On Monday 19 January the Deputy Prime Minister Nick Clegg hosted a Mental Health Conference, bringing together leading clinicians, policy makers and campaign groups to discuss the future of mental health services in England.
At the conference, co-hosted by the Minister of State for Care and Support Norman Lamb, the Deputy Prime Minister called on all NHS trusts to commit to a new ambition for ‘zero suicides’ in order to dramatically reduce suicides in our health service. This ambition has already been adopted in some areas with Mersey Care in Liverpool, South West England and East of England all making the commitment.
Deputy Prime Minister Nick Clegg said:
Suicide is, and always has been, a massive taboo in our society. People are genuinely scared to talk about it, never mind intervene when they believe a loved one is at risk.
That’s why I’m issuing a call to every part of the NHS to commit to a new ambition for zero suicides. We already know that this kind of approach can work in dramatically reducing suicides.
This isn’t about blame. It is doing more in every area of our society to ensure that people don’t get to that point where they believe taking their own life is their only option.
The Deputy Prime Minister lifted the lid on the last taboo in mental health – suicide. Most people think that suicides are inevitable, not preventable. As the Samaritans say, the majority of people who feel suicidal don’t actually want to die.
Suicides can be prevented; together we need to create a culture in our country where everyone can talk about their mental health problems without fear, embarrassment or judgement.
Today the Deputy Prime Minister signaled a whole new way of working to prevent people from taking their own lives.
He called for every part of the NHS to commit to a new ambition for ‘zero suicides’ to dramatically reduce the number of people taking their own lives. We know this kind of approach can work in dramatically reducing suicides. A mental health programme in Detroit, USA, which signed up to a ‘zero suicide’ commitment has reported that nobody in the care of their depression services has taken their own life in over 2 years.
In the UK, pioneering health workers in Liverpool, the south-west and in the east of England are already re-thinking how they care for people with mental health conditions to achieve this ambition for ‘zero suicides’ in our own health service. The Deputy Prime Minister called on the health service to look at this work being done by these 3 pioneering areas. Adopting these approaches across the country could save thousands of lives.
Almost 4,700 people died by suicide in 2013 in England – almost 3,700 (78%) of those people were men, with suicide remaining one of the biggest killers for men under the age of 50.
The ‘zero suicide’ ambition is about changing how people in NHS care are treated, so that they are not forgotten when they move or leave the service they have been in. All of this will be done in close collaboration with GPs, other specialist providers, commissioners, public health experts and others.
How would it work?
Everywhere will be different, but methods could include:
- keeping in touch with patients who move back home after being on a ward
- having a personal safety plan in place so that patients, family and friends know what to do and where to go for help if they need it and have regular contact with someone they know and trust
- bringing safety systems in line with treatment for physical health – for example, designing a process for any member of staff to follow if a patient is at high risk of suicide. This would tell staff what to do, who to call, where to send the patient, and how to follow it up
- joining all services up so that patients who are at risk will not fall through the cracks – linking GP, carers and mental health services
A programme in Detroit, USA, which has already signed up to this commitment has reported 2 and a half years without a single suicide, as well as a reduction in suicide in the city as a whole.
Meanwhile, Mersey Care in Liverpool has created a programme to eliminate suicide by 2017 to 2018 which includes:
- improved training for staff, focusing on the clinical skills needed to work with patients and their families to develop a ‘safety plan’ – a personalised care plan with clear ways to get help 24/7
- working with other providers and stakeholders to share best practice – including CALM, Samaritans and the Cheshire and Merseyside Reduction Partnership
- a dedicated Safe from Suicide team will provide advice, support, assessment and monitoring
As part of their ‘zero suicide’ ambition, South West of England is looking to:
- work closely with A&E to better identify and support people who present with suicidal thoughts or attempts
- explore ways of providing better mental health support for people once they’ve been discharged, regardless of which NHS service they’ve been in contact with
- explore how to target high risk groups, such as middle aged men, with tailored support
- work with other agencies, such as the police and transport services, to identify ‘hot-zones’ – areas where higher than average numbers of suicides occur – and understand the reasons behind these figures
In the East of England, the whole region has come together to pledge to suicide prevention, with 4 pilot areas helping to improve care by:
- providing training to give police, paramedics, midwives and GPs greater confidence in talking to people who are in distress and help provide the care needed to keep them safe
- working to remove the means of suicide in local communities, for example erecting barriers at a ‘hot-spot’ at a shopping centre
- setting up a website (led by the charity MIND) to help educate communities in Cambridge and Peterborough and raise awareness about suicide. This is now being rolled out in other locations across the region
- developing ‘safety plans’ – a personalised care plan developed with every person with risk factors, involving families and carers, with clear ways to get help around the clock
Co-hosting with the Minister of State for Care and Support, Norman Lamb, the Deputy Prime Minister was joined by policy makers, clinicians, practitioners, academics, researchers and campaign groups involved in mental health. They discussed progress made and future opportunities in mental health provision.
Care and Support Minister Norman Lamb said:
When it comes to our physical health we believe the NHS should do everything possible to keep us alive and well – the same must be said for mental health.
Suicide is not inevitable for people in crisis and these deaths can be prevented with the right care. Three areas have this vision already and are doing incredible things to improve and importantly to save lives. I want every part of the health service to be as ambitious.
We all have a role to play. By talking openly about suicide we can remove the fear that stops people asking for help. We may feel uncomfortable, or frightened of saying the wrong thing, but if we tackle this stigma then we will save lives.
The conference is part of a wider campaign by the Deputy Prime Minister to bring treatment for mental health problems out of the shadows and in line with physical health. In government he has helped build a strong foundation for the improvement of mental health services, including:
- setting up and leading the first ever Mental Health Task Force with senior ministers from across the coalition
- securing a £400 million investment over the course of this parliament to improve access to talking therapies
- £150 million investment for treatment and support for children and young adults with eating disorders
- introducing ground-breaking waiting time and access standards to put a limit on the length of time people have to wait for treatment, backed up by more than £120 million investment
- £54 million for the Children and Young People’s Improving Access to Psychological Therapies programme
- £7 million investment to fund 50 new inpatient beds for children and young people