Quarterly suicide death registrations in England: 2001 to 2019 registrations and Quarter 1 (Jan to Mar) to Quarter 3 (July to Sept) 2020 provisional data

• Provisional data show there were 10.7 suicide deaths per 100,000 people in Quarter 3 (July to Sept) 2020 in England, equivalent to 1,334 deaths registered; this rate is similar to rates seen in the third quarter of previous years.

• In the provisional Quarter 3 2020 data, there were 16.3 deaths per 100,000 males (992 deaths registered) and 5.4 suicide deaths per 100,000 females (342 deaths registered); these rates are similar to rates observed in the same quarter in previous years.

• Whilst the provisional rates observed in Quarter 3 2020 for men and women are statistically significantly higher compared with Quarter 2 (Apr to June) 2020, this is because of the lower number of suicides registered in Quarter 2 that have subsequently been registered in Quarter 3.

• The lower number of suicides registered in Quarter 2 2020 is likely to be caused by the coronavirus (COVID-19) pandemic having an impact on the coroner's service resulting in delays to inquests.

If you are a journalist covering a suicide-related issue, please consider following the Samaritans' media guidelines on the reporting of suicide, owing to the potentially damaging consequences of irresponsible reporting. In particular, the guidelines advise on terminology and include links to sources of support for anyone affected by the themes in the article, such as Samaritans.

If you are struggling to cope, please call Samaritans for free on 116 123 (UK and Ireland), email jo@samaritans.org or visit the Samaritans website to find details of the nearest branch. Samaritans is available round the clock, every single day of the year, providing a safe place for anyone struggling to cope, whoever they are, however they feel, whatever life has done to them.

Around two in five of the suicides registered to the end of September in 2020 had a date of death that was also in 2020

The data reported in this release cannot be used to show the number of suicides with a date of death in 2020, including those that occurred during the coronavirus (COVID-19) pandemic.

Of the 3,441 suicides registered in England between January and September of 2020, around two in five of these had a date of death that was also in 2020 (1,375 deaths or 39.9%). This is in line with expectation, given coroner involvement with the investigation of these deaths and the amount of time it takes to hold an inquest.

Looking at Quarter 1 (Jan to Mar) of 2020 specifically, 3.6% of the 1,262 suicides registered in this period had a date of death in the same period (45 deaths), with the remaining deaths (96.4% or 1,217 deaths) occurring before 2020.

For Quarter 2 (Apr to June) of 2020, 5.3% of the 845 suicides registered in the period occurred in the same period (45 deaths), with the remaining deaths occurring in the first quarter of 2020 (43.7% or 369 deaths) or prior to 2020 (51.0% or 431 deaths).

For Quarter 3 (July to Sept) of 2020, 5.3% of the 1,334 suicides registered in the period occurred in the same period (71 deaths), with the remaining deaths occurring in the first quarter of 2020 (34.9% or 466 deaths), the second quarter of 2020 (28.3% or 378 deaths) or prior to 2020 (31.4% or 419 deaths).

The increase in registered suicides during the third quarter of 2020 likely reflects the resuming of coroner’s inquests

The number and rate of registered deaths from suicide increased in the third quarter of 2020 when compared with the second quarter of 2020. However, this increase likely reflects the resuming of coroner’s inquests as opposed to a genuine increase in suicide. The suicide rate in the third quarter of 2020 is similar to those observed in the same quarter in previous years. We will continue to monitor and update the statistics on a quarterly basis.

The number of suicides registered in the second quarter of 2020 is lower than expected and should be interpreted with caution

The 845 suicides registered in the second quarter of 2020 is the lowest number of any quarter since 2001, when the data time series reported for this statistical release begins.

These numbers should be interpreted with caution. It is likely that the lower number of suicides registered in this period reflects the impact of the coronavirus pandemic on the coroner’s service in England and Wales, for example, delays to inquests caused by the service adapting to social distancing measures. It is unlikely that the reduction in registered deaths reflects a genuine reduction in the number of suicides. Further information on the reduction in the second quarter of 2020 can be found in our previous release.

In England and Wales, when someone dies unexpectedly, a coroner investigates the circumstances to establish the cause of death. In July 2018, the standard of proof used by coroners to determine whether a death was caused by suicide was lowered to the “civil standard” – balance of probabilities – where previously a “criminal standard” was applied – beyond all reasonable doubt.

Since the change in the standard of proof, suicide rates have not seen unprecedented increases. Recent increases have been seen among English males and females, but these increases started before the change in the standard of proof.

Whenever a change in suicide rates occurs, the reasons are complex and will rarely be because of one factor alone. For further information on the impact of the legal change see Change in the standard of proof used by coroners and the impact on suicide death registrations data in England and Wales.

Suicide

This release is based on the National Statistics definition of suicide: this includes all deaths from intentional self-harm for persons aged 10 years and over and deaths where the intent was undetermined for those aged 15 years and over. For further information on the definition used, please see our annual release.

Year of registration

Figures are based on deaths registered in each calendar year, rather than the date on which the death occurs.

Registration delay

The registration delay refers to the time lag between the date of death (that is, when the death occurred) and the date the death was registered. For further information on the impact of registration delays, see Section 6.

Age-standardised mortality rate

Age-standardised mortality rate in this bulletin refers to a weighted average of the age-specific mortality rates per 100,000 people and standardised to the 2013 European Standard Population. They allow for differences in the age structure of populations and therefore allow valid comparisons to be made between geographic areas, the sexes and over time. For more information see section 9 of the Suicide rates in the UK QMI.

Statistical significance

The term "significant" refers to changes or differences based on unrounded figures. Significance has been determined using the 95%, where instances of non-overlapping confidence intervals between figures indicate the difference is unlikely to have arisen from random fluctuation. For more information see section 9 of the Suicide rates in the UK QMI.

Figures are for deaths registered, rather than deaths occurring in each quarter. In England, deaths caused by suicide are investigated by coroners; the investigation, known as an "inquest", can take months and sometimes years. The amount of time it takes to complete an inquest creates what is known as a "registration delay", which is a lag between the date of death and the date of death registration. For deaths caused by suicide, this generally means that around half of the deaths registered in a given year will have occurred in the previous year or earlier.

As such, publishing suicide figures based on death registration year means that many deaths appear in the statistics of a year that is later than the year in which the death occurred. Despite registration delays, publication of suicide statistics by registration year enables figures to be published in a timely manner. The alternative would be to publish statistics based on the year in which the death occurred. However, this would delay publication, cause repeated revisions to historical data and be inconsistent with other published mortality figures. Additionally, data provided in our annual release (Suicide occurrences, England and Wales) show that when you compare rates based on registration year and rates based on the date of death, these follow the same pattern of peaks and troughs over time.

Quarterly age-standardised rates

Age-standardised mortality rates are calculated using the number of deaths and mid-year population estimates provided by our Population Estimates Unit. Mid-year population estimates were used for 2001 to 2019 rate calculations whilst 2018-based ONS population projections were used for 2020 age-standardised rates. For more information on age-standardisation, please see the Quality and Methodology Information report.

Calculation of mortality rates for quarterly deaths requires adjustments to be made to annual population estimates in order to calculate rates that are comparable with annual rates.

We calculate an annual population centred on the mid-point of the quarter using two years' worth of population estimates or projections. This is then multiplied by the proportion of the number of days within a quarter of the total number of days within that year. The output is used as the population denominator in calculations of age-standardised and age-specific morality rates.

Quarter 3 (2020) population:

where:

• m is the number of days from 1 July 2020 (the start of the mid-year for the population estimate) to the mid-point of the relevant quarter, inclusive

• N is the number of days in the quarter, for example, Quarter 3 (July to Sept) 2020

• M is the number of days in 2020

• (i) is the age group

Quality and methodology

More quality and methodology information on strengths, limitations, appropriate uses, and how the data were created, including the change in the standard of proof, is available in the Suicide rates in the UK QMI. It is also explained in this article: New standard of proof for suicide at inquests in England and Wales.

This release aims to monitor suicide death registrations in England, based on the best available provisional data.

Quarterly data for 2020 are provisional and may be subject to changes once annual death registrations are complete. For example, some deaths may be registered but the underlying cause of death has not yet been coded. Data for 2020 will be finalised in the annual Suicides in the UK release in 2021.

Quarterly age-standardised rates are included to aid interpretation, such as whether changes by quarter in a given registration year are statistically meaningful. This is especially important when interpreting low numbers of deaths, which are prone to random fluctuation and volatility over time.

Numbers of suicides by quarter are often small, particularly where males and females are analysed separately, as demonstrated by the relatively wide confidence intervals. For this reason, any comparisons should be interpreted with caution and particular attention should be paid to overlapping confidence intervals where differences are then not statistically significant.

Since the beginning of our data time series in 2001, the number of suicide registrations in Quarter 1 (Jan to Mar) tends to be lower than those observed in any of the other quarters, something that should be kept in mind when making comparisons. Further guidance on how to interpret the data included in this release is available in the "Table interpretation" tab of the accompanying dataset.