Suicide is one of the UK’s biggest public health issues but now the government is bringing it to the top of its agenda and looking to boost support for vulnerable people

6,188. An insignificant number if you compare it to the number of people living in London (8.63 million) or the population of the UK (64.1 million). But when 6,188 is the number of deaths from suicide, recorded by the Office for National Statistics (ONS) in the UK in 2015, it’s not so insignificant after all. And to put this figure into perspective, 6,188 is almost half the capacity of Wimbledon’s Centre Court and nearly a thousand more than the capacity of the Royal Albert Hall.

Since 2007, there has been a gradual increase in the UK suicide rate, especially among women, and suicide is now the leading cause of death for young people aged 10-34 in the UK. Commenting on these suicide figures, Paul Farmer, chief executive of mental health charity Mind, says: “We are concerned that the suicide rate has risen again, as it has done for several years. We are particularly concerned that women seem to be at increasing risk, while men still account for the majority of suicides overall, despite a focus in recent years on tackling male suicide.” 

In fact, 75 per cent of suicides in 2015 were male and 25 per cent were female, showing a significant gender disparity.

Other worrying statistics released by NHS Digital in late 2016 revealed that one in five adults in England report that they have thought of taking their own life, and one person in 15 has made a suicide attempt at some point, further highlighting the need for something to be done to support the mental health of people across the country.

Intervention from the top

On 9 January, Theresa May gave her first speech on healthcare as prime minister and took the opportunity to raise awareness of mental health problems and suicide prevention.

She outlined plans to create a “shared society” which focuses on the responsibilities we have to one another instead of just individual responsibilities, as well as the need to deliver social reform across every layer of society so that everyone is given the help they need, rather than just the very poorest. She said: “At the heart of the plan is a commitment to building a fairer society and tackling the burning injustices that have been allowed to stand for too long.”

She continued: “I want to turn to one of those burning injustices in particular – the burning injustice of mental health and inadequate treatment that demands a new approach from government and society as a whole.” Ms May’s comments alluded to the reality that if you suffer from a mental health problem, there is not enough help available and on the occasions it is available, often the support is lacking or involves a significant waiting time.

To tackle this, Ms May announced measures that she hopes will start the ball rolling to improve services and care, including mental health first aid training for teachers, an extra £15 million for community care, and improved support in the workplace. She emphasised the need for employers, parents, teachers and communities to work together to end the stigma surrounding mental ill health and focused on the expansion of digital mental health services – including a £67.7 million investment – which, in the right cases, she said “can offer access to treatment far quicker than traditional services.”

Ms May’s speech has been welcomed by mental health charities, with Mind’s Paul Farmer highlighting the importance of the prime minister talking about mental health. “[It] shows how far we have come in bringing the experiences of people with mental health problems up the political agenda,” he comments. “Mental health should be at the heart of government, and at the heart of society and communities – it’s been on the periphery for far too long.” However, Paul added: “The proof will be in the difference it makes to the day-to-day experience of the one in four who will experience a mental health problem this year,” suggesting only time will tell whether these measures have any lasting effect.

Jenny Edwards CBE, chief executive of the Mental Health Foundation, largely agrees, saying: “Theresa May has signalled a long-awaited and much-needed shift in thinking towards preventing mental health problems rather than just treating the symptoms.

“The government has recognised that the answers to creating a mentally healthy society are held within our schools, communities and workplaces, not just in our health service. My concern now is that resources are placed where they are needed most: in communities that are surviving and not thriving. The prime minister has a real opportunity to lead a prevention revolution in our society – starting with those groups who need support now.”

Putting it into practice

As part of her shared society speech in January, Ms May announced the publication of a strengthened cross-government suicide prevention strategy by the Department of Health. This, she explained, “sets out a comprehensive plan to reduce the suicide rate in this Parliament, and targets those most at risk such as young and middle-aged men, those in contact with the criminal justice system and those in the care of mental health services.”

As well as discussing the activity that has taken place across England to reduce deaths by suicide in the year ending March 2016, the report updates a 2012 strategy in five key areas:

• Expanding the strategy to include self-harm prevention in its own right
• Every local area to produce a multi-agency suicide prevention plan
• Improving suicide bereavement support in order to develop support services
• Better targeting of suicide prevention and help-seeking in high risk groups
• Improve data at both the national and local levels.

It is hoped that these updates will result in every local area having a multi-agency suicide prevention plan in place by the end of 2017 and will help to reduce the number of suicides by 10 per cent by the year ending March 2021. 

These two goals were also detailed in the Mental Health Taskforce’s Five Year Forward View for Mental Health – a report that the government has fully accepted and started to implement, showing its commitment to supporting mental ill health. 

In response to the government’s updated suicide prevention strategy, Paul says: “We are pleased that the Department of Health has strengthened its plans around suicide prevention.” He adds: “No one in touch with services, asking for help, should reach the point of taking their own life. So much more can be done to prevent people reaching crisis point in the first place if people at risk get the right support at the right time.” 

Pharmacy’s role

While it’s relatively easy for the government to prioritise mental health support and develop suicide prevention strategies, bringing about actual change and altering the nation’s mindset is less so. This is partly a result of stigma and because mental health has always been disregarded as a secondary issue to physical health. 

While public awareness of mental illness has grown significantly in the last few years and more people now talk openly about it, there is still a long way to go to fully eradicate the stigma that has long surrounded the issue. Indeed, according to statistics from Rethink Mental Illness and Mind’s Time to Change initiative, nine out of 10 people with mental health problems experience stigma and discrimination.

But pharmacy is in an ideal position to help tackle this stigma, raise awareness of the support available to people with mental illness and play a part in suicide prevention.

Cal Strode from the Mental Health Foundation, says: “More than two-thirds of people who die by suicide have not been in touch with mental health services in the year before their death. That’s why awareness campaigns encouraging people to access support and encourage others to do so are crucial. We all have a part to play in encouraging people to access support and frontline pharmacy professionals are well placed to reach people.”

The main theme running throughout the recent speeches, strategies and reports from the government is that all suicides are preventable and a good starting point is simply offering people the opportunity to talk. Having a listening ear is extremely helpful for managing mental illness and people might actively seek help in this way. However others may be less open and it might not be so obvious that something is wrong. Cal says: “Self-harm is one of the strongest indicators of suicide risk. By looking out for signs of self-harm and other signs of mental distress we can encourage people to seek and access the range of support available to them through their GP.”

A report by the Health Select Committee to help inform the government’s suicide prevention strategy published in 2016 branded the scale of avoidable loss of life by suicide as unacceptable and stated that “renewed focus should be given to providing mental health training for staff in public facing roles, especially in higher risk situations”. Cal agrees that extra training for staff on how to handle difficult conversations such as those centred on mental health and suicide is important. He says: “The Samaritans have a range of posters available on their website and offer workplace training on how to handle difficult conversations with customers and respond appropriately to sensitive subjects.”

We all have a part to play in encouraging people to access support and frontline pharmacy professionals are well placed to reach people