When someone takes their own life, the consequences – for that person, their family and their loved ones – are deep and permanent. Suicide can be prevented, and we have a responsibility to do everything possible to ensure that people receive the support they need at times of distress or crisis.
In an interim report published this week, the House of Commons Health Committee sets out the evidence on suicide prevention, and makes a powerful argument about the inadequacy of our current systems of support:
“Approximately one third of people who end their lives by suicide have not been in contact with health services in the year before their death. However, this is not because they are in some way ‘unreachable’—on the contrary, we should regard all suicides as preventable. In Liverpool we met a bereaved mother who said simply ‘my son wasn’t hard to reach—it was the services that were hard to reach’. If such a high proportion of people in need of help are not accessing current services, then we must adapt the services we offer.”
There are many reasons that people commit suicide, and they are often difficult to identify and separate. Nonetheless, we know that people experiencing multiple needs face greatly increased risks. St Mungo’s interviewed forty people with experiences of rough sleeping, and found that one in four had considered or attempted suicide while homeless. Research by the University of Manchester also suggests that people using heroin have rates of suicide at least three times higher than the general population, with official data suggesting that women are particularly vulnerable.
It’s especially concerning that this year the Howard League for Penal Reform reported the highest number of people in prison taking their lives since records began in 1978. The rate of self-inflicted deaths in prison is over 12 times that of the general population. There is widespread concern at the levels of isolation, violence and lack of constructive activity in prisons, with not enough being done to address the mental health and substance misuse needs of people in custody.
The Committee makes a number of welcome recommendations for action, ahead of the expected publication of a revised Government suicide prevention strategy in the new year. In particular, they call for measures to identify those most at risk in the community, particularly in non-traditional settings where the voluntary sector can play an important role.
The report notes the elevated risk that people face when leaving mental health services, and the Committee recommend that all patients being discharged from inpatient services should receive follow-up within three days rather than seven. Alongside this, they highlight the need for liaison psychiatry – the provision of psychiatric support in hospital settings such as accident and emergency – to be adequately staffed and resourced.
We very much hope that the Government acts on these recommendations, and that the forthcoming strategy takes into account the wide range of factors – homelessness, substance misuse and contact with the criminal justice system – which can contribute to heightened risk of suicide. A strategy alone is not enough, though: it is the responsibility of all of us – as practitioners, policymakers and citizens – to ensure that people receive the specialised support they need, when and where they need it.