Nurses working in primary care should receive better training in identifying patients who may be contemplating taking their own lives, according to a report on suicide prevention by MPs.
The Commons’ health select committee said today that the current suicide rate in England was “unacceptable”.
“Suicide is preventable and much more can and should be done”
The committee has published an interim report on suicide prevention in order to draw attention to “emerging themes” from its current inquiry into the topic ahead of an updated government strategy. The government is expected to reveal its new suicide prevention strategy in the new year.
The MPs said in their report that the government must prioritise a “clear implementation strategy and increase support for public mental health and early intervention services if it is to bring down the unacceptable suicide rate”.
Regarding implementation, the committee called for a clear strategy, with strong national leadership and clear accountability, alongside regular and transparent external scrutiny.
Wider support for public mental health and wellbeing was needed alongside targeted support for at risk groups through early intervention services and access to help in non-clinical settings.
The committee said it recommended improvements in both primary and secondary care, and services for those bereaved by suicide.
“Identifying those at risk and making the right intervention can be very challenging”
Renewed focus should be given to providing mental health training for staff in “public facing roles”, especially in higher risk situations, said the committee in its report.
This training was needed to provide practical support for those experiencing adversity that may lead to a crisis, including bereavement and financial distress, it stated.
To help people who are in contact with primary care services, GPs need better training in suicide risk, said the report. NICE guidelines should be “promoted and implemented” across primary care.
All patients being discharged from inpatient care should receive follow up support within three days of discharge, rather than the current standard of seven days, the committee recommended.
Meanwhile, it said the deadline for establishing liaison psychiatry services in every hospital should be brought forward from 2020 to 2017.
“Money hasn’t come as quickly as promised”
In addition, it said professionals needed better training to ensure that opportunities to involve families or friends in a patient’s recovery were maximised, where appropriate.
It added that “timely and consistent” data was needed to enable “swift” responses to suspected suicides and to identify possible clusters, in order to prevent further suicides.
The committee said it had published its interim report to allow the emerging themes from witnesses to be presented to government in time to inform the updated suicide prevention strategy.
A full report will follow next year, once the government strategy has been published and witnesses have been invited to give their views, it said.
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Committee chair Dr Sarah Wollaston said 4,820 people were recorded as having died by suicide in England last year, but “the true figure is likely to be higher”.
“Suicide is preventable and much more can and should be done to support those at risk,” she said. “I hope to see the most important messages from witnesses to our inquiry taken into account by the government in their renewed suicide prevention strategy.
The Royal College of Nursing said the committee was “right” to highlight that, as well as better public mental health, those subject to multiple risk factors, such as deprivation, needed “targeted action”.
Ian Hulatt, the RCN’s professional lead for mental health nursing, said: “Nurses and other health staff have considerable expertise in working to prevent suicide, though identifying those at risk and making the right intervention can be very challenging, especially with the enormous pressures on a small workforce.”
He noted that the RCN had contributed, along with the government and other organisations, to a “consensus statement” aimed at improving information and support for families concerned about a relative who may be at risk of suicide, which the committee “rightly says should be heeded”.
“The NHS has a duty towards individuals and the community to improve care for people with known mental health problems, as well as those who may be at risk of developing them,” said Mr Hulatt.
He added: “Public services must now work together when the government’s strategy is refreshed to ensure that individuals do not slip through the net and tragedy can be avoided wherever possible.”
Sean Duggan, chief executive of the Mental Health Network, which is part of the NHS Confederation, said: “We completely agree with the committee that a lot more can be done to prevent suicide.
“Developing mental health services is essential but money hasn’t come as quickly as promised and this is holding-up progress,” he said.
“For too long we have seen year-on-year increases in prison suicide and there are worrying trends around childrens’ mental health too, with insufficient investment to improve their care,” he added.
The committee’s key messages for suicide prevention:
- Implementation – a clear implementation strategy, with strong national leadership and clear accountability, alongside regular and transparent external scrutiny
- 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 through early intervention services and access to help in non-clinical settings. The Committee recommends improvements in both primary and secondary care and services for those bereaved by suicide
- 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
- 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. The Committee recommends changes to help the law to make sure that suicides are not missed
- 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 be given to what changes should be made to restrict access to harmful internet content, which may encourage suicide