Agenda item
SUICIDE PREVENTION PLAN - DRAFT FOR CONSULTATION
Minutes:
Dr Hannah Emmett, Speciality Registrar in Public Health, gave a short introduction on the report and provided a presentation on creating a Suicide Prevention Plan for Tower Hamlets and, in doing so, focussed on the following points:
Context
· 5 year forward view for mental health: requirement for all local authorities to have a suicide prevention plan in place by 2017.
· National target – 10% reduction 2016-21
· Public Health England guidance: risk factors and possible areas for action
Risk Factors – children and young people
· Mental ill health and domestic violence in the family
· Academic and exam pressures
· Physical, emotional or sexual abuse or neglect
· Social isolation or withdrawal
· Bereavement of a family member of friend
· Physical health conditions that have a special impact
· Bullying either in person or online impact
· Excessive alcohol use or illicit drug use
· Suicide-related internet use
· Mental ill health, suicidal ideation, self-harm
Focus for consultation
· Are these the right priorities?
· Are the monitoring arrangements sufficient?
· Should the zero suicide option be adopted?
Risk Factors
· Long-term circumstances e.g. history of drug or alcohol abuse
· Acute life events e.g. loss of employment or debt
Key Issues
· Numbers relatively small
· Far-reaching impact
· Specific local concerns
Local data
· Men outnumber women 4 to 1
· Over half suicides are aged 20-39
· Most common methods are injury and hanging
Improving help for those in crisis – long term aims
More people will:
· Feel in control of their mental health
· Know how to access help when they need it
· Access mental health services in an appropriate setting
Improving help for those in crisis – in the next 12 months
We will:
· Examine the needs of people attending A&E in crisis
· Map the current crisis referral pathway and address any gaps
Shaping the Strategy
· LBTH Council departments
· NHS
· Emergency services
· Universities and schools
· Voluntary sector
· Transport services
· Directorate Leadership Team (DLT) and Corporate Leadership Team (CLT)
· Mental Health Partnership Board
· Drug and Alcohol Action Team
· Educational psychology
· TH Inter Faith Forum
Early intervention and prevention – long term aims
More people will:
· Access services in the early stages of mental illness
· Be assessed for mental illness when they are most at risk
· Have the personal tools to help them cope with stressors
Early intervention and prevention – in the next 12 months
We will:
· Work with specialist mental health services for targeted groups
· Improve signposting of our existing preventative work
Identifying the needs of vulnerable people – long term aims
· Frontline staff will recognise signs of mental illness and have a range of referral options
· Service users in temporary accommodation will be followed up appropriately
· Responsibility for service users housed outside the borough will be clear
Identifying the needs of vulnerable people – in the next 12 months
We will:
· Share safeguarding lessons learnt
· Improve practice in non-clinical statutory services
· Improve support for specific vulnerable groups
Addressing training needs – long term aims
We will:
· Ensure that suicide prevention is embedded in the wider community
· Meet the training needs of clinical and non-clinical staff
Addressing training needs – in the next 12 months
We will:
· Provide the first phase of suicide prevention training to frontline staff
· Address general mental health training needs
Zero suicide
· No suicide is unavoidable
· Represents shift in outlook from part of mental health care to being a never event
· Where successful ‘boldness’ has galvanised teams
· If not zero, how many?
Communication and awareness – long term aims
We will:
· Have a communications strategy that promotes local work and supports relevant national campaigns
· Supporting responsible reporting of suicide in the media
Communication and awareness – in the next 12 months
We will:
· Identify sites where suicides occur and install appropriate signage
· Use social media to foster links between statutory and third sector services
Key areas of discussion
· Children and young people
· Bereavement support
· Zero suicide
Next Steps
· Public consultation
· Review by steering group
· Agree action plan for coming year
· Approval of Health and Wellbeing Board
Questions
· Are these the right priorities?
· Are the monitoring arrangements sufficient?
· Should the zero suicide aspiration be adopted?
The meeting then became inquorate due to the two representatives from the NHS Tower Hamlets Clinical Commissioning Group (CCG) leaving the meeting. The Chair agreed that the Board would make ‘shadow decisions’ and would have them formally ratified at the next meeting of the Health and Wellbeing Board.
Dr Emmett explained that they were committed to undertake public consultation in the next few weeks as final approval of the Suicide Prevention Plan was required in September 2017. Consequently, the Chair explained that the Board would contact CCG colleagues outside of the meeting to confirm that they were happy with the recommendations made by the Board, to enable the September deadline to be met.
Debbie Jones, Director of Children’s Services, pointed out that in relation to suicide, under reporting was a big issue. She asked if there was anything further that could be done to flag up the risks. Chris Lovitt, Associate Director of Public Health, explained that it was important to know when a death was being considered as a suicide. He pointed out the importance of organisations such as the Metropolitan Police sharing information as the plan required cooperation. Sue Williams, Borough Commander for the Metropolitan Police, stated that her staff attended every suicide call in the borough and confirmed that they would have a lot of relevant information that could be shared. She also added that deaths from high rise buildings were not treated as suicides.
Dr Evans welcomed the plan and explained that after suicides, the NHS looked into the care that that person had received. She confirmed that there was a lot more that could be done.
Mr Goulbourne referred to the responsibility that employers had to provide support to staff and stated that it was important that this was included in the Strategy.
Ms Bollen suggested increasing the consultees by possibly seeking the views of those that have attempted suicide and relatives of those who had committed suicide as a way of obtaining relevant and meaningful information. Mr Lovitt confirmed that they were identifying sites where suicides often occur with the intention of strengthening their knowledge on the subject. He confirmed that he was happy to amend the consultation document, subject to agreement by CCG representatives.
Councillor Islam referred to the communication and awareness section of the draft consultation document and suggested including some information on how different religions respond to and view suicide.
Ms Williams stated that, as a result of 3 PC suicides, the MPS had produced a Strategy on suicide. She confirmed that the 3 PCs had had underlying mental issues and that colleagues had been aware that something was wrong. She referred to the importance of giving appropriate advice and guidance to employers, colleagues and peers.
The Chair gave the view that a significant barrier was resources as support could not be offered to everyone who was at risk of suicide. She stated that if the target was zero suicides, then there would be pressure to reach that target and it may be considered as failure if zero was not reached. She confirmed that the ambition should be that suicide did not happen.
Mr Banerjee suggested that the paragraph in the consultation document that read “the national target is a reduction in the suicide rate by 10% over the period of 2016 to 2021” be removed and instead to explain that suicide should be a “never event”.
The Health and Wellbeing Board were recommended to:
1. Consider whether these are the correct priorities
2. Consider whether the action plan addresses the priorities
3. Consider whether the monitoring arrangements are sufficient
4. Request the Suicide Prevention Plan to return, post consultation, to the September Board for adoption.
The remaining Members of the Board agreed that the above recommendations were put to the Health and Wellbeing Board on 5 September 2017, for formal adoption.
Supporting documents:
- Suicide Prevention Strategy, item 7. PDF 139 KB
- Suicide Prevention Strategy - Appendix 1, item 7. PDF 354 KB
- Suicide Prevention Strategy - Appendix 2, item 7. PDF 2 MB
- Suicide Prevention Strategy - Appendix 3, item 7. PDF 58 KB