Adrian James
- 1. Zero Suicide: a collaborative approach America Square Conference Centre 15 September 2016 London Dr Adrian James Consultant Psychiatrist Devon Partnership NHS Foundation Trust & Chair of the Zero Suicide Collaborative
- 3. David Cameron 11 Jan 16 ‘There is the terrible fact that suicide has become the leading cause of death for men under 50’ ‘And the challenge is that, all too often, people are just left to get to crisis point either because the health service simply can’t cope, or because they’re worried about admitting to having a problem in the first place’
- 4. ONS 2015 Suicide remains the leading cause of death in England and Wales for men aged between 20 and 34 years of age (24% of all deaths in 2013) and for men aged 35 to 49 years (13% of all deaths in 2013)
- 5. • The male suicide rate in the UK decreased in 2014 from 17.8 to 16.8 deaths per 100,000 population; while the female suicide rate increased from 4.8 to 5.2 deaths per 100,000 population
- 6. • The suicide rate in England increased in 2014 (10.3 deaths per 100,000). The increase was driven by a rise in female suicides
- 7. ONS 2014 ( published 4 Feb 16) Suicide rates increased across all English regions in 2014 apart from Yorkshire and The Humber, the South East and the South West
- 11. Key Messages • One suicide is too many • Your life matters • Can do approach to change • We encourage collaboration • Our approach is based on tried and test methodology • Nothing magic • Not re inventing the wheel
- 14. Does suicide prevention work?
- 15. Five mental health service changes linked to the biggest falls in suicide were • increasing availability specialist community services (eg crisis resolution and home treatment) • better management dual diagnosis (ie, drug or alcohol misuse as well as major mental illness); • reviews with families after suicide • introducing policies to help manage the transition to adult mental health services for young people; • implementing NICE guidelines depression.
- 16. implementing recommendations and service changes was associated with significantly lower suicide rates (20-30% decrease in the suicide rate from around 12 suicides per 10,000 contacts with mental health services to approximately 9).
- 17. Do safety measures reduce suicide rates? 0. 3.5 7. 10.5 14. 17.5 2003 2004 2005 2006 0-6 recommendations 7-9 recommendations * *Patient suicide rate per 10,000 * * = significant difference p<0.05 Source: National Confidential Inquiry, Lancet,
- 18. The Zero Suicide Collaborative includes the following stakeholders: People with lived experience Clinical Commissioning Groups Area Teams Primary Care Physicians Providers Mental HealthServices Acute Hospitals / ER Third sector organisations Samaritans Police service Ambulance service Academic Health Science Networks Local Authorities Coroner’s office Public Health Childrens services Royal National Lifeboat Institute Public Health
- 19. Success • Came together and survived • Collaboration/ networking • Knowledge: personal/data • Sharing projects • New projects • Publicity/ Media • NHS E and Political engagement
- 20. Projects • Samaritans/Brewery/Trust : Posters in Pubs • RNLI : Hotspots • Somerset Collaborative: support after bereavement • ASIST training • Letter of hope
- 21. Projects • Refinement and spread of Bristol self harm register • Prison release follow up • Network rail hotspots • Follow up of discharge from MH setting
- 22. Could do better • Support service users/ carers/ everyone • Evaluation • Application of rigorous methodology
- 23. FIVE YEAR FORWARD VIEW FOR MENTAL HEALTH An independent report of the Mental Health Taskforce 15 Feb 2016
- 24. Taskforce 15 Feb 16 • By 2020/21, at least 10% fewer people will take their own lives, saving up to 400 lives each year • evidence-based interventions that target high- risk locations and support high-risk groups within their population, drawing on the best available local data.
- 25. July 2016
- 26. Delivering the objectives: Data, payment and other system levers National programmes Suicide prevention 2016/17 £m 2017/18 £m 2018/19 £m 2019/20 £m 2020/21 £m 5.0 10.0 10.0 CCG allocation
- 27. Measurement Metric : Suicide: age-standardised death rate per 100,000 ONS Now (annual) ‘localities should agree further metrics to support transparency in monitoring delivery of the agreed actions within their suicide prevention plan’
- 31. • What the judges said about the South West Zero Suicide Collaborative entry: • “The judges said that they really liked this project and the collaborative approach. They showed real commitment and learnt from best practise examples.”