Social Care News and Features

The government has launched a strategy to “rapidly reduce” England’s suicide rate, which has remained stuck since 2018 amid increasing numbers of deaths of children and young people.

Ministers want to see the current rate fall within the next two-and-a-half years and have set out more than 100 measures to achieve this in the five-year plan, most of which are ongoing.

However, while welcoming the strategy – the first since 2012 – Samaritans criticised the lack of funding behind it.

The suicide rate across England and Wales fell sharply from 1998-2010, from 14 to 9.3 deaths per 100,000 population per year.

No fall in suicide rate since 2018

However, since 2018, it has hovered between 10 and 11 deaths per 100,000, while provisional data suggests there were 5,275 deaths by suicide in England last year.

And while rates are lower among children and younger people than other age groups, they have increased over the past decade among under 25s, particularly among young women.

Children and young people are one of seven high-risk groups that the strategy is targeting, along with:

• middle-aged men, who have the highest suicide rate of all demographic groups (20.1 per 100,000 in 2021);
• people who have self-harmed, who have a significant risk of suicide;
• people in contact with mental health services, who account for just over a quarter of suicides in England each year;
• people in contact with the justice system, who have higher suicide and self-harm rates than the general population;
• autistic people, amid evidence that they are at higher risk of dying by suicide than non-autistic people;
• pregnant women and new mothers, with suicide being the leading cause of death for women in the year after giving birth.

Key risk factors

The strategy also identifies six risk factors – physical illness, financial difficulties, harmful gambling, substance misuse, social isolation and loneliness, and domestic abuse – as priorities for action.

In relation to substance misuse, it stresses the importance of services having a ‘no wrong door’ approach, so that people with drug or alcohol problems receive support and treatment for their mental health needs and vice versa.

Along with prevention and risk reduction, the strategy also references actions being taken to improve mental health crisis care, including work to provide all-age crisis services and 24/7 crisis helplines for mental health patients by the end of 2023-24.

In a foreword to the strategy, the national adviser on the suicide prevention strategy, professor Louis Appleby, said: “The strategy stresses the crucial role of frontline services. We need to ensure that mental health patients at risk of suicide are not denied support because of assumptions about mental capacity or impulsiveness. We need frontline agencies to work together to respond to people in crisis. We need to take adolescent distress seriously.”

There does not appear to be new funding for the plan’s initiatives, aside from a £10m grant, announced last month, for charities to invest in suicide prevention activity. It otherwise relies on existing resources, including £57m allocated to local NHS areas for suicide prevention from 2020-24 and £150m for crisis care from 2023-25.

Samaritans criticises lack of new funding

In response to the strategy, Samaritans chief executive Julie Bentley said: “It is great to see that the government has responded to our calls for a new national suicide prevention strategy in England.

“In particular, a ‘no wrong door’ approach to be taken by public services should mean people in need of support no longer falling through the gaps, but instead will be part of a joined-up system that recognises the challenges they face are complex and shouldn’t be taken in isolation.

“However, a plan without proper funding is like a car with no petrol – it may look great but it’s not going to get you where you need to be.”

She called on chancellor Jeremy Hunt to provide dedicated resources for the strategy in his autumn statement, in November.

College’s concerns over ‘inaccurate’ risk assessments

Separately, the Royal College of Psychiatrists has raised concerns about mental health providers’ use of “fundamentally flawed” suicide risk assessments.

It said these had “tick-box” checks had been found by research to be inaccurate, with 80-90% categorising people as ‘no risk’ or ‘low risk’, which it said meant many missed out on life-saving support.

However, despite 2022 National Institute for Health and Care Excellence guidelines on self-harm urging professionals to “not use risk assessment tools and scales to predict future suicide or repetition of self-harm”, the college said mental health providers were continuing to do so.

It said that “good therapeutic clinical care is very likely to reduce the chance of suicide”, but providers required more resource to move away from suicide risk assessments.

The government cited the NICE guidelines in its strategy and said NHS England was In the strategy

Do you need support? Call 116 123 to speak to Samaritans.