Suicidal behaviours in South East London: Prevalence, risk factors and the role of socio-economic status (2013)
Lisa Aschan, Laura Goodwin, Sean Cross, Paul Moran, Matthew Hotopf, Stephani L. Hatch
Suicidal behaviours, such as thoughts about and attempts of suicide, are more common in those in lower socioeconomic groups (for example those who are unemployed, or have a lower income or education). Given that common mental disorders, such as depression, are also more common among lower socio-economic status (SES) groups, this may explain why suicidal behaviours are more common in lower SES groups. However, there may also be other reasons why suicidal behaviours are more common in low SES groups.
We aimed to 1) look at how common suicidal behaviours are in the community; 2) describe which factors are related to suicidal behaviours; and 3) test if mental health problems could explain why there were more suicidal behaviours in low socioeconomic groups.
How the study was conducted
Information on suicidal behaviours was gathered by asking participants in the South East London Community Health Survey (SELCoH) about suicidal thoughts and suicide attempts during their lifetime. We used the same questions as those from a national health survey (2007 Adult Psychiatric Morbidity Survey in England, APMS). Mental health was measured using structured interviews for common mental disorders (like depression or anxiety), post-traumatic stress disorder, personality dysfunction, and hazardous alcohol use, and a questionnaire about illicit drug use. This study also used five different measures of SES: income, education, benefits receipt, housing tenure and employment. These five measures were combined using statistical methods to create a single measure of SES.
What we found
Both suicidal thoughts and suicide attempts were more common in people from the SELCoH survey compared to England overall. Around one fifth of the individuals from SELCoH (20.5%) reported experiencing suicidal thoughts during their lives, compared to 13.7% in APMS. 8.1% from SELCoH reported previous suicide attempts compared to 4.8% in APMS. We found that suicidal behaviours were more common in those with poor mental health, those who were non-married or non-cohabitating, and those in lower SES groups. Suicidal behaviours were less common in Black African ethnic groups and women reported more suicide attempts.
The association between SES and suicidal thoughts was explained by the fact that mental health problems were also more common in those with a lower SES. The association between SES and previous suicide attempts was not found to be explained by mental health problems.
Identifying individuals who are more likely to develop suicidal thoughts or attempt suicide is an important clinical goal for services. This study showed that people from low SES groups are at greater risk, specifically those who are not working, whether due to unemployment or limiting health problems. Mental health interventions to prevent suicide might be particularly effective if they focused on these groups. Suicidal behaviours were also more common in the South East London area compared to England. This might partially be explained by greater socio-economic deprivation in the local area.
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