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Substance Abuse Associated with Increased Suicides and Homicides in Northern Ireland

 A new report by the University of Manchester has found that alcohol and drugs are associated with increased homicide and suicide rates in Northern Ireland.

The report, called the “Suicide and Homicide in Northern Ireland Report” also found that the increased suicide rate in Northern Ireland is greatest among young people. There were 332 suicides in people under age 25 during the study period (2000 to 2008), with mental illness, substance abuse, previous self-harm, and deprivation as contributing factors in most cases.

The survey found that a total of 1,865 suicides occurred in Northern Ireland between 2000 and 2008, or 207 per year—a rate that is higher than the United Kingdom’s but lower than Scotland’s.

During the study period, there were 533 suicide in mental health patients—those who had received mental health treatment in the previous year—amounting to 29 percent of all suicides and corresponding to 58 patient deaths per year.

Young people who committed suicide were more likely than others to be living in poor areas, and had to lowest rate of receiving mental health services at 15 percent. Young mental health patients who committed suicide also tended to have high rates of drug abuse (65 percent), alcohol abuse (70 percent), and previous self-harm (73 percent).

The study also found that there were 142 homicide convictions between 2000 and 2008, equating to 16 homicides per year. This rate is similar to that of England but lower than that of Scotland.

Louis Appleby, professor of psychiatry at the University of Manchester and NCI Director, said that alcohol abuse was a factor in 60 percent of patient suicides, and alcohol dependence was the most common clinical diagnosis in patients convicted of homicide, more than half of whom had a problem prior to conviction.

The report also found that there were no “stranger homicides” by a patient with mental illness throughout the study period. “Stranger homicides” refer to the killing of a stranger or unknown person, which is likely to be associated with mental illness. This report suggests otherwise, however, in that there were no “stranger homicides” among those with mental illness. Appleby noted that although almost a third of homicides involved the killing of a stranger, they were not associated with a mental disorder.

The report also found that the suicide rate in Northern Ireland (in the general population and among mental health patients) increased in the later part of the study period, in contrast to the United Kingdom. There were 35 in-patient suicides between 2000 and 2008, with 28 percent occurring off-site. Eight occurred while the patient was under observation.

The researchers recommend that better care planning prior to being discharged from the hospital, including patient follow-up within seven days, could reduce the risk of suicide and homicide by patients. The study found that 125 patient suicides and nine patient homicides occurred within three months of being discharged from the hospital.

In addition, introducing an assertive outreach function into the community health services through staff training, reduced case loads, and new team structures could help reduce suicide and homicide cases.

Source: Science Daily, Alcohol Blamed for High Suicide Rates in Northern Ireland, June 28, 2011

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