Olney letter: Suicide risk assessment must be improved

Sarah Olney, MP for Richmond Park, and Steve Mallen, co-founder of the Zero Suicide Alliance are the lead signatories in an open letter to Sajid Javid published in yesterday’s Times. Olney and national charities have teamed up with Philip Pirie whose son Tom, a young teacher, took his own life a day after a counsellor determined that he was at “low risk” of suicide.

An average of 17 people a day took their own lives in 2020. An average of five of these were in touch with mental health services and four out of those five had been assessed as “low” or “no” risk. Standardised risk assessment tools are poor predictors of suicide. Yet despite NICE guidance saying such assessments should not be used they are still commonplace.


Letter to the Times 19 April 2022

Sir, We are calling on the health secretary to address an urgent concern regarding suicide risk assessment practices used in the mental health sector. According to the latest data, 6,211 people in the UK died by suicide in 2020. Suicide is the most common cause of death among people aged 20 to 34.

We are alarmed that, of the 17 people who die by suicide each day in this country, five are in touch with mental health services and four of those five are assessed as “low” or “no risk”. Standardised risk assessment tools are poor predictors of suicide. National guidelines, including those drafted by the National Institute for Health and Care Excellence in January this year, determine they should therefore not be used for that purpose. However, most standardised tools remain.

The severity of our concern is highlighted in a Royal College of Psychiatrists report published in July 2020, which concluded that the approach to suicide risk assessment is “fundamentally flawed”. Further, nearly half of the patients consulted in a Lancet Psychiatry report, published in November 2020, were critical of the assessment process — highlighting the impersonal nature of the assessment and reporting that their feelings and views were disregarded.

Every suicide is a heart-breaking tragedy for family and friends who lose loved ones, and every effort should be made to save lives. Risk should not be defined as a number, nor treatment determined by a “score”.

We welcome the recently announced review of the 2012 Suicide Prevention Strategy for England and see this as an opportunity to reassess current suicide risk assessment practices used in the mental health sector. We therefore urge the health secretary to ensure that the new strategy includes a review of the use of suicide risk assessments in breach of present guidelines, and to take appropriate steps to ensure that existing guidance around not using these tools to assess suicide risk is strictly followed by both the public and private health sectors.

Sarah Olney, MP for Richmond Park
Steve Mallen, co-founder, Zero Suicide Alliance

Co-signed by:
Paul Farmer, chief executive of Mind
Ged Flynn, chief executive of Papyrus – Prevention of Young Suicide
Julie Bentley, chief executive, Samaritans
General Sir Nick Carter, former chief of the defence staff
Daisy Cooper MP, Liberal Democrat spokeswoman for health and social care
Jeff Smith MP, chairman of the all-party parliamentary group (APPG) on mental health
Baroness Tyler of Enfield, vice-chairwoman of the APPG on mental health
Baroness Watkins of Tavistock, vice-chairwoman of the APPG on mental health
Wera Hobhouse MP, vice-chairwoman of the APPG on mental health
Liz Twist MP, chairwoman of the APPG on suicide and self-harm prevention
Rachael Maskell MP, vice-chairwoman of the APPG on suicide and self-harm prevention
Johnny Mercer MP, former minister for veterans
Lord Foster of Bath, chairman of Peers for Gambling Reform
The Lord Bishop of St Albans, vice-chairman of Peers for Gambling Reform

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  • Ruth Bright 20th Apr '22 - 5:58pm

    The BBC published figures the other day showing that 11% of Irish travellers die through suicide.

  • Brad Barrows 21st Apr '22 - 6:19pm

    Over 80% of suicides in the UK are of males. We need to have a policy that addresses both the need to identify the causes of male suicide and also outlines measures to effectively tackle them.

  • Peter Hirst 22nd Apr '22 - 4:43pm

    Suicide is caused by suicidal thoughts so a better understanding of these and thoughts in general will reduce suicides. We can’t do much about thoughts but we can understand the nature of thoughts and if we just hold on other nicer thoughts will occur. Circumstances do not determine our thoughts

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