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Better early intervention needed to help tackle suicide rates, says RCN


A campaign for better mental health provision and early intervention in the community has been launched by the Royal College of Nursing in partnership with the family of a man who took his own life after receiving inconsistent care.

The family of Martin Strain has joined forces with the RCN and the Mental Health Foundation to highlight the need for people with mental health to have better access to treatment.

They want to see more community-based mental health staff employed to triage patients that present to GPs with mental health conditions.

“We are no longer in the dark ages in terms of knowing how to treat mental illness. But..there needs to be a step change in the way in which community services are staffed and resourced”

Peter Carter

Coordinated care plans should also be in place, they say, for people who have moderate or severe depression and are also at risk – due to factors including age, gender, drug use and major trauma – at a lower threshold than is currently required.

The family is also calling for better support for GPs, so they can work more closely with other mental health services and recognise warning signs for those at risk of suicide.

Martin Strain took his own life in 2014 after experiencing severe depression over a period of several years.

His GP was aware of his condition and prescribed him anti-depressants. However, the family claim she referred him to mental health services that she had little knowledge of and that he saw more than a dozen different counsellors and psychiatrists over seven years.

Meanwhile, his family added he was not allowed to access secondary services, because it was felt that his drug and alcohol abuse would have hindered his engagement with talking therapies.

Two weeks before he died, he visited his GP for a review and more anti-depressants but the doctor failed to ask if he was suicidal, they added.

His family believes that if he had received more consistent, coordinated care he would have been less likely to have missed appointments and could have responded better to available treatments.

“We need to step back and ask what reasonable steps can be taken to prevent people from having to reach mental health crisis”

Jenny Edwards

His father Adrian Strain said: “While no one can say with confidence that Martin’s depression would ever have been cured, if a community-based nurse as well as sustained care from a coordinated care plan had been available to Martin through that GP, we would at least be able to satisfy ourselves now that Martin was as well supported as possible.”

Peter Carter, chief executive and general secretary of the RCN, said: “Suicide is a complex issue, and it is difficult to say with certainty that individual deaths can be prevented, but we must listen to families like the Strains who have spoken so eloquently about their son’s experience and the gaps in the provision of care.

“We are no longer in the dark ages in terms of understanding or knowing how to treat mental illness – treatments do exist and do work for many people,” he said. “But for everyone to benefit from these advances, there needs to be a step change in the way in which community services are staffed and resourced.”

Jenny Edwards, chief executive of the Mental Health Foundation, added: “Ultimately, we need excellent care, but we also need to step back and ask what reasonable steps can be taken to prevent people from having to reach mental health crises. Early intervention is the key”.

Latest figures from the Office of National Statistics, published yesterday, showed a particular rise in suicides among men during 2013 – the most recent year for which statistics are available – making it the highest rate since 2001.

Overall, there were 6,233 suicides among people aged 15 and over in the UK in 2013, 252 more than in
2012 – a 4% increase. Of these, 78% occurred in males and 22% were in females.

Within England, the suicide rate was highest in the North East at 13.8 deaths per 100,000 and lowest in London at 7.4 per 100,000 population.


Readers' comments (7)

  • Unfortunate reporting. Martin Strain did not commit suicide, he died of depression.

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  • What a strange comment Jessica. The report says he took his own life. Is that not suicide?

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  • Yes, you could also say that Martin died of suicide. However, he did not 'commit' suicide, this is an incredibly outdated term, still used by the media, which implies an offence has occurred and has an awful lot of negative connotations surrounding it.

    Suicide has not been an offence for many, many years, so why do we still talk like it is?

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  • I know what you mean Jessica but that isn't the most important issue here. This poor man had suffered from a treatable disorder for years. The relationship with a consistent therapist can make a difference and trained mental health nurses are often best at providing this type of care. There has been a need for more funding for these type of services for many years. Let's hope more trained nurses are provided to treat mental health issues as soon as possible.

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  • Services such as the Community Advice & Support Service (in the Magistrates' Courts in Plymouth and Cornwall) have been triaging and referring people with mental health difficulties for 10 years now, but remain charitable and dependent upon philanthropic funding to maintain the largely volunteer team. Please everyone understand that triaging cannot help if necessary NHS treatment is not available. We have regular experience of clients with severe difficulties being excluded from NHS care because there is insufficient capacity to help them in CAMHS. We need major investment in treatment services which should be made even in these straitened times.
    Triaging can divert people from unnecessary use of NHS services to other support when that is appropriate, or arrange complementary support to improve outcomes when it is. Using high-paid NHS staff to triage is not necessary, diverts trained people from delivering treatment, and is also not very effective - people with mental difficulties often need access to a range of help, not just NHS. This kind of triaging does not fit the NHS culture which is generally exclusive of other providers even when they offer more relevant and cheaper solutions. We need to accept that (relatively) high cost, limited access NHS services are not the single answer, even though they are clearly a part of the answer. I know these points are generalizations and may challenge, but that does not make them invalid.
    Think outside the box - triaging of the kind suggested requires a different attitude, skill set, knowledge base and more time than possessed by NHS workers. It can be done well using (trained) volunteers. We know, we do it every day. Don't reinvent the wheel, look at what already exists - if you don't you will simply prove the point that the NHS is exclusive and unable to learn from others. If I sound frustrated it's because I am! Triaging is an idea whose time has come; lots of people say so as if it is a new idea, but none of you are learning from the people already doing it.

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  • I was an ED nurse and lost a colleague who took their own life after inconsistenent, poor care, poor attitudes and mental health staff lacking the skills and knowledge. Also, saw other patients treated in such a way that caused further distress.

    Also, my own son who has autism under mental health failed, abused and let down. Hence, why I gave up a job I loved to care for him myself. Mental health is not on the same levelas physical conditions and seems to attract managers and clinians who are not always sincere and driven by profit and reputation

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  • Anonymous | 24-Feb-2015 1:23 pm

    It is so sad to hear such stories as I have professional experience in Europe of totally integrated psychiatric services in a hospital where it is a specialist department like all of the others providing excellent support at all levels to those who need it with a wide range of facilities and available 24/24 for consultation and A&E care where the on call HO can be available within about half an hour and with support of the triage staff until they arrive.

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