National Suicide Prevention Alliance Conference at the Kia Oval, London 31st January

Professor Louis Appleby,Chair

National Suicide Prevention

Strategy Advisory Group.

Feedback Notes.

The conference started with registration and copious amounts of tea, coffee, freshly squeezed fruit juice with a choice of toast, bacon butties and pancakes with maple syrup, cake and Danish pastries.

10.10 First Session: Reflections on the national strategy: an important year for suicide prevention.

1 Suicide records have been kept since 1861.

2 Records show a 6% fall in suicide 2016.

3 In 2017 records show a 5% fall in male but an 8% rise in female suicides.

4 Building trade suicides have doubled in the last few years.

5 Building trades now have the highest incidences of recorded suicides with Agricultural closely behind in second place.

6 Prison suicides have fallen but self-harm is on the increase.

7 Mental ward inpatient suicides have fallen, all credit to Mental Health Staff.

8 150 under 20’s suicides in 2017

9 There has been a significant rise in suicide of youngsters in their late teens.

10 Highest rates of suicide in men in their mid-40’s and the over 85’s.

11 70% of all suicides: no warning, out of the blue.

10.40 Second Session: Suicide Prevention: the importance of psychological factors.

Professor Rory O’Connor, Director of the Suicidal Behaviour Research Laboratory, University of Glasgow. (Visit www.suicide.research.info for research paper on Cortisol)

Scottish Well-being study: data collated from suicide notes.

There are 6000 suicidal deaths per annum. Behind every suicide death is a tragedy.

Most young people not receiving help and support for mental health issues.

Major understanding of suicidal thoughts:

a entrapment, no escape

b impulsivity

c capability

d having a means

Research on those with suicidal thoughts to suicide attempts, has found that the cortisol system has broken down, resulting in a heightened pain threshold, fearlessness to pain and fearless of death. Factors that may have contributed to lower cortisol may have been brought on by childhood trauma, such as a family death, sexual abuse, bullying.

The natural instinct when in danger is to “fight or flight” and this fear increases cortisol levels.

“Cortisol, a steroid hormone, helps control blood sugar levels and regulates metabolism, helps reduce inflammation and assists with memory formulation. It has a controlling effect on salt and water balance and helps control blood pressure. All of these functions make cortisol a crucial hormone to protect health and well-being.”

11.10 Workshop 1: Men and Suicide: reaching high risk groups beyond healthcare settings.

Keith Waters, Director of the Centre for Self-harm and Suicide Prevention Research

Jennifer Ness, Research Project Manager, Derbyshire Healthcare Foundation Trust.

Barriers to reaching high risk groups out in the community

1 Isolation, bereaved, elderly.

2 Not part of the community, shy.

3 Housebound, disabled.

4 Farming community.

Public Survey shows that 60% of 25-34 year olds had suicidal thoughts.

30% spoke to no-one whereas 40% sought help from relatives and/or friends.

Glyn Evans, Regional Director, The Farming Community Network, and Karen Ellis, Volunteer, are sitting on the back row following the Workshop presentation.

1 There are 125,000 farming employees in UK

2 16% are women

3 68 suicidal deaths a year of farmers and related trades

4 In 2016 there were 27 recorded “farmer accidental deaths”

5 Some suicide deaths are not recorded as farmers.

6 National FCN helpline for farmers

7 Farmers face an uncertain future with Brexit.

8 They face isolation, volatile milk prices, delayed BPS payments,

12.15 Third Session: The role of employers: experiences of suicide prevention in the workplace.

Dr Paul Litchfield, Chief Medical Officer, BT Group plc

2008 Recession: drop in share price, housing market collapsed and consumer need dropped therefore little work for “open reach” with no overtime and redundancies. The impact on staff was significant, suicide rates doubled. People took lives on BT premises because high buildings and long drops gave them the opportunity to do so. This made suicide prevention a priority.

Senior Management consulted with Samaritans to bring issues out into the open; they talked about mental health issues and suicide in particular. They drew up guidelines for line managers with desk aids to help managers support staff with mental health issues. They provide HR support and set up peer support network training to help staff understand the issues. Mental health is a business issue and talking about it makes it normal.

Joscelyne Shaw, Executive Director, Mates in Mind (mental health and wellbeing in construction)

The construction industry has 3.7% higher cases of recorded suicides and is now higher than any other industry. Mental Health is a taboo within the construction business.

Good safety = good business but what about health and mental health.

The aim of Mates in Mind:

1 Help raise awareness of mental issues.

2 Address the stigma of poor mental health.

3 Improve positive mental wellbeing in the UK construction industry.

Achieved through

1 Guidance and Support

2 Awareness and Education

3 Research and Development

4 Communication

5 Shared repository of campaign material

6 Help small and medium organisations overcome isolation in a holistic approach.

12.50 Fourth Session; Engagement of people with personal experience of suicide – the Australian model. Bronwen Edwards, Founder and CEO, Roses in the Ocean.

Bronwen’s brother Mark had taken his own life 31st August 2008. He was a successful airline pilot.

It left her and her two children then aged three and five, devastated. One day to help make sense of the situation they visited the beach to recall all the happy times they had spent there together and decided to throw roses in the ocean in memory of Mark.

Bronwen and several other survivors formed a support group “Roses in the Ocean” and set about “getting to know who’s who in the zoo” of the 31 Primary Health Care networks across Australia. The authorities were afraid at first and wondered what they were going to do with them. They are now included in policy making, working with different cultural and minority groups, building a communities safety net that helps prevent suicide. The Black Dog institute is collating data.

The Strategic Plan is to

A improve quality of life

B improve governance

C improve infrastructure

The Vision is to save lives.

Reduce emotional pain following a suicide and to empower people to live.

13.15 Fifth session: Government action on suicide prevention; reaching the 10% target by 2021

Secretary of State for Health and Social Care: The Rt. Hon Jeremy Hunt MP, Conservative.

Firstly Jeremy thanked Louis Appleby for supplying him with the data surrounding suicide and recognises that suicide is the litmus test for how well they are doing on mental health.

Need to recruit 19,000 more staff in Mental Health Care.

Government putting in an extra £25 million into MH Care.

Vision ZERO Suicide for all receiving MH care.

ZERO in patient suicide and post discharge suicides.

When improving mental health patient care need to look at improving staff mental health care, “care for the carers”

1 Need a much better and much quicker system to collate

“real time” suicide data across the UK.

2 Mental Health to provide a specific suicide plan for all

MH patients.

3 To create a culture of openness to talk about suicide and MH problems.

Urgent need for Government to contact all Local Authority Public Health Care teams to actively embrace the ZERO tolerance strategy of NO MORE SUICIDE and to actively provide documentation that they are doing so. (CWAC PH active since April 2016. I am a member of the steering group)

An interesting concept shared with us by The Rt Hon Jeremy Hunt, MP and he quoted,

“Do not go where the path may lead, instead go where there is no path and BLAZE a TRAIL.”

For further information see the Government Response to the Health Select Committee’s Inquiry into Suicide Prevention, Presented to Parliament by the Secretary of State for Health by Command of Her Majesty July 2017

The Department of Health is also working with the Department for Communities and Local Government and other stakeholders to support local authorities in assuring the quality of their multi-agency suicide prevention plans. This will be based on best practice guidance on developing and implementing suicide prevention plans and suicide bereavement services issued to local authorities by Public Health England:

https://www.gov.uk/government/publications/suicide-prevention-developing-a-local-action-plan and

https://www.gov.uk/government/publications/support-after-a-suicide-a-guide-to-providing-local-services

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13.45 Lunch

Dainty beef burgers and chips, BBQ Chicken on skewers, thin pasta salad, coleslaw, lettuce with rolls and butter. Black forest gateau, blueberry cheese cake and other finger pastries. Various fresh fruit juices and copious amounts of speciality teas and coffee.

And for those with special dietary needs there was a “Dietary needs Station.”

The Kia Oval Cricket Club certainly knew how to look after its guests.

14.45 Workshop 2: Effective bereavement support: the vital role of multi-agency working

First presentation by Dr Sarah Bates, Executive Lead, Support after Suicide Partnership

Highlighted the vital role of support after suicide and for the provision of effective proactive support.

They are partnered with Public Health England and proactive in producing “Help is at hand” booklet.

Ambition to get copies to all UK funeral directors as they are the frontline contact with families and loved ones bereaved by a suicide.

Second presentation by Shirley Smith, Founder and CEO, “If U Care Share”

Founder of “If U Care Share” foundation, providing effective bereavement suicide support.

Charity formed 2011

Word of mouth, open to anybody affected by suicide, a bespoke service, tailored to survivor, grief is unique. Suicide is a scary subject.

Real time suicide reported to them via police/coroner and 48hr contact made with survivors.

Third presentation by Shani Stapledon, Suicide Liaison Supervisor, Listening Ear Merseyside

Amparo Charity formed 2014. A postvention service.

Contact within 24hrs, face to face meeting within 7 days.

Real time service, risk assessment, signposting to relevant services unique to person.

One of the strengths of Amparo service - No waiting list, we react immediately.

Challenges faced by Amparo - Funding and advertising the service.

Ceo Richard.Brown@listening.ear.co.uk

15.40 Panel discussion: The missing ingredient: moving from a local suicide prevention plan to an effective local plan.

Prof. Jim McManus, Director of Public Health, Hertfordshire County Council

Geraldine Strathdee, Population MH Advocate; PHE National Clinical Lead, MH Intelligence Network

Chair: Ruth Sutherland, Co-Chair, NSPA; CEO, Samaritans

Dr Lisa McNally, Consultant in Public Health, Bracknell Forest Council

Steve Gilbert, Serious Mental Illness Living Experience Consultant.

What would work to make local plan effective?

Every local Authority to have a No Suicide Plan!

Elective members of Local Authorities need to be targeted. The Panel

Communities need to address isolation.

MH patients need same support package as Cancer patients.

Healthy life style support

The right therapy

The right medicines

Patients need a sense of hope

Individual Placement Support

Real people with lived “attempted suicide” experience speaking out

What saved me?

What stopped me?

We need to trust each other

How do we address ourselves?

We love doing things for people, not with people, we must learn to do things with people.

With Public Health budget cuts this will affect local plans and we were asked to reflect on the thought that Governments and Local Authorities can throw as much money as they like at a project but if it’s the wrong people managing the project, it will fail.

My post conference thoughts

Session 1 Copy of the power point presentation would have been useful as the graphs fully illustrate the impact of suicide trends.

Session 2 Rory described my son Jeff to a tee. Jeff was diagnosed as bi-polar following a motor bike accident. Jeff had a heightened pain threshold, was impervious to pain and fearless of death: Jeff thought he was invincible.

If only it was so simple to measure a MH patients cortisol levels and the ability to replace cortisol.

Session 3 I was impressed by BT’s positive approach to MH and suicide and the support on offer by “Mates in Mind” to the construction industry. This support will be invaluable following the collapse of Carillion. It looks like Network Rail is likely to pick up the High Speed Railway contract.

Session 4 Bronwen’s personal account was most moving but through determination she has turned her personal tragedy into supporting others bereaved by suicide.

Session 5 I will remember The Rt Hon Jeremy Hunt, MP’s quote,

“Do not go where the path may lead, instead go where there is no path and BLAZE a TRAIL.”

It was good to meet up with Glyn Evans and Karen Ellis FCN and to help give out the “Fit for Farming” booklets and the stress cows. Cheshire Ag Chap also got a mention during the presentation.

It was lovely to meet up with Shani Stapledon, Amparo and Mike Caulfield, Lead Clinician, Bowmere.

We are members of the CWAC Public Health steering group looking at the Government’s “No More Suicide” initiate and led to the formation of SoBS Chester.

The Welcome to NSPA Conference was made by Brian Dow, Co-chair, NSPA, Director of External Affairs, Rethink Mental Illness.

Brain set the scene for the conference by highlighting that today is a “Blue Riband Day” an opportunity to talk about real people, about real lives. Focus on Local Action, National Impact.

We are all here with one aim to support each other in the reduction of suicide and commended us all for attending the conference and taking time out of our busy lives.

Monica Haworth, Cheshire Agricultural Chaplain and SoBS Chester group leader.