The influence of disability on suicidal behaviour

AbstractDisability has long-term practical and social consequences, and is associated with mental disorders, in particular with depressive disorder. In this paper we investigate disability in relation to suicide attempts. We hypothesised that such attempts would be more common in people with a disability, and that this would be commensurate with the number of practical difficulties. We also hypothesised that the effect of disability on suicidal behaviour would be mediated by depression. Finally we examined whether particular disabilities were more strongly associated with suicide attempts. A random probability sample comprising 7461 respondents were interviewed throughout 2007 for the third national survey of psychiatric morbidity of adults in England. Disability was measured by difficulties in activities of daily living (ADL) and instrumental activities of daily living (IADL). About one in every 150 adults in England had made a suicide attempt in the past 12 months. Those with some form of disability were four times more likely to have attempted suicide after adjusting for significant sociodemographic and socioeconomic correlates: female, not married, not employed, being in debt and having a physical health problem. Difficulty in managing ones financial affairs (budgeting and paying bills) and dealing with paperwork (writing letters and filling in forms) appear to have a greater influence on the likelihood of suicide attempts than difficulties in carrying out personal care, practical or household activities. Helping people with activities with a high cognitive content as well as with more physical activities is an important element in a suicide prevention strategy