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The prevention of suicide in later life: a task for GPs?

Suicide is a relatively uncommon event. In England about 5000 people of all ages take their own lives each year. In the 4 years between 1996 and 2000, the deaths of 20 927 people from suicide, undetermined causes or where there were open verdicts were reported to the National Confidential Inquiry for England and Wales.1

However, suicide rates among older people — particularly men — are rising worldwide.2 In the UK about one in every eight people who commit suicide is aged 65 years or over. Men aged over 75 years have the highest rate of suicide of any age group, a trend reflected in the study of suicidal ideas among older people seen by Australian GPs, reported in this issue of the Journal.3

In England and Wales 1126 men and 628 women in the age group 65–74 years committed suicide, as did 1178 men and 736 women aged 75 and over. Although older women are more likely than men to experience severe depression, men are more likely to commit suicide. Among older people 80% committed suicide on what was apparently their first attempt.

If we can understand why people kill themselves we may be able to help them avoid suicide as a solution to their problems. In the present policy climate this logic leads to the publication of strategies to prevent suicide, with implementation groups addressing problems at local levels.4–6 Early indications from England are that this strategic approach is having an effect and the suicide trend is now downward. This seems to have been accomplished by addressing issues broadly and thorough multiagency collaboration, by conducting audits and identifying areas where there are major knowledge gaps, and by lowering risks, notably through reducing access to means of suicide.7

Most older people who …