Suicides among primary and secondary school teachers: psycho-social autopsy study, quantitative analysis of risk factors for self-harm and suicidal thoughts and qualitative investigation of potential preventive interventions

The latest occupation and suicide figures for England show that female primary and nursery education teachers are at a 50% increased risk of suicide, with 102 deaths over a four year period [1]. Male secondary school teachers also have an elevated risk of 13%, with 133 deaths over the same period, although statistical evidence for this is weaker. Other jobs that fall into the same major occupational group as teaching (“professional occupations”) are generally at lower risk of suicide [1]. Little is known about why teachers are at heightened risk compared to occupations of similar income / status. Further, school-based suicide prevention interventions tend to focus on students rather than teachers, despite the elevated risk among this group of workers. Previous studies have used a psychological or sociological autopsy approach to investigate suicides occurring in particular groups [2,3], and three of the supervisors have experience of this methodology. This project will be unique in applying the approach to understanding suicides among teachers. It will also make use of quantitative methods to understand risk factors for suicidal thoughts and attempts and self-harm behaviour among this occupational group, which are known to be predictive of future suicide [4], and qualitative methods to explore the potential for preventive interventions. It is anticipated the project will lead to a funding application for the development of an intervention to reduce suicides among teachers.

The research questions and methods will be:

1. What are the risk factors associated with suicide among school teachers in England? Method: review the coroners’ records of a subset of ~80 primary and secondary teacher suicide cases within the ONS report [1], to identify possible psychological and sociological causal factors.

2. What factors are associated with suicidal thoughts, suicide attempts and non-suicidal self-harm behaviour among teachers? Do these differ from those associated with these outcomes in the general population? Method: logistic/linear regression to examine association between work and non-work related risk factors and suicidal thoughts/attempts and self-harm behaviour among (i) the general population in England, through secondary analysis of Office for National Statistics (ONS) national adult psychiatric morbidity survey data, 2016 (ii) primary and secondary school teachers through collection of self-complete data from a random sample across England and Wales (~1000).

3. What interventions might address work-related risk factors identified in the previous two studies? What are the views of those working within primary and secondary school settings regarding potential interventions? Method: qualitative focus groups with teachers in 10 schools (5 primary, 5 secondary), and interviews with school leaders, governors and local authority representatives/Academy chain leaders to explore their views on how identified risk factors could be addressed in the school context.