Suicide by young men in Lothian 1993 and 1994

To examine the circumstances surrounding the suicides during 1993 and 1994 of young men aged 20-29 from the Lothian region.

The list of suicides for Lothian residents in this group was obtained from the General Registry Office and information relating to these people abstracted from records held in General Practice and at the Forensic Medicine Unit at the University of Edinburgh.

Thirty-nine men met the selection criteria which gave a suicide rate of 28.7/100,000. Twenty-five had zero blood alcohol recorded post mortem and ten had blood alcohol concentrations above the legal driving limit of 80 mg/100 ml. Ten (26%) had seen their General Practitioner (GP) in the week and 13 (33%) in the month before suicide. Previous suicide attempts (seven within a year of death) were recorded in 19 men. Ten men left suicide notes.

Using an overall rate to describe suicide hides the complexity of the issues involved: the inclusion or not of undetermined deaths in numerical targets also causes confusion. Targets should be interpreted carefully and suicide rates should not be considered as a proxy for the mental health status of a population. Prevention cannot be the domain of only the GP. Assessment of suicide risk should be integrated as part of improved mental health training for all health service staff.