Trends in completed suicide by method were analysed for Belgium between 1968-1972 and 1978-1981, using the information reported on death certificates. Around 1980, hanging was the most preferred method of suicide in both sexes, followed by firearms in males and poisoning by solid and liquid substances in females. Between 1970 and 1980, rates for all but one method (domestic gas) increased. The largest changes among men were seen for firearms and for poisoning, accounting respectively for 43% and 33% of the overall increase. For women, 48% of the rise was attributable to poisoning and 24% to drowning. The choice of method was seen to be influenced by age: hanging and drowning were the preferred methods for older people, whereas poisoning was the most popular among younger adults. The male-female ratio decreased for firearms and was reversed for poisoning and drowning. These findings are compared with trends in other industrialized countries, and the possibilities for suicide prevention by reducing the firearms and poisoning rates are discussed.

The geographical variation of reported suicide among the 43 Belgian districts was analysed for each method of suicide in both sexes and in two time periods: 1968-72 and 1978-81. Different descriptive methods were used to assess the patterns and changes in method-specific indirectly standardized death rates. It appeared that the overall suicide pattern was not always a good reflection of the method-specific patterns. Moreover, these seemed consistent in time and between sexes. Two important methods, which could be partially influenced, showed a remarkable concentration in some southern districts: suicidal poisoning by solid and liquid substances (in both sexes) and the use of firearms (in males). Drowning was much more concentrated in the West of the country and jumping was especially frequent in Brussels. Possible explanations and the relevance of these findings for prevention are discussed.