after the age of 65; (ii) a significant negative correlation between the number of new outpatient appointments for mental illness and suicide rates in males and females for each of the four five-year age bands between the ages 65-85 years; (iii) a significant positive correlation between the average daily number of available beds for mental illness and elderly suicide rates, for all five-year age bands between the ages 65-85 years; (iv) a significant negative correlation between the number of field social work staff and day centre staff and elderly suicide rates for each of the four five-year age bands after the age of 65 for males and females; and, (v) a significant positive correlation between the total number of elderly in all residential homes and the number of elderly in local authority residential homes and elderly suicide rates for each of the four five-year age bands between the ages 65-85 years for males and females. A trend of decline in age-specific suicide rates in the elderly in England and Wales from 1985 to 1998 was significantly associated with changes in various health and social variables. These included the number of general practitioners and hospital medical staff, the hospital psychiatric services, the number of local authority staff and the number of elderly residents in accommodation supported by a local authority. The results of this study suggest that changes in these variables may be important factors contributing to the recent decline in suicide rates but this effect should be viewed in the context of other health and social factors.