Masterclass “Building suicide-safer communities” 14th March, ‘Mental Health, from strategy to reality’ conference, Manchester Conference Centre

Suicide-Safer London cordially invites you to the conference: “Mental Health – From strategy to reality” held in Manchester UK, on 14 March 2013. In this conference our Nick Barnes and other partners will deliver a 45-minute Masterclass session and make a presentation titled: “Early intervention: Building suicide-safer communities in Greater London, Wales and UK”

MASTERCLASS DETAILS

Title:

Early intervention: building suicide-safer communities in Greater London, Wales & UK

Theme

Creating a suicide-safer community: how your organization can become suicide-safer: life protection, life promotion, intervention and reducing harm.

Aims/Objectives

Understand how the suicide-safer approach works, how you can begin building a suicide-safer community in your area, and how suicide-safer communities have been saving lives for tomorrow, today.

Delegate Benefits

Gain a deeper understanding of current suicide prevention programmes in UK, and how versatile the suicide-safer model is for any community. How to begin / obtain advice with your own initiative, can we build a Suicide-Safer Nation, together?

Summary

• The birth of suicide-safer communities
• How suicide-safety works in UK, the story so far
• Working together: the over-riding principal
• Prevention, intervention, postvention: the complete suicide prevention programme
• A Suicide-Safer London – the next 5 years, A Suicide-Safer Nation?

Speakers

Nick Barnes
CEO
Suicide-Safer London

Fiona Aldred
CEO
Mind Aberystwyth

Sofia Wadman
Postvention Consultant
Suicide-Safer London

“Mental Health – From strategy to reality” conference, features a high-profile panel of speakers who are integral to the construction of the Implementation Framework, and who are already leading initiatives recommended within it. Delegates will have the opportunity to challenge, discuss and debate the key issues and gain insights that will furnish them with the tools to transform their own professional practice.

More info: http://www.publicserviceevents.co.uk/overview/241/mental-health

7 August, 2012: “U Can Cope” – World Suicide Prevention Day 2012 Campaign

Open Minds Alliance CICSamaritans, the Royal College of Psychiatrists and Southwick Media Consultancy are leading the U Can Cope multimedia multiagency media campaign to support and promote the 2012 World Suicide Prevention Day (WSPD) on 10 September. The theme of the 2012 WSPD is ‘Strengthening Protective Factors and Instilling Hope’.

To this end, we have commissioned a film entitled U Can Cope which will be released on Monday 10 September. The film features compelling stories of surviving suicidal thoughts, with commentaries from Dr Alys Cole- King, a leading psychiatrist in the field, and Professor Stephen Platt, an eminent academic in this area who have both worked closely in the production of this powerful and thought-provoking film.

The film will promote 3 main messages:

1.      Anyone can experience suicidal thoughts.

2.      There is always hope.

3.      There is always help.

This resource has the added benefit of being developed by partner agencies engaged with the Call to Action for Suicide Prevention in England and begins to action the identified consensus priority of developing a shared suicide prevention campaign to improve help-seeking behaviours amongst ‘high risk’ groups and the whole population.

We will also be highlighting three new Royal College of Psychiatrists’ resources:

U Can Cope Charity

The U Can Cope Charity will be set up to fund the development and dissemination of compassionate resources (including web based resources available to all) for people in distress and for those who wish to help them. It will be kindly hosted by the Cronfa Betsi Fund website.

Woman’s Hour

On 26 July, Dr Alys Cole-King joined a discussion on Woman’s Hour about self-harm in your people. She gave help-seeking advice and explained where parents and carers can get support. promoting help seeking advice and support for parents or carers.

We are working with over a hundred organisations including academics, voluntary groups, Royal Colleges and other professional bodies on the U Can Cope WSPD campaign, and would be delighted if you would be willing to support the initiative. You can keep up to date by following the campaign on Twitter (@UcanCope) and on the Connecting with People website.

15 July, 2012: Suicide on the rise among older men

The Guardian today reports Suicide rates are increasing amongst the older male age group:

“The number of suicides and prevalence of suicidal tendencies is rising faster among older men than in any other age group, according to research released in the week the government postponed its suicide prevention strategy.

Data from the Office for National Statistics (ONS) shows that the number of suicides among men aged over 55 has risen by 12% over the past decade, while suicides by men aged under 34 dropped by 30%. The mental health charity Calm said men aged 45 to 54 were still most likely to seriously consider taking their own life.

Charities and mental health experts are concerned that across all age ranges there are far more male than female suicides.

Jane Powell, the Calm chief executive, speculated that the recession might be having more of an impact on older men.

“If you are middle-aged just now and your job and life prospects are diminishing then this is tough,” she said. “There is work to show that the impact of unemployment hits men harder, and later on in life; that it’s easier for women whose lives are not necessarily defined by work and for whom part-time or temporary work isn’t by definition bad.

“Our research shows that thinking about suicide is more common than we realise, and that men and women are almost equally liable to feel suicidal. What is significant is that more men actually go on to take their lives.”

Official statistics show that 4,517 people in England and Wales killed themselves in 2010, of whom 75% were men.

Powell said there were two reasons for the discrepancy. “First, because men are by default supposed to be in control, in charge at all times and so therefore needing help is by definition unmanly.

“And second because all too often men don’t recognise what the problem is – they’ll feel out of control, angry with everything, find that their life is out of focus, not be interested in what’s happening around them – and they won’t recognise that they are depressed. And because as a man they’re supposed to be invulnerable, then suddenly the options they have of getting out of their situation start to look very slim.”

Calm, which began as a Department of Health initiative in 1997 and became a charity in 2006, has traditionally focused on reducing suicide among young men. Now it is changing its remit to include the older generation.

According to a YouGov survey carried for Calm of adults who had considered taking their own lives, a key driver was relationship status. The number of children in a household was also a factor with 18% of men with one child expressing suicidal thoughts, compared with 27% with three or more children. The government planned to launch its suicide prevention strategy last week but postponed the initiative until September.

Catherine Johnstone, chief executive of Samaritans, said: “There is strong evidence to show that interventions to support people at risk of suicide make a difference. However, it is often the case that services are failing to reach and engage men, which is why Samaritans launched a campaign in late 2010 to target working-class men who are the most at risk.

“Suicide is preventable and requires the action of multiple government departments. We welcome the forthcoming suicide prevention strategy for England and hope that it will continue to be a catalyst for change. To make a real impact, however, the strategy requires commitment from the public, private and voluntary sectors, as well as government.”

Last week it emerged that people in Manchester were more likely to kill themselves than in any other city. At a public meeting called by Manchester Users Network, a group for people with mental health issues, participants criticised cuts to services, in particular community centres, which act as lifelines to people with depression.

A Department of Health spokesperson said: “The government is taking strong action on suicide prevention. We have been listening to families who have sadly been bereaved following a suicide, and have called upon experts in healthcare, criminal justice and transport to help us put together a new suicide prevention strategy for England to help save lives. We have considered all the responses received, and intend to publish our plans in September.”

10th World Suicide Prevention Day 2012: “Suicide Prevention across the Globe: Strengthening Protective Factors and Instilling Hope”

September 10th, 2012 marks the 10th anniversary of the World Suicide Prevention Day: ten years of research, ten years of prevention, ten years of education and dissemination of information.

The efforts of this decade are founded on research evidence that we can prevent suicide. Indeed, the most important aim of this initiative, organized by the International Association for Suicide Prevention (IASP) in collaboration with the World Health Organisation (WHO), is raising awareness among the scientific community and the general population that suicide is preventable. Hence we must reduce the stigma and silence that still surrounds it.

The theme of World Suicide Prevention Day this year is “Suicide Prevention across the Globe: Strengthening Protective Factors and Instilling Hope”.

Public health awareness and education campaigns have often focused on the role of risk factors in the development of suicidal behaviour. In order to increase effectiveness in preventing suicide we propose to direct our efforts not only towards reducing risk factors but also toward strengthening protective factors, with the aim of preventing vulnerability to suicide and strengthening people’s resilience.

Suicide: extent of the problem and patterns of suicidal behaviour

The magnitude of the problem

Suicidal behaviour has become a major public health problem across the world. It is a complex phenomenon that usually occurs along a continuum, progressing from suicidal thoughts, to planning, to attempting suicide, and finally dying by suicide, which represents the final tragic outcome of a morbid process. Data from the WHO indicate that approximately one million people worldwide die by suicide each year. This corresponds to one death by suicide every 40 seconds. The number of lives lost each year through suicide exceeds the number of deaths due to homicide and war combined. Suicide attempts and suicidal ideation are far more common; for example, the number of suicide attempts may be up to 20 times the number of deaths by suicide. It is estimated that about 5% of persons attempt suicide at least once in their life and that the lifetime prevalence of suicidal ideation in the general population is between 10 and 14%. Suicide is one of the leading causes of death in the world and over the last years rates have increased by 60% in some countries. In addition, suicide statistics may not always be accurate. Many suicides are hidden among other causes of death, such as single car, single driver road traffic accidents, unwitnessed drownings and other undetermined deaths. In addition, suicide is estimated to be under-reported for multiple reasons including stigma, religious concerns and social attitudes. The psychological and social impact of suicide on the family and community is enormous. Furthermore, the economic costs associated with self-inflicted death or injuries are estimated to be in the billions of US dollars a year.

Age differences

Suicidal behaviour can occur at any age. The frequency of suicidal behaviour escalates steeply from childhood through middle to late adolescence and into adulthood. Suicide ranks as the second cause of death worldwide among 15-19 year olds, with at least 100,000 adolescents dying by suicide every year. Suicide rates are high among middle-aged and older adults and highest among those aged 75 and older. Elderly people are likely to have higher suicidal intent and use more lethal methods than younger people, and they are less likely to survive the physical consequences of an attempt.

Gender differences

On average, there are about three male suicides for every female suicide. This is more or less consistent across different age groups and in almost every country in the world. Conversely, rates of suicide attempts tend to be 2-3 times higher in women than in men, although the gender gap has narrowed in recent years. The disparity in suicide rates has been partly explained by the use of more lethal means and the experience of more aggression and higher intent to die, when suicidal, in men than women.

Country differences

Prevalence rates of attempted and completed suicide are significantly different across the world. However, due to the already cited limitations of data collection, these differences should be considered carefully. Documented rates are highest in Eastern European countries, such as Lithuania and the Russian Federation, and lowest in countries of Central and South America, such as Peru, Mexico, Brazil and Colombia. The United States, Western Europe and Asia fall in the middle range. Unfortunately, for many countries in Africa and some countries in South-East Asia suicide statistics are not yet available.

Who is at risk of suicide?

Suicide affects everyone, but some groups are at higher risk than others:

People with a history of suicide attempts or self harm.

A history of previous suicide attempt(s) or self harm is the strongest predictor of future death by suicide, corresponding to a 30-40 times higher suicide rate than the general population. The first days and weeks following psychiatric hospitalization represent the most critical period of suicide risk for patients. This finding highlights the need to attend carefully to continuity of care for psychiatric patients.

People with a psychiatric disorder and/or substance-related disorder

It has been documented that approximately half of the people who seriously consider taking their lives have been diagnosed with a mental disorder during their life, and that up to 90% of people who die by suicide have at least one psychiatric diagnosis. Among all diagnoses, depressive disorders are most commonly associated with suicidal behaviour, followed by substance-related disorders, schizophrenia and personality disorders. Alcohol and drug abuse and dependence have been identified as important risk factors for suicidal thoughts and behaviours. Current substance use, even in the absence of abuse or dependence, is a significant risk factor for unplanned suicide attempts among those with suicidal thoughts. Comorbidity, namely the presence of two or more psychiatric disorders or a psychiatric disorder and a substance use disorder, significantly increases the risk of suicide.

Those who experience stressful life events

Stressful life events often act as precipitants of suicide attempts or suicide by those with a diminished capacity to cope with them. Impulsive attempts may follow stressful life events, including family and interpersonal conflicts, relationship breakdowns, other interpersonal difficulties, the presence of legal/disciplinary problems, and financial and job difficulties. Periods of economic crisis and unemployment are associated with greater social vulnerability and often an increase in deaths by suicide. Bereavement, consistently described as one of life’s most stressful events, has been shown to elevate the risk of suicide and suicidal behaviour in vulnerable people, particularly if the death is by suicide. The risk of suicide is also greater among patients with severe physical illnesses, such as cancer or HIV infection – in fact, increased suicide risk has been found to be associated with a large number of medical conditions, ranging from asthma to traumatic brain injury. The experience of persistent stress also may explain the elevated risk of suicide in some occupations, such as physicians, military personnel and police officers, as well among people in prison. Moreover distal stressors, e.g. childhood trauma, have consistently been linked to an increased risk of suicidal behaviour in adult life.

Strengthening protective factors and instilling hope

Protective factors

Despite the wide experience of the above-cited risk factors in populations, the fact that completed suicide is a relatively rare event indicates that there are a range of protective factors that act to mitigate the effects of exposure to risk factors. Among psychological factors, resilience (the ability to cope with adverse life events and adjust to them), a sense of personal self-worth and self-confidence, effective coping and problem-solving skills, and adaptive help-seeking behaviour are often considered to be protective against the development of suicidal behaviours. Social and cultural factors such as religious and social integration, social connectedness and maintenance of good relationships with friends, colleagues and neighbours, access to support from relevant others and ready access to health care are associated with a reduced risk of suicide and reduced repetition of attempted suicide. In addition, a healthy lifestyle, with maintenance of good diet and sleep habits, regular physical activity, abstinence from smoking and illicit drug use, is also associated with a reduced risk of suicidal behaviour.

Suicide prevention is possible

Suicide is a multi-determined phenomenon that occurs against a background of complex interacting biological, social, psychological and environmental risk and protective factors. Despite the complexity of this phenomenon, suicide can be prevented.

Primary prevention of suicide requires broad modifications of social, economic and biological conditions to prevent members of a population from becoming suicidal. Primary prevention involves population-based interventions, rather than focusing on the individual at risk. Primary preventive interventions include restricting access to lethal methods, promoting physical health and positive mental health, promoting a responsible representation of suicide in social and other media, seeking to reduce stigmatization of mental illness and suicide and encouraging help-seeking behaviour through public awareness and education campaigns.

Secondary prevention is aimed at minimising suicide risk in high-risk populations. In this sense, early identification of suicidal individuals, accurate diagnosis and effective treatment of mental health problems, especially mood disorders and substance-related disorders are crucial. More than half of the patients who die by suicide have seen their primary care physician within the month before their death. Therefore, improving primary care physicians’ recognition of psychiatric symptoms and disorders, suicide risk evaluation, treatment interventions and referral skills are key components of suicide prevention. Similarly, providing educational programs for “gatekeepers” (people who regularly come into contact with individuals or families in distress, such as clergy, first responders, pharmacists, teachers and police) can improve recognition of the risk of suicide and self-harm and facilitate referral of vulnerable people to appropriate assessment and treatment facilities.

Finally, tertiary prevention is aimed at preventing relapses of suicidal behaviour after a suicide attempt. This also involves the critical work of postvention — the care, support and treatment of those impacted by suicide.

Priorities for suicide prevention – and a focus on protective factors:

We need to continue to research suicide and non-fatal suicidal behaviour, addressing both risk and protective factors.
We need to develop and implement awareness campaigns, with the aim of increasing awareness of suicidal behaviours in the community, incorporating evidence on both risk and protective factors.
We need to target our efforts not only to reduce risk factors but also to strengthen protective factor, especially in childhood and adolescence.
We need to train health care professionals to better understand evidence-based risk and protective factors associated with suicidal behaviour.
We need to combine primary, secondary and tertiary prevention.
We need to increase use of and adherence to treatments shown to be effective in treating diverse conditions; and to prioritise research into effectiveness of treatments aimed at reducing self-harm and suicide risk.
We need to increase the availability of mental health resources and to reduce barriers to accessing care.
We need to disseminate research evidence about suicide prevention to policy makers at international, national and local levels.
We need to reduce stigma and promote mental health literacy among the general population and health care professionals.
We need to reach people who don’t seek help, and hence don’t receive treatment when they are in need of it.
We need to ensure sustained funding for suicide research and prevention.
We need to influence governments to develop suicide prevention strategies for all countries and to support the implementation of those strategies that have been demonstrated to save lives.

28 April, 2012: Bullied ‘more prone to self harm’

The research, from King’s College London, also showed that victimised children with mental health problems were at greater risk of self-harming in later life.

In their paper the authors suggest that efforts should focus on improving the ways in which children cope with emotional distress.

“Bullying by peers is a major problem during the early school years,” they said.

“This study found that before 12 years of age a small proportion of children frequently exposed to this form of victimisation already deliberately harmed themselves and in some cases attempted to take their own lives.

The researchers also raised fears over the long-term implications of bullying which, they said, could result in psychological issues, serious injury or death.

“This study adds to the growing literature showing that bullying during the early years of school can have extremely detrimental consequences for some children by the time they reach adolescence,” they wrote.

“This finding is even more concerning given that studies have suggested that early patterns of self harm can persist through adolescence into adulthood and increase the risk of later psychological problems.”

The authors looked at more than 1,000 pairs of twins – born between 1994-1995 in England and Wales – at five, seven, 10 and 12 years old.

The children were assessed on the risks of self-harming in the six months prior to their twelfth birthdays.

Data from 2,141 participants showed that 237 children were victims of frequent bullying and, of that number, 18 (around 8%) self harmed.

This involved cutting or biting arms, pulling out clumps of hair, a child banging its head against walls or attempting suicide.

Of 1,904 children who were not bullied, 44 (2%) self harmed.

It also showed bullied children who had family members who had either attempted or committed suicide were more likely to self harm than others.

“Although only a small proportion of bullied children in this sample engaged in self harm, this is clearly too many and victims need to be provided with alternative coping strategies from a young age,” the authors said.

Full story available at http://www.bbc.co.uk/news/health-17868476