Health Check: Why suicide rates in men are dropping

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The Independent Culture
I SHALL be calling in a bet I made five years ago this week. Nothing excessive, just a pint or two with a sceptical friend and the rare satisfaction of being proved right.

In November 1993, I wrote an article in The Times, for which I then worked, making what some regarded at the time as a rash prediction that the suicide rate, which had been rising among men for 20 years, was likely to fall. Virginia Bottomley, the former health secretary, had just launched the "Health of the Nation" strategy which included a target 15 per cent cut in the suicide rate by the year 2000. That was considered ambitious at the time, but I believed that the goal was in sight. My confidence rested on two remarkable cases of failed suicide attempts. A 26-year-old man had written a suicide note and sat for an hour in his car with a hosepipe funnelling the exhaust fumes into the passenger compartment. He failed to end it all because his car was fitted with a catalytic converter. Apparently unaware of this technological advance in pollution control, he was rescued and taken to the accident and emergency department of the Royal London Hospital, where he made a complete recovery.

In a second case, a 43-year-old man recovered after five hours of breathing in exhaust fumes in a car fitted with a converter. Carbon monoxide poisoning normally causes loss of consciousness within a few minutes, and death within half an hour, but catalytic converters cut emissions by 90 per cent. In this case, the carbon monoxide level in the man's blood was only just above the level that would be normal for an urban smoker.

Suicide by car exhaust poisoning has long been a popular method among men. In 1992, the year before catalytic converters became mandatory in all new cars, 1,168 men in Britain took their lives this way (classified as "poisoning by other gases and vapours").

By 1996 that figure had fallen to 738, a drop of 37 per cent, which represents a saving of 430 lives.

Women tend to choose other methods, probably because they are less likely to be car-owners, but the rate dropped among them, too, from 143 deaths in 1992 to 104 in 1996. Experts have long known that suicide rates depend on the availability of a method. When it is removed, some people find alternative means of taking their lives, but many do not. In the Sixties, putting your head in the gas oven was the commonest method of suicide, until carbon monoxide levels in town gas were lowered and it was replaced by non-toxic North Sea gas. The overall suicide rate fell by a third.

Dr Robert Kendall, president of the Royal College of Psychiatrists, who records the latest figures in The Lancet, says cleaner cars in the Nineties are saving lives in the same way that cleaner ovens did in the Sixties. "The introduction of catalytic converters has decreased the number of suicides without substitution of other methods."

This is cause for celebration, but the Samaritans will have none of it. While they naturally welcome the saving of lives, they insist that the removal of a method of taking life will not improve the emotional well- being of the community. This seems to miss an essential point about suicide - that it is often an impulsive and desperate gesture from which there is no going back. If you can stop that gesture ending fatally, you not only save a life - you also offer the survivor a chance to renew it.

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