Rates of suicide in England and Wales have plummeted in middle-aged and elderly men

Jul 10 2004

British men who hit their mid-fifties today are half as likely to kill themselves as their fathers and grandfathers.

Rates of suicide in England and Wales have plummeted in middle-aged and elderly men, who are less likely to kill themselves than men in their 20s and 30s, Professor John Snowdon of the University of Sydney, Australia, told the conference.

He said the trend revealed by the Office of National Statistics was not global. While a similar pattern appeared to be emerging in Australia, it was not occurring in the US, Japan and the rest of Europe, where suicide rates steadily increase with age. In both Britain and Australia, much lower rates of suicide in women have hardly changed since the 1950s.

Professor Snowdon said better identification of depression in older people had contributed to the reduction in suicide rate. ‘Only around 4 per cent of young people who kill themselves are depressed compared to 47 per cent of over 55-year-olds and 57 per cent of over 75-year-olds. Doctors have a lot to congratulate themselves on. Their success in recognising depression in older men and the arrival of modern anti-depressants (SSRIs) have meant that once they recognise severe depression, they feel confident about treating it,’ he said.

Other changes that might have contributed to men’s deciding to stay alive include increased affluence, better access for the disabled, improved treatment of painful conditions and, just possibly, Tony Blair. ‘There is some evidence that suicide rates rise under Conservative governments,’ he said.

Professor Snowdon said research carried out at University of Sydney, based on 210 coroners’ files, including suicide notes, showed that a minority of older people who take their own lives appear to have made a ‘rational’ decision. He quoted one man with terminal kidney and bowel cancer, who killed himself at the age of 65, who wrote to his wife: ‘Soon I will just be a vegetable and in pain. I want you to remember me as I am.’ Another with terminal cancer at 80 said: ‘I feel so ill.’

But Professor Snowdon warned that around a quarter of those who killed themselves had severe pain but were also depressed, and therefore made a decision that was based on a false perception of reality. ‘’Around 36 of the 210 files mentioned the word ‘burden’, he said. ‘When I hear that word spoken, it rings alarm bells for me. When someone feels they are a burden on their relatives, it increases the chance that they may take their own life.’

He said it was essential that GPs ensured that pain was adequately dealt with and that what has been called ‘psyche-ache’, or intense mental pain is also treated – with antidepressants and counselling to allow the person to give vent to their feelings and adapt to what is happening to them. ‘There’s evidence that when fears are addressed, their pain treated and they know that the doctor will be available until the end, many people who might have considered suicide, or, where possible, euthanasia, decide they want to make the most of the time they have left.’

Professor Snowdon said that suicide in older men remained at least twice the rate among women – partly because men are more likely to feel that once they are on the slippery slope of losing their mental and physical vigour and past their prime, life isn’t worth living. It’s a ghastly, awful view of life.’