In December 2016, we published an interim report on suicide prevention in order to help inform the Government’s updated suicide prevention strategy. We welcome the Government’s recent focus on suicide prevention and mental health, and the publication of its update to the strategy in the form of a progress report, the third of its kind. We subsequently heard further evidence on the progress report from stakeholders and this report builds on our initial findings and takes account of their views.
The clear message we have heard throughout our inquiry is that suicide is preventable. The current rate of suicide is unacceptable and is likely to under-represent the true scale of this avoidable loss of life.
We agree with witnesses to our inquiry that the underlying strategy is essentially sound but that the key problem lies with inadequate implementation. Whilst we welcome the fact that 95% of local authorities now have a suicide prevention plan in place or in development, we are concerned that there is currently little or no information about the quality of those plans. It is not enough simply to count the number of plans in existence—there must be a clear, effective quality assurance process and implementation at local and national level.
We welcome the provision of funding for suicide prevention but we are concerned that it will be too little and too late to implement the strategy as effectively as required. We call on the Government to set out how it will make sure that funding is available for the actions outlined in the strategy.
Recognising the need to reach people who are at risk of suicide but not in contact with any health services, we welcome the role of the voluntary sector and the importance of those working in non-clinical settings. A joined-up approach is essential and local authorities’ suicide prevention plans should include a strategy for reaching those who are unlikely to access traditional services, particularly men. We recognise the importance of ongoing work to tackle stigma and build public confidence to discuss mental health. We are pleased that Health Education England and Public Health England are reviewing the training materials for staff working in front-line settings to help them to recognise and provide initial help and signposting for individuals who are in distress.
We heard evidence that clinicians sometimes fail to recognise patients who are suicidal. We call on the General Medical Council, Royal College of General Practitioners and Health Education England to improve training for students and clinicians in the assessment of suicide risk.
We are disappointed that the Government has not adopted our recommendation that all patients who are discharged from inpatient care should receive follow up within three days. We remain concerned that the ongoing workforce shortfall is the key barrier to this goal. We call on the Government to resource crisis resolution home treatment teams, to establish and sustain liaison psychiatry services in all acute hospitals and to implement the Mental Health Taskforce recommendations.
Self-harm is the single biggest indicator of suicide risk. We agree with the Government that it is unacceptable that only 60% of people who present at emergency departments for self-harm receive a psychosocial assessment. As well as a guaranteed psychosocial assessment, all patients presenting with self-harm should have a safety plan.
We are disappointed with the lack of progress on the promotion of the Consensus Statement on information sharing as this could save lives, and by the lack of proposals for action in the progress report.
Throughout our inquiry we heard from bereaved families about the devastating and lasting impact of suicide. Those bereaved in this way are themselves at far greater risk and high quality support for individuals bereaved by suicide must be included in suicide prevention plans.
Irresponsible media reporting can have a damaging effect on vulnerable people. We recognise and commend the important work done by Samaritans in this area and urge the Department of Health and Public Health England to be vocal and proactive in supporting their work. The IPSO Editors’ Code of Practice and the Ofcom Broadcasting Code should be strengthened to ensure that detailed descriptions of suicide methods, particularly those that are new or emerging, and locations which could be a precedent for other vulnerable individuals are not presented or portrayed.
Unreliable and inaccurate data hampers suicide prevention. It is difficult to reliably assess which public health initiatives are the most effective without consistency in the recording of suicide. We are disappointed that the Government has not committed to look at this in more detail or to review the standard of proof for conclusions of death by suicide. We consider it essential that there is better guidance for coroners to reduce the number of hard-to-code narrative conclusions and that there is rapid communication between all agencies so that local public health teams are aware of possible clusters or new methods so that early preventative action can be taken.
If the Government wishes to be truly ambitious in reducing the toll of suicide, there are many further steps which it could take, as set out in this report. The Government must prioritise effective implementation because without it, any strategy is of very limited value.