The National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) has unveiled its Annual Report for 2025, highlighting a concerning 19% rise in suicides among individuals diagnosed with bipolar disorder over the past decade. The report underscores significant deficiencies within the UK’s mental health system, particularly in the provision of specialist care and the prescription of lithium, a medication proven to reduce suicide risk.

Between 2012 and 2022, NCISH recorded 1,491 suicides among patients with bipolar disorder, with a notable surge occurring between 2019 and 2022. Despite lithium’s efficacy in mitigating suicide risk, only 39% of those who died had been prescribed the medication, and a mere 12% had access to psychological therapies. These figures suggest a systemic shortfall in delivering comprehensive care to this vulnerable population.

Professor Tania Gergel, head of research at Bipolar UK, expressed alarm over these findings. In her recent article published in The Lancet Psychiatry, she noted: “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.”

The Nuffield Trust has projected a £4.8 billion shortfall in the NHS England revenue budget for 2024/25, raising concerns about potential cuts to mental health services. This financial strain could exacerbate existing challenges in providing adequate care for individuals with bipolar disorder.

Simon Kitchen, CEO of Bipolar UK, emphasised the urgency of addressing these issues: “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.” He further highlighted the underutilisation of lithium and the scarcity of specialist services, calling for immediate and decisive action.

Individuals living with bipolar disorder have reported difficulties in accessing psychiatric care, a lack of continuity in treatment, and insufficient monitoring during high-risk periods. The dearth of bipolar specialists in the UK often leads to delayed or incorrect diagnoses, further increasing the risk of suicide.

Professor Gergel pointed out significant gaps in research and clinical practice: “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.” She also suggested that current statistics might underestimate the true prevalence of suicide among those with bipolar disorder, as many may die before receiving an accurate diagnosis or appropriate treatment.

The NCISH report also identified systemic failures contributing to preventable deaths. Patients with bipolar disorder were more likely to die within three months of being discharged from inpatient care, highlighting critical gaps in post-discharge support. Additionally, 15% were noted to have missed vital clinical appointments prior to their deaths, often due to social isolation or medication side effects. The limited access to psychological therapies, with only 12% receiving such interventions, further compounds the issue.

With over a million people in the UK living with bipolar disorder, these findings represent a significant public health concern. Bipolar UK is advocating for several urgent measures:

• Establishment of specialist bipolar services in every NHS region. This would ensure timely diagnosis, access to evidence-based treatments, and care tailored to the complexities of the condition.
• Increased prescribing of lithium in line with NICE guidelines. Ensuring that every individual who could benefit from this treatment is given the opportunity.
• Enhanced suicide prevention strategies. This includes improved follow-up care after hospital discharge and targeted support for those who miss appointments or struggle with medication adherence.

Simon Kitchen concluded with a call to action: “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.” He stressed that bipolar-specific services are essential and that the forthcoming 10-Year Plan presents a critical opportunity to implement these changes. “The government and NHS must act now before more lives are lost to preventable tragedy. It is time to get it right.”