Magda Czarnecka, Dermot Gorman, Rachel King, Wojtek Wojcik Key themes from a study of Polish suicides in Lothian and Scotland 2012- 2016- recommendations for policy and practice Magda Czarnecka, Dermot Gorman, Rachel King, Wojtek Wojcik

Why? Concern about suicides by Polish nationals from Polish Consulate and Feniks. Is there a problem and, if so, what should be done?

Determining ‘Polish suicides’ from death records is complicated. Calculated the suicide rate of Polish residents living in Scotland. Using suicide and undetermined deaths -(WHO includes suicide only in official statistics) Reviewed Crown Office records of all the cases Police reports hold detail about the person & circumstances Post mortem reports 68 sets of notes – seen at the Crown Office in Edinburgh

Results – Polish in Scotland 2012-16 59 suicides and 9 undetermined deaths 2012-16 58 men and 10 women Polish population in Scotland - 86,000 (ONS, 2017)

21.6 20.8 14.1 Polish people living in Poland and Scotland have similar suicides rate. This is a higher level than Scotland.

Characteristics Time in Scotland: 2 weeks – 12 years Mean age men 37.0, women 32.8 Migrants and mostly living in areas in the most disadvantaged quintile Migration putting relationships under stress

Methods Hanging Poles in Scot. 63% Scotland 46% Poland 80-90%

Employment Unemployed - 35% Low-skilled shift work - 50% Isolated 24 (6 recent job loss noted, 1 recent benefits cut highlighted) Driver (Bus, HGV etc.) 5 Catering / restaurant 6 Food production 2 Farm labour 4 Carer School 1 Building / construction trades 8 Cleaning job / recycling plant Company executive Housewife 3 Retired Unknown Total 68 Employment Unemployed - 35% Low-skilled shift work - 50% Isolated Cleaning or driving jobs

Marital status

Alcohol Information in 30 sets of notes Financial issues ‘Alcoholic or heavy drinker’ described in 20 Another 5 drunk at time of death Debt and gambling Alcohol Information in 30 sets of notes Financial issues

GP registration more common in women 9 of 10 than men 37 of 58 several registered but hadn’t seen GP, 11 had been seen by GP in last month of life Presentation rare for mental health problems If sees the GP then Hides what is going on, Consult primarily for physical problems, also use Polish practitioners and medical care at ‘home’ Source medication from Poland NHS contact

May be clear warning signals... Gave partner flowers – telling her she ‘wouldn't have to look after him any more (also previous police call out re suicide threat) Told hospital staff she intended to go home and kill herself. She left 20 minutes after a nurse saw her and killed herself. Left a suicide note and had been googling 'how to hang yourself' Drowning attempt several months before Had visited a psychiatry clinic where previously treated & GP in days before death - 'told it is 12 week wait for psychiatry on day he died’

Unfamiliar with legal situation Had developed a concern that he was not really allowed to drive (a goods vehicle) after a drink driving ban Cautioned regarding computer contents on day before he was found hanged.

Summary Poland’s higher suicide rates carried into Scotland Similar range of ‘reasons’ for suicide to Scots Relationship breakdown Shift work and isolation Job loss Benefits or legal problems Migration often a potential aggravating factor Language Understanding of and access to services Using Polish healthcare while in Scotland Lack of family and friends

Further work – huge potential range e.g. Work with existing services – offering training to staff on Polish suicide issues Suicide prevention work to raise awareness within the Polish community of health resources and lines of support A campaign targeting Polish nationals & large employers of Polish people. Build capacity in employment agencies and benefits centres to increase ability to support individuals in distress

Thank you