Agenda item

[To receive an update report on suicide prevention].

The outgoing Chair of the Suicide Prevention Stakeholder Forum presented an update report on suicide prevention.  The incoming Chair of the Forum had sent her apologies due to sustaining an injury.  He had been the Chair of the Forum for three years since its initial inception.  His background was working with the Local Samaritans, he also had a regional role with the Samaritans working with the twelve prisons in the West Midlands Region.

The outgoing Chair of the Suicide Prevention Stakeholder Forum remarked that nationally there had been 5821 suicides in the year 2017.  This equated to 16 suicides a day.  It was estimated that there were ten times as many suicides attempts as completed suicides.  Nationally, approximately 75% of people who took their own life were male.  The peek for men was age 45-49 and for women age 50-54.  72% of the people had not been in contact with secondary mental health services in the year prior to taking their own life.  It was estimated that the direct and indirect cost to the economy of one suicide equated to £1.7 million.  It was the single biggest killer of men under the age of 45 in the country.  On a local level there had been 25 suicides in Wolverhampton in 2017.  Broadly there had been a downward trend since 2002.  Slightly more men had taken their own life than women in Wolverhampton in 2017.

The outgoing Chair of the Suicide Prevention Stakeholder Forum commented that the national strategy had two key aims, to achieve a reduction in the suicide rate in the general population of the country and to offer better support for those bereaved or effected by suicide.  The national report recommended 60 areas where organisations should be placing their efforts, particularly focusing around suicide audits and suicide prevention action plans as part of a multi-agency approach.  The Centre for Public Scrutiny had produced some guidance on the scrutiny of suicide prevention work.  The report circulated with the agenda answered the questions that the Centre for Public Scrutiny had suggested should be asked by a Scrutiny Panel.  He supported the Centre for Public Scrutiny Guidance suggestions on the ten areas that a Scrutiny Panel should seek answers. 

The outgoing Chair of the Suicide Prevention Stakeholder Forum stated that in 2014-2015 a comprehensive Needs Assessment had been carried out by a Consultant in Public Health.  The assessment looked at the perceived needs, the services available, where the gaps were and what could be done to rectify them.  The Needs Assessment had resulted in a strategy being drawn up which was refreshed on an annual basis.  The Forum’s work was very much driven by the strategy.  It was important to sustain momentum in suicide prevention work.  He was pleased that the Forum was independently Chaired, which helped to cement the concept that a multi-agency approach was required, rather than suicide prevention being seen as solely a Local Authority function in conjunction with a limited amount of certain partners.  There were now 70 people on the Suicide Prevention Forum mailing list.  Every meeting of the Forum was attended by between 15-20 people.  There were targets as to the most needed groups with refugees and migrants and the LGBT community being high on the list.  A considerable amount of work had gone into improving bereavement support and training agencies on suicide. 

The outgoing Chair of the Suicide Prevention Stakeholder Forum commented that one of the key challenges remaining was the provision of real-time information.  Up to date information was important, it was however a real struggle to obtain information from the Black Country Coroner.  There was a greater push for regional activity on areas such as data sharing with the Coroner.  The Suicide Prevention Strategy had to be live, meaningful and kept up to date.  In 2020 there would be a fundamental review of the strategy, focussing on areas such as raising awareness of suicide, training and support to Bereavement Services and further joined up working on a national and regional basis. 

Members raised a concern that the Coroner had not shared important information to help in the work of the Suicide Prevention Stakeholder Forum. 

A Member of the Panel remarked that suicide prevention should be a compulsory component of health training.  They commented that children should see school nurses more often and that teachers should also proactively identify bullying, loneliness, behavioural changes, self-harm and identity issues.  A Panel Member added that social media had made it more difficult to obtain a full understanding of all the issues. 

The outgoing Chair of the Suicide Prevention Stakeholder Forum commented that they were pro-actively working to try and introduce suicide prevention into the training for GPs.  His successor as Chair was very clear about having a universal training programme that could be rolled out in the City.  As a Forum it was their responsibility to engage with as many different people as possible from different organisations. 

A Member of the Panel commented that the risk of suicide increased after a recent bereavement, particularly for men.  The outgoing Chair of the Suicide Prevention Stakeholder Forum responded that they had been working with “Cruse Bereavement Care” on a regional level and they also worked specifically with Compton Care and other organisations.  He thought men were particularly affected after a bereavement because they were less likely to talk about their emotional wellbeing and seek support.  They were putting a great deal of effort into this area.  A Panel Member remarked that football teams could play an important role in helping men obtain support.  

There was a discussion about where the most suicides took place in the City, which seemed to be happening in the most deprived areas of the City.  Members raised the importance of the role of the community in providing support to people in despair.

The Consultant in Public Health remarked that suicide prevention was much wider than the medical health system.  There were various contributors as to why someone became suicidal.  Identifying support to find employment and conditions in school were examples of where targeted work could help.  It was therefore not just about identifying people with mental health issues and then giving them access to mental health services.

A Member of the Panel asked if there was any data on attempted suicides.    The outgoing Chair of the Suicide Prevention Stakeholder Forum stated that it was difficult to obtain because self-harm incidences were not necessarily all suicide attempts.  A far greater number of women self-harmed relative to men.  Judging intention was very difficult and therefore accurate data on suicide attempts was hard to gather.      

There was a discussion about the most common methods that men and women used to take their own life, and which were most likely to be fatal.  The Senior Public Health Specialist commented that it was possible that the suicide figures for women were lower, as women tended to use less fatalistic methods.  It was crucial to obtain more data from the Coroner to be able to have a full understanding of the picture in Wolverhampton and to help prevent suicides in the future.

The Chair asked if any data was captured for suicides under the age of 15.  The outgoing Chair of the Suicide Prevention Stakeholder Forum stated that accurate data collation was even more difficult for under 15’s.  Since 2011 the figures were for confirmed suicides. There was more sensitivity and reticence in this area because of the prospect of parents and guardians blaming themselves for the suicide of their child.  The Public Health Specialist commented that nationally there had been a significant increase of suicides under the age of 15, but thankfully this had not been the case in Wolverhampton, where the numbers remained small. 

The Public Health Specialist stated that the figures for suicide were likely to increase.  This was because since 2018 the Coroner now could judge his verdict of suicide on the balance of probabilities rather than the criminal standard of beyond reasonable doubt.  The Coroner therefore had a broader scope to reach a verdict of suicide.

A Member of the Panel made reference to the report which stated that 72% of those who died by suicide were not in touch with secondary mental health services within one year prior to death.  He asked if it was known how many people were in touch with primary care service and were being treated for depression, pain or anxiety and on medication such as benzodiazepines, antidepressants or opioids.  He added that if it was not known, whether the data could be captured in the future.  The Consultant in Public Health responded generally stating that it was not always a medical issue which was the cause for suicide.  They were training GPs in suicide prevention work. 

Resolved: That the Chair of the Health Scrutiny Panel write to the Black Country Coroner on the matter of improving data sharing between the Coroner and the City of Wolverhampton Council’s Public Health Team.