Suicide and self harm

A world map of suicide rates.
Image from https://www.who.int/data/gho/data/themes/mental-health/suicide-rateImage credit: World Health Organization

Suicide is a major global health issue, with over 700,000 people dying by suicide each year, with many more engaging in acts of self-harm and being bereaved. Suicide and self-harm are complex behaviours and as a result an interplay of several factors which operate at the individual, community, and societal level. As such research into these behaviours needs to include a range of expertise from several disciplines. 

Bristol hosts a vibrant community of quantitative, qualiatative and clinial researchers whose common aim is to better understand the causes of suicide and self-harm so as to inform clinical and population based prevention strategies. Two of the world's largest trials of self-harm prevention were led by Bristol researchers.

We are keen to hear from people interested in suicide and self-harm research, including prospective students, collaborators and those with lived experience. 

Follow our research updates on Twitter and on our research website.

Key resources

Key resources for research into suicide and self-harm in Bristol include:

  • Repeated measures of self-harm in the ALSPAC cohort (n=13,000 participants)
  • Data from a rural Sri Lankan cohort of over 200,000 people collected as part of one of the world’s largest suicide prevention trials.
  • Extensive experience interviewing suicidal individuals
  • Strong collaborative links with leading suicide researchers in the UK and internationally particularly Sri Lanka, USA, Canada, Belgium, Denmark, Malaysia, Taiwan and Australia
  • Excellent working relationships with the World Health Organisation (WHO), and charities such as Samaritans and Self-Injury Support, and the Tellmi young person’s mental health app
  • The Bristol Health Partner’s Self-Harm Health Integration Team and strong links with local liaison psychiatry services
  • Lancet Commission on Self-Harm -  https://doi.org/10.1016/S0140-6736(24)01121-8

Bristol's suicide and self-harm research interest group (SASH) meets monthly with informal presentations on ongoing research projects, invited guest speakers and journal club style presentations. Contact Dee Knipe (Dee.Knipe@bristol.ac.uk) for further details.

Selected Publications

    Knipe D, Padmanathan P, Newton-Howes G, Chan LF, Kapur N. Suicide and Self-harm. The Lancet 2022, DOI: 10.1016/S0140-6736(22)00173-8.
    McManus, S., Walby, S., Capelas Barbosa, E., Appleby, L., Brugha, T., Bebbington, P., Cook, E., & Knipe, D. Intimate Partner Violence, Suicidality, and Self-Harm: A Probability Sample Survey of the General Population in England. Lancet Psychiatry, 9(7), 574-583. https://doi.org/10.1016/S2215-0366(22)00151-1
    Troya, M. I., Spittall, M., Pendrous, R., Crowley, G. F., Gorton, H., Russell, K., Bryne, S., Musgrove, R., Hannam-Swain, S., Kapur, N., & Knipe, D. (2022). Suicide rates amongst individuals from ethnic minority backgrounds: a systematic review and meta-analysis. EClinicalMedicine, 47, 1-23. [101399]. https://doi.org/10.1016/j.eclinm.2022.101399
    Knipe, D., Silva, T., Aroos, A., Senarathna, L., Hettiarachchi, N. M., Galappaththi, S. R., Spittal, M. J., Gunnell, D., Metcalfe, C., & Rajapakse, T. (2021). Hospital presentations for self-poisoning during COVID-19 in Sri Lanka: an interrupted time series analysis. Lancet Psychiatry, 8(10), 892-900. https://doi.org/10.1016/S2215-0366(21)00242-X
    Cohen, R., Rifkin-Zybutz, R., Moran, P. & Biddle, L. (2022). Web-based support services to help prevent suicide in young people and students: A mixed-methods, user-informed review of characteristics and effective elements. Health & Social Care in the Community, 00, 1–10. https://doi.org/10.1111/hsc.13819
    Mars B et al. Personality difficulties and response to community-based psychological treatment for anxiety and depression. J Affect Disord. 2021 Jan 15; 279:266-273
    Russell AE et al. An exploration of the genetic epidemiology of non-suicidal self-harm and suicide attempt. BMC Psychiatry. 2021 Apr 23;21(1): 207.
    Russell A et al. Investigating evidence for a causal association between inflammation and self-harm: a multivariable Mendelian Randomisation study. Brain, Behav Immun. 2020. 89. 43-50.
    Gunnell, D, Biddle, L. Suicide and the media: reporting could cost lives. Detail, sensationalism, and accounts of the method used are unnecessary and harmful. BMJ 2020;368:m870 doi: 10.1136/bmj.m870
    Biddle L, Derges J, Goldsmith C, Donovan J, Gunnell, D Online help for people with suicidal thoughts provided by charities and healthcare organisations: a qualitative study of users’ perceptions. Social Psychiatry and Psychiatric Epidemiology 2020 55 (9), 1157-1166
    Bandara, P., Page, A., Senarathna, L., Kidger, J. L., Feder, G. S., Gunnell, D. J., Rajapakse, T. N., & Knipe, D. (2020). Domestic violence and self-poisoning in Sri Lanka. Psychological Medicine. https://doi.org/10.1017/S0033291720002986
    Jackson, J., Nugawela, M. D., De Vocht, F., Moran, P., Hollingworth, W., Knipe, D., Munien, N., Gunnell, D., & Redaniel, M. T. (2020). Long-term impact of the expansion of a hospital liaison psychiatry service on patient care and costs following emergency department attendances for self-harm. BJPsych Open, 6(3), e34. https://doi.org/10.1192/bjo.2020.18
    Mars, B et al. Predictors of future suicide attempt among adolescents with suicidal thoughts or non-suicidal self-harm: A birth cohort study. The Lancet Psychiatry. 2019. 6(4), pp327-337
    Biddle, L, Derges, J, Goldsmith C, Donovan J, Gunnell, D. Using the internet for suicide-related purposes: contrasting findings from young people in the community and self-harm patients admitted to hospital. PLoS ONE 2018 13(5): e0197712
    Knipe, D., Gunnell, D., & Eddleston, M. (2017). Preventing deaths from pesticide self-poisoning—learning from Sri Lanka's success. Lancet Global Health, 5(7), e651-e652. https://doi.org/10.1016/S2214-109X(17)30208-5
    Pearson, M., Metcalfe, C., Jayamanne, S., Gunnell, D., Weerasinghe, M., Pieris, R., Priyadarshana, C., Knipe, D., Hawton, K., Dawson, A., Bandara, P., de Silva, D., Gawarammana, I., Eddleston, M., & Konradsen, F. (2017). Effectiveness of household lockable pesticide storage to reduce pesticide self-poisoning in rural Asia: a community-based, cluster-randomised controlled trial. Lancet, 390(10105), 1863-1872. https://doi.org/10.1016/S0140-6736(17)31961-X
    Moore TH, Kapur N, Hawton K, Richards A, Metcalfe C, Gunnell D. Interventions to reduce the impact of unemployment and economic hardship on mental health in the general population: a systematic review. Psychol Med 2017; 47: 1062-1084
    Biddle L, Derges J, Mars B, Heron J, Donovan J, Potokar J, Piper M, Wyllie C, Gunnell D. Suicide and the Internet: changes in the accessibility of suicide-related information between 2007 and 2014. J Affect Dis 2016; 190: 370-375.
    Mars B, Heron J, Crane C, Hawton K, Kidger J, Lewis G, Macleod J, Tilling K. Gunnell D. Clinical and social outcomes of adolescent self-harm: Findings from the ALSPAC birth cohort. BMJ 2014;349:g5954 DOI: 10.1136/bmj.g5954