A comparison of Child-Sex-Abuse-Related and Mental-Disorder-Related suicide in a six-year cohort of regional suicides: The importance of the child protection-psychiatric interface

The study compares Mental-Disorder-Related (MDR) suicide rates with Child-Sex-Abuse-Related (CSAR) suicide of 'Victims' and 'Perpetrators' of child sex abuse, based upon an examination of all Coroners' inquest files over a six-year period (n = 1,017). Census data, psychiatric case register and police records were used to calculate the potential MDR and CSAR populations. There were five main findings: (i) male and female CSAR victim suicide rates were 2.2. and 2.5 times the General Population Suicide Rate (GPSR), respectively; (ii) every female, and 80 per cent of male CSAR victim suicides, also had a mental disorder but none of the CSAR perpetrator suicides; (iii) male and female MDR suicide rates were 5 and 6 times the CSAR Victim rates; (iv) the sex abuser perpetrators' suicide rate was more than 3 times the male MDR rate; (v) the intra- and extra-familial perpetrator suicide rates, were 25 and 78 times the GPSR, respectively. Possible explanations for these surprising results are briefly discussed. They confirm the over-representation of people with mental disorder amongst suicides, and identify an over-representation of CSAR suicides, particularly perpetrators. The results have implications for suicide prevention programmes, whilst highlighting the importance of the child protection-psychiatric interface, and indicates the futility of simple explanations in an area of practical and moral complexity