Trends in national suicide rates for Scotland and for England & Wales, 1960-2008.

BACKGROUND Suicide rates in Scotland have increased markedly relative to those in England in recent decades. AIMS To compare changing patterns of suicide risk in Scotland with those in England & Wales, 1960-2008. METHOD For Scotland and for England & Wales separately, we obtained national data on suicide counts and population estimates. Gender-specific, directly age-standardised rates were calculated. RESULTS We identified three distinct temporal phases: 1960-1967, when suicide rates in England & Wales were initially higher than in Scotland, but then converged; 1968-1991, when male suicide rates in Scotland rose slightly faster than in England & Wales; and 1992-2008, when there was a marked divergence in national trends. Much of the recent divergence in rates is attributable to the rise in suicide among young men and deaths by hanging in Scotland. Introduction of the 'undetermined intent' category in 1968 had a significant impact on suicide statistics across Great Britain, but especially so in Scotland. CONCLUSIONS Differences in temporal patterns in suicide risk between the countries are complex. Reversal of the divergent trends may require a change in the perception of hanging as a 'painless' method of suicide.