This report updates Members of Health and Wellbeing Board on the suicide prevention programme. In Medway, the Public Health team provide strategic leadership for suicide prevention, including the Suicide Prevention Strategy and Steering Group.
In 2018, new funding of £667,978 was secured from NHS England for suicide prevention work across the Kent and Medway Sustainability and Transformation Partnership (STP) area in 2018/19. STPs bring together a range of stakeholders including the NHS and local government. Kent and Medway was one of eight areas nationally to receive funding.
This report provides an overview of suicide prevention work that has taken place during 2018/19 and plans for 2019/20. The programme was agreed by the multi-agency Suicide Prevention Steering Group that supports this work in Kent and Medway. The proposed interventions are based on the best evidence available to inform suicide prevention.
This report was considered by the Health and Adult and Social Care Overview and Scrutiny Committee on 18 June 2019 and the comments of this Committee are set out in section 5 of the report.
It was recognised that suicide was a tragic event that could have a devastating impact for family and friends of the person and on the community as whole. In Medway, as nationally, men, particularly middle aged men, were at a greater risk of suicide than women. In the year before a suicide, a third of people had contact with secondary mental health services, a third had contact with their GP and a third had no contact with health services. This suggested that there was a need to look at community interventions as well interventions relating directly to health services. In 2018, new funding was secured from the NHS for the suicide prevention across the Kent and Medway Sustainability and Transformation Partnership (STP). Kent and Medway was one of eight areas nationally to have been awarded additional funding for the programme.
This was an evidenced based programme which through the Suicide Prevention Steering Group engaged with a wide range of partners, including transport and education providers, the voluntary sector and had representation from families who had been bereaved by suicide. The programme delivered over the last year had consisted of nine strands of work set out in detail in Table 2 of the report. Four areas were highlighted in particular, as follows:
1. The ‘Release the Pressure’ social media campaign. This campaign had been extended significantly over the last year to reach more men and encourage them to seek help. The campaign signposted them to a 24 hour / 7 day a week helpline staffed by trained counsellors. 4,500 calls from Medway residents had been made to the helpline during the previous year.
2. The ‘Saving Lives Innovation Fund’ was launched which provided grants to community organisations to undertake innovative projects to prevent suicides. 29 such projects had been undertaken in the year, with over 1,000 people benefitting from these. An example project was a mentoring programme to support men going through family breakdown.
3. Suicide prevention training for professionals and the public. One programme had trained over 100 adults. E-learning had also been launched.
4. The Kent and Medway NHS and Social Care Partnership Trust (KMPT) had also developed a Zero Suicide Plan.
Each suicide prevention workstream was assessed for impact, for example data on the number of calls to the helpline had been collected. The programme had also been externally evaluated, although this data was not yet available. Qualitative data was set out at paragraph 3.6 of the report. Feedback from the national team responsible for funding the programme suggested that work in Medway was well advanced compared to the other seven areas awarded funding.
Funding had also been secured for 2019/20 to further develop the programme. Table 3 of the report outlined the plans for the forthcoming year. This included a new workstream on system leadership which would focus on reviewing care pathways. The Kent and Medway Suicide Prevention Strategy would also be refreshed for 2020.
A Board Member said tackling suicide had to be holistic and could not be achieved by one individual or organisation on their own. Young people in education settings faced particular challenges and it was explained that a lot of work had been undertaken to support students in crisis. This included a ‘Suicide Safer Universities’ project, in which universities had introduced policies and training for staff to help support students, established tea and talk sessions and undertaken awareness raising about where to seek help. This was targeted around particular pressures students were likely to have, for example exam and relationship pressures.
A Board Member commended the suicide prevention projects for children and young people. He explained that in Medway, the Rivermead Trust coordinated a programme which provided an educational bridge for children and young people who had been in a mental health unit for a period of time to return to education locally. He asked that the Suicide Prevention Programme undertook targeted work for children and young people who had been in Tier 4 Child and Adolescent Mental Health Services (CAMHS) including working with the programme mentioned and within pupil referral units.
In response to a question concerning future funding for this programme, the Public Health Consultant said that the Suicide Prevention Steering Group met quarterly and would continue to do so post funding in 2019/20. In addition, the Suicide Prevention Strategy would be refreshed over the forthcoming year. The work set out in the Strategy would also continue beyond funding obtained for 2019/20. The 2019/20 funding was granted specifically to deliver the new workstream, however the Steering Group would be reviewing the sustainability of the programme, for example by seeking to embed programmes where possible and developing e-learning.
A Board Member asked whether officers had contacted the police to obtain data on the number of individuals they had contact with who had experienced a mental health issue but were not known to other organisations. The Public Health Consultant explained that the partnership worked closely with the police, sharing information and obtaining data from the coroner with respect to suicides.
A Board Member asked how it had been established that a third of people who commit suicide were not known to health services. The Public Health Consultant explained that this proportion was derived from robust audit data which reviewed the records of individuals who had completed suicide.
With respect to a question concerning the measurement of outcomes from the 4,500 individuals who had called the helpline promoted by the ‘Release the Pressure’ campaign, the Public Health Consultant explained that where appropriate, individuals would be asked about their wellbeing at the beginning and the end of the call. This information would be recorded to determine whether their wellbeing had improved.
A Board Member asked whether difficulties in accessing GP appointments contributed to individuals reaching crisis without seeking further help from health services. The Public Health Consultant advised that evidence suggested that where people had not had any contact with health services this was because of the stigma surrounding help seeking. Asked whether stigma had reduced as a result of campaigns to increase help seeking, the Board was advised that attitudes to mental health were changing but further progress was needed. It was recognised that the other initiatives to reduce stigma associated with mental health should be promoted.
With reference to mental health in the workplace, the Board was advised that the Council had signed up to the Time to Change Pledge. The Managing Director, Medway Community Healthcare (MCH) added that providers within the emerging Integrated Care Partnership (ICP) had committed to join the Zero Suicide Alliance. In addition, at the next Transformation Board, members would receive a presentation on the Zero Suicide Plan developed by KMPT.
Asked what support was provided to the voluntary sector to in turn support their clients who might be at risk, the Public Health Consultant explained that suicide prevention training could be accessed by these organisations. Different training programme focussed on supporting adults and children and young people and included face to face training sessions as well as e-learning, so there would be an option to suit each organisation and meet the need of the client base. Organisations forming the voluntary sector were also welcome to attend the Suicide Prevention Steering Group. An undertaking was given to ensure the Medway Voluntary Action Group was on the mailing list for the Steering Group.
The Health and Wellbeing Board:
a) noted the comments of the Health and Adult Social Care Overview and Scrutiny Committee set out at section 5 of the report;
b) noted the update on the suicide prevention programme; and
c) requested that officers contact the police to obtain data on the number of individuals they have had contact with who have experienced a mental health issue but are not known to other organisations and share this with Board Members.