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Health & Social Care Committee

Suicide Prevention (pdf)

Published: 5th December 2018

“Suicide is everybody’s business, that’s the key message we’ve heard; that’s the message we all need to remember and share. “We shouldn’t rely on medical professionals or the emergency services to provide that support, we can all help by offering an opportunity to talk. “We need to raise awareness of the small things we can all do and spread the message that talking to someone in distress won’t make the situation worse.”

– Committee Chair, Dr Dai Lloyd AM (Plaid, South Wales West)

Useful links: Samaritans, Help is at Hand (pdf)

1. There’s a desperate need for frontline staff training in suicide prevention alongside increased public awareness

There were 360 recorded suicides in Wales for 2017, an increase of 38 compared to 2016 and with no signs of a long-term downward trend. These figures may also be an underestimate due to borderline cases which aren’t ruled as suicides by coroners.

The Royal College of Psychiatrists said a lack of compassion amongst frontline staff may lead to people not getting the help they need, but while witnesses accepted many people who have committed suicide will have had contact with their GPs, it was unfair for them to be expected to be a specialist in everything.

Patients who persistently self-harm have a stigma attached to them, but in a bit of good news, a number of frontline organisations – including the police, rail staff and fire service – were receiving suicide prevention training. Network Rail told the Committee that a public awareness campaign (Small Talk Saves Lives) prevented 1,700 suicides during 2017. Training and awareness clearly work.

The Committee recommended that GPs be told that where there’s a risk to someone’s life or a pattern of self-harming behaviour, they’re allowed to talk about it with family members without breaching doctor-patient confidentiality as set out in General Medical Council (GMC) guidelines.

2. Access to specialist services needs to improve

While for most physical illnesses, you can easily access specialist treatment if required, the same can’t be said for mental health. GPs complained that even when they’re worried about a patient’s suicide risk, the capacity in secondary/specialist care isn’t there for them to be referred to – one witness said GPs should have a direct line to a dedicated psychiatrist.

Dialectic behavioural therapy (DBT) was cited as a very successful treatment for people at risk of suicide, but even though it’s available in Wales, treatment for mental illness wasn’t said to carry the same esteem as that for physical illness and many people waiting for therapy contacted The Samaritans in the meantime.

When there’s a crisis, it’s often the police who respond – 12% of all police call-outs were said to be a result of mental health crises – and a number of witnesses said crisis care hasn’t received anywhere near the investment it should’ve had.

3. There’s a lack of support for people bereaved by suicide

One estimate suggests that every suicide “deeply affects” at least another 6 people, possibly more, and exposes 135 people. Network Rail said every fatality on the railway often involved 10 people and can be deeply harrowing due to the extent of the deceased’s injuries.

There was praise for how some organisations – namely the emergency services – handle the bereaved, often with great skill and kindness. However, many people were often unaware of the assistance available (Help is at Hand – pdf) until several months afterwards; a number of witnesses said they were often left alone to deal with their loss. Waiting lists for counselling are lengthy and last several months.

The emergency services are often deeply affected by suicides and Mind Cymru’s “Blue Light” programme was praised while the Ambulance Service said they contact staff who’ve been involved in a traumatic incident within 72 hours.

4. Certain groups should be prioritised for targeted help

The groups listed as being at heightened risk of suicides include middle-aged men (and men generally), young people who are not in work, education or training, people with long-term illnesses, the deprived, those with substance abuse problems and those with a history of mental health issues and (non-lethal) self-harm.

Suicide is the single biggest cause death of men aged 20-49 and the Committee said it should be considered a “national emergency”, made worse due to men’s general reluctance to seek help for health problems. More had to be done to reduce the stigma around discussing mental health despite some good work being carried out to date.

While suicide may well be a male problem, women aged 19 and under have the highest rates of self-harm (which will likely develop into a suicide risk in adulthood) and the Committee described the levels of self-harm amongst young people as “alarming”.

5. The media should report suicide responsibly

We saw plenty of irresponsible reporting in the media during the 2007-08 Bridgend suicide cluster. It continues to this day with a variety of conspiracies floating around on the internet blaming everything from Wi-Fi to Satanism. It was even subject of a sensationalist Danish film which offended many families of the deceased.

The Committee was told that “good progress” has been made on responsible reporting, such as including pointers to help and advice alongside articles on suicide. Nonetheless, they recommended the Welsh Government work with universities and other interested parties to ensure guidance relating to the reporting of suicide was fully understood by trainee journalists.