National suicide prevention strategies propose sex-specific approaches. Sex moderates pathways underlying suicidal behaviour, with oestrogen decline implicated in suicidal behaviour in women postpartum and during menopause, and testosterone linked to threat responsiveness in men consistent with the rise in suicidal behaviour in mades form adolescence to a middle-age peak.

Domestic abuse (DA) is legally defined in England as harm perpetrated by an adult towards another adult who is a partner or relative. Domestic abuse, including domestic homicide, is more commonly experienced by women compared to me, and more commonly perpetrated by men than women. A 2013 review showed association of domestic abuse and suicidal behaviour, but was limited by sample size, and by incomplete exposure measurement and outcome collection, and only studied women. Mental health services are a critical site for positively impacting suicide prevention, so I describe work to:

a) systematically measure DA exposure and perpetration and
b) assess association of DA exposure and perpetration with suicide and self-harm, in men and women using mental health services in England.

Implications of these results are discussed for implementation of suicide prevention by mental health service providers, practice guidelines for DA presponses, and epidemiological surveillance for suicide/self-harm and risk factors.