Yesterday was supposedly “blue Monday” – the most depressing day of the year. The idea was dreamed up in 2005 by a TV marketing campaign to sell holidays and the myth persists.
But yesterday, Nick Clegg and I were talking about something really serious. Almost 4,700 people took their own lives in 2013 in England alone, and suicide remains one of the biggest killers for men under the age of 50. We hosted a conference bringing together leading figures in the mental health world to call for an ambition for ‘zero suicides’ across the NHS.
Liberal Democrats in Government have already taken vital steps to address the institutional bias against mental health in the NHS: legislating for parity between mental and physical health, establishing the first mental health access and waiting time standards, setting standards in mental health crisis care for the first time and giving mental health patients the same rights to choice of where you get treated as physical health patients.
But suicide remains a huge social taboo. Some people feel unable to talk about suicidal feelings – and as a result fail to access the help and support they so desperately need. Others around them might be too scared to intervene when they know someone is at risk – or may just feel there is nothing they can do about it.
A mental health programme in Detroit, USA, which signed up to a ‘zero suicide’ ambition has reported two-and-a-half years without a single patient suicide, as well as a reduction in suicide across the city as a whole. It is hugely encouraging to see that the mental health NHS organisations in Merseyside, the South West, and the East of England are already rethinking the way they care for people with mental health conditions to achieve this ambition for zero suicides in our own health system.
We want to see this sort of approach taken across the country. Service providers should take inspiration from the example set by Mersey Care in Liverpool, which has created a dedicated Safe from Suicide team to provide advice and support. Meanwhile the NHS in the South West of England is looking to work with police and the transport services to identify areas where there is a higher than average number of suicides and to investigate why.
Different regions will find different ways of targeting ‘zero suicides’. Approaches could include facilitating closer collaboration between GPs, specialist providers, commissioners, and public health experts. Patients could also benefit from having a personal safety plan so that patients, family and friends know what to do and where to go for help if they need it. But as much as anything else, we need a change of mindset in our health system and in our society to understand that suicide is something that we can prevent and that we can talk about openly without shame.
I believe that whenever someone takes their own life through suicide it is not just a tragedy – it should be a reminder that we must work towards a system where this simply does not happen. This is something we can achieve – and the Liberal Democrats are determined to lead the way. Together we can save thousands of lives.
* Norman Lamb is MP for North Norfolk and was Liberal Democrat Minister of State at the Department of Health until May 2015. He now chairs the Science and Technology Select Committee
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6 Comments
I’m looking for suicide statistics, but I can’t find anything more up to date than 2012. I saw some figures in a BBC headline article at the end of last year, but it seems the article might have been deleted (I can’t find it anywhere).
The article I saw showed a big increase in female suicides and I remember it didn’t get a mention. It was just there in the tables. My point is that we should be careful not to turn this into a “men’s issue”.
Politics could unite if we focused on alleviating suffering, not just in suicide, but all aspects of life.
Talking can work for some, it can be ignored by others, and the wrong thing said at the wrong time can trigger the very action you want to avoid. Sometimes people just need to be left alone. Sometimes they just need a distraction. Sometimes they need a counsellor, other times a psychiatrist, other times a friend, and other times a brief conversation with a child can put things in perspective. This is a subject that should not be over simplified and the agenda should be driven by those with direct experience; it should not in my opinion involve politicians scoring political points or mental health experts with theories to prove.
If this is a serious initiative and not a here today gone tomorrow electioneering point then I strongly suggest starting with a widespread highly publicised open survey asking people who turned back from suicide how they turned back. Medication, professionals, Samaritans, shock tactics, sectioning, etc. And what was ineffective for them, repeat the same list. If you got 50,000 stories you’ll have 50,000 different reasons and 50,000 different solutions I suspect. You will find that in many cases suicide was prevented by something completely random and impossible even unethical to clinically reproduce. Zero suicides is a ridiculous and impossible target. Perhaps not even desirable where painful terminal illness is involved. Permanent reductions rely on having done the long, laborious research. You can’t target this research on small numbers of known mental health sufferers as significant numbers of “survivors” will have gone nowhere near any healthcare professional and those that did are highly unlikely to have revealed the full truth. Neither can you look at the 5,000 people who succeeded and say what did we miss. You will never know for sure what may have prevented the suicide. Sometimes nothing would have stopped it.
Taking best practice from around the world and actively investigating the ways in which the lessons can be applied here to reduce the number of suicide deaths to an absolute minimum is a wholly laudable approach as is the ambition to eliminate death by suicide completely, and that is something we should be fighting for. But we have to be careful in the way that we present it. We have to remember that we do not speak directly to people for the most part; we speak through media channels which choose how to present our message.
To declare a goal of no suicides, in the current environment of cynicism about politicians and their promises is to invite ridicule and disbelief (my own immediate reaction, and I’m a member of the Party). Yes, the policy to be pursued should indeed be one of zero tolerance, but to be believable it might be better to promote the idea of aiming to reduce suicide to an absolute minimum. Now, there’s a novelty; politicians under claiming.
Suicide is a tragedy. However suicide can be a logical and ethical choice. This was explained to me by a Macmillan nurse when I was a student nurse in 1993/4. I was told that a headmaster developed a hereditary condition of Huntington’s Chorea. He saw the condition reach its course in a brother; younger or older, I am not sure. And it resulted in the brother abusing his own mother. The headmaster did not want to go the same way and committed suicide.
The nurse referred to this as “situational suicide”.
A contributory factor in suicide is stress. The stress of poverty could be reduced by eliminating the bureaucratic hoops, rules and regulations that benefit claimants have to go through. At present, it seems that the best way to avoid this is to become an alcoholic and register as disabled and unable to work because of alcoholism.
I am not saying that people voluntarily choose this way of life but people who are in this situation have no incentive to alter their behaviour.
However, I agree with previous comment; it is better to promote the idea of aiming to reduce suicide to an absolute minimum. And it was Giuliani who said it was better to under promise and over deliver.
Robert Wootton
Quote: ‘ suicide can be a logical and ethical choice.’
The example you give shows that the man in question wanted to take his own life out of fear that he would act in the same way as his brother. Fear is not a logical reason to accept suicide. It is neither desirable nor necessary.
I still cannot understand why Norman Lamb advocates assisted-suicide so enthusiastically yet works hard to prevent suicide and tackle mental illness like depression. It is a well-known fact that many terminally patients take anti-depressants. The Falconer Bill does not allow for Psychiatric screening of patients.
It is disingenuous of Lamb to make a distinction between suicide and assisted-suicide. No attempt to change the language will do either.
It’s hardly a bundle of laughs to be told you have a terminal illness and face a potentially very painful death. It is hardly surprising therefore that anti-depressants might be prescribed but that does not mean that the patient is suffering from mental illness such that they are incapable of making a logical and reasonable decision to curtail their life and the pain. There is physical and mental pain that is curable, and physical pain that is not and can only get worse. They are very different and distinct medical outcomes. In the former there is a duty to try and save the patient even if they cannot see a positive outcome at that stage. In the latter, there are no happy endings and everyone has a right to control their final days as they see fit. It is not for anyone else to impose their personal ethical or religious values on that individual. If I am diagnosed with terminal cancer tomorrow and choose when to depart this world on my own terms, frankly Helen that is my business and mine alone. I would like the State to help me make the passing dignified and painless or at least not arrest and prosecute any friends or family that assisted me. Why would I need psychiatric screening if I’m heading for a horrible and painful death for goodness sake. Of course it comes from fear, fear of pain, unnecessary but inevitable pain. Preventing suicide in that situation is cruel and heartless in my view but more importantly it’s nobody else’s business. Lamb is right to make the distinction.