The impact of place on suicidal behaviour

This chapter provides a rapid evidence review of empirical studies, from the UK and Republic of Ireland, that have examined associations between suicidal behaviour (suicide and non-fatal self harm) and area-level deprivation. Five electronic databases (Medline, Embase, PsycINFO, Social Sciences Citation Index and EconLit) were searched from 2005 to 2015. Eighteen studies were included; one was a cohort study, eight were repeat cross-sectional studies and nine were cross sectional studies. Overall, these studies found a strong association between area-level deprivation and suicidal behaviour: as area-level deprivation increased, so did suicidal behaviour. The chapter contextualises these results by applying insights from the wider geographical literature about health and place, leading to the identification of potential mechanisms (‘suicidogenic’ pathways) underpinning the association between area-level deprivation and suicidal behaviour. These mechanisms include compositional factors (the characteristics of people living in deprived areas, such as marital status) and contextual factors (the nature of the places themselves, such as the social environment). It concludes by reflecting on the implications for policy, practice and research, suggesting that, as there is a socio-spatial gradient in suicidal behaviours, every local area should have a suicide prevention strategy and action plan and that deprived areas should have additional support via a proportionate universalism approach to reducing geographical inequalities in suicide.