(image: Michelle Henderson: Unsplash)

Trigger warning: discusses suicide

The National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) released its Annual Report for 2025 last week, revealing that over the past decade, nearly 20% more individuals with bipolar disorder are dying by suicide due to shortcomings in the UK’s mental health system.

According to national charity Bipolar UK, the report provides stark evidence that specialist care is lacking, Lithium (an important mood stabiliser medication) is under-prescribed and suicide prevention measures are falling short.

The report highlights that from 2012 to 2022, there were 1,491 suicides by patients with bipolar, with an alarming 19% increase from 2019 to 2022. Despite Lithium being a clinically proven suicide prevention treatment for people with bipolar, only 39% of those who died were prescribed it and just 12% were receiving psychological therapy​.

This data echoes the findings and lived experience of Professor Tania Gergel, Head of Research at Bipolar UK, in her recent article in The Lancet Psychiatry where she said: “Globally, 15-20% of people with bipolar disorder die by suicide, with 30-60% making at least one attempt. These rates are not decreasing despite an overall decline in global suicide rates.”

According to the Nuffield Trust, there is set to be a £4.8 billion unfunded shortfall in the NHS England revenue budget for 2024/25, raising the prospect that without further funding, service cuts may be inevitable.

With bipolar increasing an individual’s risk of suicide by 20 times that of the general population, Bipolar UK is urging the government to commit to addressing health waiting lists and to invest money in creating a dedicated care pathway for bipolar to reduce suicide rates.

Simon Kitchen, CEO of Bipolar UK, said: “This report is devastating but not surprising. We’ve been shouting from the rooftops that people with bipolar aren’t getting the care they need and now the data lays it bare.

“Bipolar carries one of the highest suicide risks of any mental illness, yet specialist services are practically non-existent, and Lithium – the gold-standard treatment for suicide prevention – is underused. The time for excuses is over. We need real action, and we need it now.”

The charity has heard from its community of people living with the condition, who are concerned that they are unable to access psychiatrists, have little to no continuity of care and are not being monitored adequately when at high risk. There is also a lack of bipolar specialists in the UK, leading to people not receiving a correct diagnosis or waiting too long to receive one – all of which add to the risk of suicide.

Professor Gergel said: “Neither bipolar disorder nor suicide in people with bipolar disorder are research priorities, resulting in major knowledge gaps in both. This can and must change. The shocking statistics might well underestimate the prevalence of suicide in people with bipolar disorder, given the probability of death by suicide before treatment or accurate diagnosis.”

Adding to that, Simon Kitchen said: “Suicide prevention in bipolar requires a shift in both research priorities and clinical practice. We know lithium saves lives, but it is still under-prescribed. We know specialist care works, but most services are generic and fail to meet the specific needs of people with bipolar. Bipolar suicide is not inevitable, but without urgent action, people will continue to die.”

(image of Prof Gergel, Bipolar UK)

The NCISH report also revealed broader systemic failures contributing to preventable deaths. Alarmingly, patients with bipolar were more likely to:

• Die within three months of being discharged from inpatient care, highlighting dangerous gaps in post-discharge support​.
• Miss vital clinical appointments, often due to social isolation or side effects from medication, with 15% identified as non-adherent before their deaths​.
• Experience extreme distress without access to psychological therapies, with only 12% receiving talking therapies​.

With more than a million people living with bipolar in the UK, the figures from this latest inquiry represent lives lost and has led Bipolar UK to call for urgent action, including implementing:

1. Specialist bipolar services in every NHS region to ensure timely diagnosis, access to evidence-based treatments and care tailored to the complexities of the condition.
2. Increased lithium prescribing, in line with NICE guidelines, ensuring every person with bipolar who could benefit from it is given the opportunity.
3. Enhanced suicide prevention measures, including better follow-up after hospital discharge and targeted support for those who miss appointments or struggle with medication adherence.

Simon Kitchen concluded: “We need all UK health authorities and departments of health across the nation to act now because lives depend on it. The evidence is undeniable, the solutions are clear, and the cost of inaction is catastrophic. Specialist care, Lithium, and targeted suicide prevention measures can and will save lives.

“Bipolar suicide is a national emergency, and the upcoming 10-Year Plan is the critical opportunity to turn the tide. Bipolar-specific services are not optional; they are a lifeline.

“The government and NHS must act now, before more lives are lost to preventable tragedy. It is time to get it right.”

(image: Simon Kitchen, CEO, Bipolar UK)

For more information about suicidal thinking and bipolar, visit: Bipolar and suicide prevention

About Bipolar UK   

Bipolar UK is the only national charity dedicated to supporting people affected by bipolar. Bipolar UK provides a range of services, including information and advice, a network of support groups, an eCommunity, workplace training and telephone and email peer support. Bipolar UK also works in partnership with research organisations and campaigns for change to tackle critical issues. For more information, visit www.bipolaruk.org