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Need for better nurse training in suicide risk awareness

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Suicide awareness training should be mandatory for health professionals working with high risk groups, the Royal College of Nursing has said in response to a critical report from MPs.

The RCN warned that nurses themselves were increasingly at high risk of suicide due to the pressure of their jobs, which was being made worse by staff shortages.

“The clear message we have heard throughout our inquiry is that suicide is preventable”

Sarah Wollaston

In a report published today, MPs said that the government’s suicide prevention strategy needed greater focus on implementation, with “tangible action” to ensure its effective introduction.

The Commons’ health select committee said that, as part of its investigation into suicide, it heard evidence that clinicians sometimes failed to recognise patients who are suicidal.

The cross-bench party group of MPs called for improve training for students and clinicians in the assessment of suicide risk.

MPs also said they were disappointed that ministers had not made it policy that all mental health patients discharged from inpatient care should receive follow up within three days.

They warned that they “remain concerned” that an ongoing workforce shortfall in the mental health sector was 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,” they said in their report.

The government updated its 2012 suicide strategy in January, expanding its aims to meet the ultimate ambitions of reducing suicides by 10% by March 2021.

“The government must go further and make suicide awareness training mandatory”

Ian Hulatt

Witnesses to the committee’s inquiry told MPs that the underlying government strategy was “essentially sound”, but that the key problem lies with inadequate implementation, said the report.

It found that 95% of local authorities now had a suicide prevention plan, but there was currently little or no information about their quality.

“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,” said the report.

The government’s provision of funding for suicide prevention was welcome, said the committee, but they were concerned it would “be too little and too late” to implement the strategy effectively.

The government has allocated £5m for 2018-19, representing an average of just under £33,000 for each of the 152 upper-tier local authority areas and the £10m allocated for each of the following two years represents an average of just under £66,000.

However, the MPs said the government must set out how it will make sure that funding is available for the actions outlined in their strategy.

wollaston sarah web

wollaston sarah web

Sarah Wollaston

They also highlighted a “clear need” to reach people at risk of suicide but not in contact with any health services, noting that the voluntary sector played a “vital role”.

It was essential that local authority suicide prevention plans included a strategy for reaching people who were unlikely to access traditional services, particularly men, said the report.

But the committee said it was disappointed the government had “not gone further to drive practical prevention” for known vulnerable groups and urged ministers to accept its recommendation that all patients who are discharged from inpatient care should receive follow up support within three days.

In too many cases, those who have died by suicide were known to be at higher risk but it had been poorly communicated or not discussed at all with those who could have protected them, said MPs.

Committee chair Dr Sarah Wollaston, Conservative MP for Totnes, said: “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 the loss of life.

“If the government wishes to be truly ambitious in reducing the toll of suicide, there are many further steps which it could take, which we have set out in this report,” she said.

“The government must prioritise effective implementation of its strategy because without it, any strategy is of very limited value,” she added.

Ian Hulatt, professional lead for mental health at the RCN, said: “The report exposes the gap between government rhetoric and action.

Ian Hulatt

Ian Hulatt

Ian Hulatt

“The funding is not getting through and little is known about the quality of local plans or their ability to reach the people who need support,” he said.

“In far too many cases, people who die are known to be at higher risk but it is not discussed with family and friends who could help,” he said. “The government must make it a priority to speed up information sharing and make the difference between prevention and tragedy.”

He added: “Nurses themselves are a high risk group, due to the strain and responsibility of their role. Sadly, this situation is being exacerbated by the pressure on the NHS and thousands of unfilled nursing jobs.

“The government must go further and make suicide awareness training mandatory for health professionals working with high risk groups, beginning with training before registration,” he said.

A resolution was passed at RCN congress in 2014 calling on the college’s council to influence higher education institutions to include suicide prevention across all fields of pre-registration nurse education.

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