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Mental health trust launches 'zero suicide' strategy

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A mental health trust based in Liverpool has launched a “zero suicide” strategy in a bid to eliminate suicide of patients under its care.

Mersey Care Trust hopes to significantly reduce suicide among the trust’s patients within the next year and a half, with the aim of having no cases by 2020.

The organisation was one of the first to publicly commit to the coalition government’s call at the start of the year for all trusts to commit to a new ambition for ‘zero suicide’.

The trust’s associate medical director for suicide prevention Rebecca Martinez told Nursing Times the organisation’s strategy would in its first year centre on staff learning.

”We are looking at new services, new approaches and potentially even new types of worker”

Joe Rafferty

All staff will complete mandatory refreshed training on suicide prevention and awareness, she said, with sessions also planned on learning from adverse incidents so mistakes are not repeated.

Dr Martinez said this was part of a four-point plan which would include a focus on engaging with service users to redesign services.

The trust’s chief executive, Joe Rafferty, added the organisation will collect and analyse patient data in new ways to better assess the risk of someone who might attempt suicide and then subsequently improve their care plan.

“So rather than somebody harbouring years of suicidal thinking, and eventually that reaching a tipping point, we can intervene at a stage much earlier in that cycle of behaviour,” he said.

He said the trust wanted to take the same rigorous approach to its use of clinical data as had been seen in the use of data to help reduce hospital acquired infections or post-operative risk in surgery.

In addition, he said the trust was in discussion with commissioners to increase liaison after discharge and about how to use buddying schemes to prevent patients from becoming isolated on their return to the community.

“We do know that in the couple of weeks post discharge, this is a really dangerous period for people who have suicidal thoughts.

“We are looking at new services, new approaches and potentially even new types of workers – there is a great opportunity for people with lived experience to move into peer mentoring schemes,” he added.

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Readers' comments (2)

  • michael stone

    I'm not going to explain this in any detail, but while suicide is very often a tragedy - and I'm 100% with 'if someone says 'I keep having these suicidal feeling but I don't want to commit suicide' THEY SHOULD BE HELPED' - the idea that all suicides 'can legally be prevented' isn't supported by our laws.

    HCPs debate endlessly the concept of 'rational suicide' which is a distraction - the fact is, 'suicide cannot necessarily be legally prevented as an action' is the legal situation.

    I KNOW that is very difficult and challenging - but I wish more clinicians could properly understand our law around mental capacity and 'automomy', as this causes me endless 'trouble' during my EoL discussions about not suicide, but refusals of potentially life-sustaining treatments.

    See

    http://www.bmj.com/content/350/bmj.h2883/rr-2

    and the piece in a newspaper by a Judge.

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  • This article does not speak about the “legality” of preventing suicide. However, in many countries ‘legal’ statutes exist to provide the time needed for the impulse of suicide to recede and provide urgent treatment.

    In America, each state has the ability to provide, by law, codes that help people.
    For Example, in California, there is the:

    WELFARE AND INSTITUTIONS CODE
    SECTION 5150-5155


    5150. (a) When a person, as a result of a mental health disorder,is a danger to others, or to himself or herself, or gravely disabled,
    a peace officer, professional person in charge of a facility designated by the county for evaluation and treatment, member of the attending staff, as defined by regulation, of a facility designated by the county for evaluation and treatment, designated members of a mobile crisis team, or professional person designated by the county may, upon probable cause, take, or cause to be taken, the person into
    custody for a period of up to 72 hours for assessment, evaluation, and crisis intervention, or placement for evaluation and treatment in a facility designated by the county for evaluation and treatment and
    approved by the State Department of Health Care Services. At a minimum, assessment, as defined in Section 5150.4, and evaluation, as defined in subdivision (a) of Section 5008, shall be conducted and
    provided on an ongoing basis. Crisis intervention, as defined in subdivision (e) of Section 5008, may be provided concurrently with assessment, evaluation, or any other service.

    Many people seldom state 'I keep having these suicidal feeling but I don't want to commit suicide’. 50% of individuals act within one hour from impulse to action. Another 25% act within 4 hours. People in a mental health crisis are not able to reach out for help. Their mindset is very limited and focused. Think of someone having a heart attack - usually too late to make a phone call. Many had tried recently - over 80% have been to their primary care providers within one month.

    That just emphasizes the need for intervention before prevention, which is the point of this article.

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