An investigation by ChronicleLive has revealed huge differences in suicide rates at a local level, with concerns that there could be an increase in deaths as the pandemic goes on.
The latest figures show that there were 266 suicides in the North East in 2019, an average of around five deaths a week - down from 287 the previous year, but up from 248 in 2017.
In total over the three years there were 801 suicides, which is the equivalent of 11.6 deaths for every 100,000 of the population.
Only Yorkshire and the Humber (12 per 100,000 people) and Wales (12.7 per 100,000 of the population) have a higher suicide rate.
However, there’s huge local variation within the figures, when compared to the population.
The data shows that 49 people took their own lives in Middlesbrough between 2017 and 2019 - 14.5 suicides for every 100,000 people, which is one of the highest rates in England.
But not far away, the suicide rate is far lower - with 37 people in Gateshead taking their own lives over the three years, and 33 in South Tyneside.
That works out as 7.2 suicides for every 100,000 people in Gateshead and 8.4 in South Tyneside.
There are many varied and complex reasons why someone might want to end their own life, so it is impossible to say with any real certainty why one area has such a high suicide rate compared to another.
But research carried out by the Samaritans has identified certain factors that increase the risk of suicide - with deprivation a particular driver.
Official Government figures rank Middlesbrough as the most deprived area in the North East, while Northumberland is the least deprived.
The suicide rate is lower in Northumberland than Middlesbrough (12.8 deaths per 100,000 people between 2017 and 2019), but is still the fifth highest in the North East.
Darlington has a particularly high rate of insolvency, which is where people cannot afford to pay their debts - although the rate is higher in County Durham, which has a suicide rate of 13.4 deaths for every 100,000 people.
In comparison, Northumberland has the lowest rate of insolvency in the county.
Middlesbrough has a high unemployment rate compared to the rest of the North East, with 7.6 per cent of working age adults out of work in 2019.
That’s almost double the national average of 3.9 per cent.
But even in North Tyneside, which has the lowest unemployment in the North East, the rate is still higher than the national average (4.3 per cent).
While of course there are other factors at play, Professor Louis Appleby - who leads the National Suicide Prevention Strategy for England - said there was a “huge amount of evidence” pointing to the link between money troubles and suicide.
This is a particular concern at the moment, due to the ongoing economic impact of the coronavirus pandemic.
So far, national statistics suggest that the pandemic has not caused a predicted spike in suicide - but clinicians fear a big increase in deaths could still be to come.
On average, there were 85.4 suicides per month across England in the months after the first lockdown was announced, from April to August last year.
That was up from a monthly average of 79.6 suicides during the same period in 2019, and an average of 84.0 per month in the three months before lockdown.
However, suicide rates were already on the rise, even before the pandemic, and the increase may also be linked to improvements in suicide surveillance systems.
The National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) - which carried out the research - has concluded that there is “no evidence of the large national rise in suicide post-lockdown that many feared”.
The NCISH says this could change and it doesn’t rule out the possibility of the lockdown having a greater impact in certain areas.
Professor Louis Appleby said: “The evidence so far is that suicide has not risen and this is consistent with most other countries.
“However, as the pandemic evolves it is possible that we will see higher levels of risk in certain groups, especially those who are facing economic stress which is well established as one of the main drivers of suicide rates.”
With shops and businesses forced to close for long periods of time - and for some to shut down permanently - the Covid-19 pandemic has already caused a great deal of financial hardship.
In the North East the number of people claiming unemployment benefits went up by more than half between last March, when the first lockdown began, and November 2020, rising from 75,433 to 118,178.
That was also up from 72,401 benefits claimants in the North East in November 2019.
These figures are a combination of claimants of Jobseeker’s Allowance (JSA) and Universal Credit (UC) who fall within the UC ‘searching for work’ conditionality.
The figures show that while Middlesbrough has the highest proportion of benefits claimants (10.3 per cent of the working age population), Newcastle has seen the biggest change.
In March there were 8,939 benefits claimants in Newcastle, which was 4.3 per cent of the working age population. As of November, that had increased to 15,336, or 7.4 per cent.
In Newcastle there were 79 suicides between 2017 and 2019, 10.5 deaths for every 100,000 people.
The good news is that in response to the growing mental health crisis seen before the pandemic, most local authorities in the North East had been increasing spending on mental health.
Northumberland County Council increased its budget for mental health support for adults in 2020/21 by 14 per cent, from £27.8m in 2019/20 to £8.9m.
South Tyneside Council raised its budget by 13 per cent from £4.9m to £5.6m, and Darlington Borough Council increased its spending by 11 per cent from £2m to £2.2m.
However, budgets were approved before the pandemic, with only Hartlepool Borough Council and North Tyneside Council making “some Covid adjustment” to mental health budgets.
Mette Isaksen, Senior Research and Evidence Manager at Samaritans said a rise in suicide rates caused by the pandemic is not “inevitable”, but Covid-19 has exacerbated a number of risk factors for suicide, including job loss and financial worries.
She said: “Suicide is a complex issue and it’s rarely caused by one thing, but we know there are a range of psychological, cultural and economic factors which can increase risk including gender, age and inequality.
“Living in a more deprived area does increase risk of suicide for a range of reasons. It might be access to support or employment opportunities - unemployment is a key risk factor for suicide.
“We also know that economic recession can have an impact on suicide rates – evidence has shown that during the last recession between 2008 to 2010, there were an estimated 1,000 excess suicides in England.
“But suicide is not inevitable and there are actions that we can take to ensure that difficult times don’t result in people taking their lives, for example we know that countries which have strong safety nets have less of an increase in suicide rates - and that’s something that we can do.
“A big part of positive well-being is purposeful work and the opportunity to provide for families.
“As part of the recovery from the pandemic, Samaritans wants the Government to introduce a mental health renewal plan to ensure that support is available for those that need it most.”
Nadine Dorries, Minister for Mental health, said: “I am acutely aware of how difficult this pandemic has been and I remain absolutely committed to supporting everyone’s wellbeing and mental health.
“It is understandable people may feel anxious or low at the moment - Every Mind Matters offers a range of great, free resources including personalised mind plans. For those who continue to feel unwell or have pre-existing conditions, mental health services remain open and I urge anyone who is struggling to come forward for help – these services are here to support you.
“We are committed to supporting good mental health and wellbeing. As part of the long term plan we have committed an additional £2.3 billion a year to mental health services, and as part of the Spending Review 2020, we have announced the NHS will receive additional £500 million to address waiting times for mental health services, give more people the support they need, and invest in the NHS workforce.”
To speak confidentially with volunteers about suicide or other issues, you can call Samaritans on 116 123 or email [email protected]