Let’s play Politics!

National Confidential Inquiry into suicide and homicide in people with mental illnesses 2016:

In-patient suicides:

Suicide by mental health in-patients continues to fall, most clearly in England where the decrease has been around 60% during 2004-14. This fall began with the removal of ligature points to prevent deaths by hanging but has been seen in suicides on and off the ward and by all methods. Despite this success, there were 76 suicides by in-patients in the UK in 2014, including 62 in England.

Suicides after discharge:

The first three months after hospital discharge continue to be a period of high suicide risk. In England the number of deaths rose to 200 in 2014 after a fall in the previous year. Risk is highest in the first two weeks post-discharge: in a previous study we have shown that these deaths are associated with preceding admissions lasting less than 7 days and lack of care planning. There has been a fall in post-discharge deaths occurring before first service contact, suggesting recognition of the need for early follow-up. In all there were around 460 patient suicides in acute care settings – in-patient and post-discharge care and crisis teams – in the UK in 2014.

First of all I want to say that every suicide is a huge tragedy and must be prevented at all costs. Behind each of these numbers are precious lives and beautiful people. I don’t allow myself to forget that even when I am angry. This blog is a mere observation on how I have seen politics being played in front of my eyes in the last week. In light of the above findings, in consultation with his expert advisors and in all his wisdom, Mr Jeremy Hunt has decided to focus his attention on in-patient deaths – a group that is manned by the most highly trained professionals in a very controlled environment, a group that is on the list of ‘never-events’, a group that has already shown a decrease by 60%, a group where even a small reduction in numbers will amount to a big percentage and will make him look good.

With all good intentions, he has converted a healthy aspiration of Zero-suicide in the community to an unhealthy target for in-patients creating huge anxieties. Last week at the NSPA conference I heard Mr Hunt speak in the most self-congratulatory of tones about how wonderful it is that UK is the first country to legislate for ‘Parity of Esteem’. I am sorry Sir, that means nothing on the ground. The workforce coming in contact with the majority of suicidal people in the UK is largely untrained. They don’t even know how to talk with them, let alone ‘look-after’ them. The massive funding cuts focus on mental health which in turn results in poor training of junior doctors. When questioned directly about ‘parity of training’, he masterfully slips and slides away.

In my eyes you don’t look good Mr Hunt.

Day 837

Posted by kidsaregifts20

NSPA Conference: Part 2. Suicide Prevention: the changing conversation.

4. State of Mind Sports Charity (http://www.stateofmindsport.org/) made a dazzling presentation about how they promote positive mental health in sportsmen and women, fans and wider communities, thereby preventing suicides. Danny Sculthorpe gave a moving account of his dark times when his brilliant rugby career was seriously threatened by a very painful back problem.

“I just felt like I had lost everything and that nobody cared. After a couple of months, I couldn’t afford to pay the mortgage, and because Bradford were denying any responsibility for the injury, I had to try and find £3,000 for the physiotherapy I needed to give me any chance of getting back playing. At that time, all I could think about was how I was unable to support my family, that my career was over and that the only way out was suicide.”

Sculthorpe found help after opening up about his feelings to his parents and through support from the Rugby Football League. He now works for the State of Mind charity, which established a partnership with the game after it was rocked by the death of Wigan and Great Britain hooker Terry Newton in 2010.

Their resounding message is: “We are all one big team.” So true!

5. Professor Tim Kendall, National Director for Mental Health, NHS England presented the 5 year forward view. He appeared rushed, ill-prepared and unempathetic to a room half full of people whose children had died. Considering he was the most powerful person in the room, he was most disappointing.

6. Counsellor Richard Kemp has been a member of Liverpool City Council for 30 years. He is passionate about providing good housing, community centres and parks for the well-being of people. Ironically he also seemed to think the suicide was a relatively small problem. Interestingly he got this insight from a psychiatrist. However, I strongly agreed with this statement he made – “We need fewer guidelines and more vision.”
We can’t have a speaker from Liverpool who doesn’t mention the Beatles – All the lonely people, Eleanor Rigby, Father McKenzie… This song was well used to speak about the widespread problem of loneliness.

7. Panel discussion at the end had representatives from – Public Health England, Champs, Grassroots and Mental Health Foundation. They discussed finding the ‘seat-belt’ of Suicide. May be there isn’t one. We should work with the information we have in addition to continually looking for stronger evidence. It is important to identify protective factors and talk about them too. Policy makers need to embed these into schools and colleges. Staff must be educated to enable them to spot the warning signs of suicide in a young person and to keep them safe.

Overall, it was clear that the conversation is changing, even though there is plenty of dead-wood around. It is apparent that the motivational level of charities is much higher than the government. There are big questions about the funding of government plans. GP training is still something that is not being addressed as it should be. Somehow there is a level of denial around it, even when it is clear to many of us as an area that needs serious attention.

The drivers of these changing conversations and policies should be survivors of suicide and those bereaved by it. Lived experience is an invaluable source of a wealth of information on the lessons that can be learnt and the changes that are required.

Ref: http://www.itv.com/news/calendar/2015-07-24/the-only-way-out-was-suicide-former-rugby-star-speaks-out-about-case-over-sacking/

Day 836

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The National Suicide Prevention Alliance (NSPA) is an alliance of public, private and voluntary organisations in England who care about suicide prevention and are willing to take individual and collective action to reduce suicide and support those bereaved or affected by suicide. (http://www.nspa.org.uk/)

Today I attended a conference organised by them. The room was filled with people who care. Here are some of the highlights as seen from my eyes:

Jeremy Hunt, Secretary of State for Health sent his apologies and a recorded message that said all the right things, unconvincingly. (Yes. I am a cynic.)
Professor Louis Appleby (Professor of Psychiatry, University of Manchester. Chair, National Suicide Prevention Advisory Group. Department of Health) talked about National Strategy and emphasised that every component of the strategy has to line up in order to impact everyday lives of people. The 5 main points on the strategy were: Local Suicide Prevention plans a must for all Local councils; a sound policy on self-harm; special attention to middle aged men, mental health patients and prisoners, better data collection and bereavement support.

He proposed that if the data was looked at differently, it could mean that the suicide rates were on a decline. Hence, the rising rate of suicide argument may not work. However, we know that suicides are grossly under-reported. So, this statement reminded me that at the end of the day he is an academic and while he does brilliant work, part of his job is playing with numbers.

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(Statistics are used by some as something to lean on rather than to illuminate.)

Rt. Honorable Norman Lamb MP for North Norfolk was the speaker with most conviction and the biggest vision. I am so proud that he is the Patron of the charity I work with, PAPYRUS. He spoke of leadership, immediate investigation of deaths so valuable lessons can be learnt before the facts get fudged and forgotten, GP training and same day referrals of patients with depression to specialist services, stop sending patients out of the area for in-patient care and provide meaningful patient support in the community. He set out a clear ambition of – Zero Suicide. He was the only one in the room who stated: “Death toll from suicide is intolerably high.” There is hope.

To be continued tomorrow.