Psychiatric targets in 'health of the nation': regional suicide 1974-1990 and employment prospects in 1990-1994 in Britain: precursors of failure?

The psychiatric targets set in 'The Health of the Nation' reflect a fundamental change in auditing the psychiatric and social services, and it is argued that suicide levels have become 'Paradoxical indicators' of effectiveness. Based upon mortality rates between 1974-1990, inter-regional comparative league tables are presented. Changes in age and gender patterns, and the accumulative impact of unemployment 1990-1994, especially in the more affluent regions, suggest that the suicide targets may not be feasible. The implications for the community and psychiatric services are briefly discussed.