1Introduction
1.The scale of the avoidable loss of life from suicide is unacceptable. 4820 people are recorded as having died by suicide in England in 2015 but the true figure is likely to be higher.1 The 2014 suicide rate in England (10.3 deaths per 100,000) was the highest seen since 2004, and the 2015 rate was only marginally lower at 10.1.2 Suicide disproportionately affects men, accounting for around three quarters of all suicides, but rates are rising in women. It remains the biggest killer of men aged 49 and under3 and the leading cause of death in people aged 15–24.4
Figure 1: Suicide rates in the UK 1981–2014
Source: Office for National Statistics, 2016.
2.Suicide is now the leading cause of death directly related to pregnancy in the year after mothers give birth—the latest Confidential Enquiry into Maternal Deaths, published in December 2016, reveals that between 2009 and 2014 111 women in the UK died by suicide during or up to a year after pregnancy.5 There are also rising levels of suicides in prisons and particular concerns about the risks following release from prison.6
3.Suicide is also a health inequality issue: there is a well-established link between suicide and poor economic circumstances.7 People in the lowest socio-economic groups living in the most deprived areas are ten times more at risk of suicide than those in the most affluent group in the least deprived areas.8
4.We launched our inquiry in July 2016, and heard oral evidence in November 2016 from a wide range of organisations, professionals and other individuals, including those bereaved by suicide or with lived experience of suicidal thoughts. We received over 170 written submissions to the inquiry and also received 1600 responses to a survey run by Mind. We are grateful for these hugely useful contributions to our inquiry.
5.We also visited the north-west, meeting representatives from the Cheshire and Merseyside Suicide Prevention Network and organisations seeking to improve mental health and wellbeing through sport in Liverpool, and a liaison psychiatry service in Salford.
6.The strong message that we have heard throughout our inquiry is that suicide is preventable.
7.The Government indicated that an update to the suicide prevention strategy9 would be published in January 2017. In order to seek to influence the updated strategy, we published an interim report in December 2016,10 in which we outlined five key areas for consideration by the Government before the finalisation of the refreshed strategy. Those areas were:
(1) Implementation—a clear implementation programme underpinned by external scrutiny is required.
(2) Services to support people who are vulnerable to suicide—this includes wider support for public mental health and wellbeing alongside the identification of and targeted support for at risk groups; early intervention services, access to help in non-clinical settings, and improvements in both primary and secondary care; and services for those bereaved by suicide.
(3) Consensus statement on sharing information with families—professionals need better training to ensure that opportunities to involve families or friends in a patient’s recovery are maximised, where appropriate.
(4) Data—timely and consistent data is needed to enable swift responses to suspected suicides and to identify possible clusters, in order to prevent further suicides.
(5) Media—media guidelines relating to the reporting of suicide are being widely ignored and greater attention must be paid to dealing with breaches by the media, at national and local level. Consideration should also be given to what changes should be made to restrict access to potentially harmful internet sites and content.11
8.The updated strategy (which took the form of an annual progress report on the strategy, the third of its kind12) was published on 9 January 2017 alongside the Government’s response to the Mental Health Task Force13 and the Prime Minister’s announcements on mental health.14
9.Following the publication of the progress report, we held an oral evidence session with stakeholders on 31 January 2017 to hear their views.
10.The Government’s recent focus on suicide prevention and mental health is welcome and necessary. Whilst the Government recognised our work in their progress report, we were disappointed that our concerns were not fully addressed nor were all of our recommendations taken on board.
11.We consider that there are further steps which could be taken to reduce suicide. Those steps are set out in this report. We would like to see greater ambition from the Government in putting in place practical measures that we, and witnesses to our inquiry, believe will make a significant contribution to suicide prevention.
12.Although the strategy could be improved in some areas, we agree with witnesses that the key issue is not with the strategy itself, but with ensuring effective and consistent implementation across the country. As set out in one of the written submissions to our inquiry, “like all strategies what really matters is how [it is] implemented”.15 It matters little how good the suicide prevention strategy is on paper if it is not effectively implemented.
13.We are grateful to all those who have contributed to our inquiry and we recognise that for many people, telling us their personal experience of bereavement or suicidal crisis will have taken great courage. We have sought to make their voices heard.
14.We wish to acknowledge the work of the National Suicide Prevention Strategy Advisory Group—we have heard from many of its members throughout our inquiry. Their work is vital and we commend their diligence and insight as they advise the Government on its suicide prevention strategy.
1 Office for National Statistics, Suicide in England and Wales, 2015 registrations
2 Ibid
3 Office for National Statistics, http://visual.ons.gov.uk/what-are-the-top-causes-of-death-by-age-and-gender/
4 Office for National Statistics, Death registrations summary tables, 2015
5 Maternal, Newborn and Infant Clinical Outcome Review Programme, Saving Lives, Improving Mothers’ Care: surveillance of maternal deaths in the UK 2012–14 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009–14
6 Howard League for Penal Reform and Centre for Mental Health, Preventing prison suicide, 2016
7 Samaritans (SPR0072)
8 Public Health England (SPR0120)
10 Fourth Report of Session 2016–17, Suicide prevention: interim report, HC 300
11 Fourth Report of Session 2016–17, Suicide prevention: interim report, HC 300, paragraph 7
12 Preventing suicide in England: Third progress report of the cross-government outcomes strategy to save lives
14 ‘Prime Minister unveils plans to transform mental health support’, Government press release, 9 January 2017
15 Royal College of Psychiatrists (SPR0174)
1087