There has been intense media interest in the deaths of several young people in the Bridgend area of South Wales.
At the time of the deaths there appeared to be high levels of threatened or actual self-harm in Bridgend and heavy demand for local services. A Welsh action plan to reduce suicide and self-harm is out for consultation.
It is unclear whether suicide and self-harm are two ends of the same spectrum. Across the UK there is substantial variation in suicide rates but 25 to 44-year-old men have the highest rates in all four nations (first chart). Each suicide is the result of self-harm but not all self-harm is an attempt at suicide and some people who kill themselves may have intended non-fatal self-harm.
For every suicide there are 20 admissions for self-harm in Wales. There are striking differences. Seventy-five per cent of suicides are among men, while over half of self-harm admissions are among women. Young women between the ages of 15 and 19 have the lowest suicide rates (threefold below 50 to 54-year-olds (second chart), but the highest levels of self-harm admissions (22-fold higher than people over 85 (third chart).
But rates have declined in under-25s for both, and male age patterns are not dissimilar.
Suicide is associated with unemployment and material deprivation and, increasingly, with social fragmentation. But the association could be misleading. For example, people at risk of suicide may move to areas of high social fragmentation.
The recession will affect measured social fragmentation, with an increase in private rental and uncertain effects on mobility.
Suicide rates among young men increased in 1970-90, and have declined since throughout the UK. Now health and social services must again consider how to address the effects of the economic climate on mental wellbeing, self-harm and suicide.
There are 6,000 emergency admissions with self-harm, and 300 deaths from suicide per year in Wales
External cause deaths in Wales: 28 per cent suicide and 16 per cent transport accidents
Ratio of suicide rates between least and most deprived quintile in Wales: 1:1.9