100 CASES OF SUICIDE IN ELDERLY PEOPLE

Background. The White Paper The Health of the Nation targets a reducti on in suicide rates. Preventive strategies must be guided by an unders tanding of the demography and antecedents of suicide. These issues are examined in relation to suicide by old people in Manchester. Method. One hundred consecutive coroners' inquisitions on people aged over 65 occurring between 1980 and 1991 in which the verdict was suicide were scrutinised and related to Health Service notes. Results. Suicides wer e rare, numbers ranging from 0 to seven per annum per Health District. Rates did not vary between district hut did within smaller sub-popula tions. Most individuals died at home; 65% were physically ill, of whom 23% had been hospitalised within the previous year. At least 60% were clinically depressed, with 25% being prescribed antidepressants. A to tal of 43% had seen their general practitioner in the previous month b ut only 14% were in contact with psychiatric services. Conclusions. Ma ny elderly people who commit suicide are not in close contact with pri mary care services; those who are may not be prescribed appropriate tr eatment, and few are referred for specialist care. Specialist services win fail to reduce suicide rates unless they embark upon programmes t o increase public awareness of therapeutic possibilities and work more closely with primary care agencies to realise these possibilities.