1. Lets Talk About Suicide Sarah Lees and Moira Maconachie Plymouth City Council Public Health National and Local Strategy for Suicide Prevention Local Suicide Audit

2. Suicide Prevention National Strategy National Strategy “Preventing Suicide in England” 2012  Reduce the suicide rate in the general population of England  Provide better support for those bereaved or affected by suicide Reduce the risk of suicide in high risk groups Tailor approaches to improve mental health in specific groups Reduce access to the means of suicide Provide better information and support to those bereaved or affected by suicide Support the media in delivering sensitive approaches to suicide and suicidal behaviour Support research, data collection and monitoring around suicide and suicide prevention

3. Suicide Prevention National Strategy Preventing suicide in England : One Year On” January 2014  Current trends in suicide 2010-12 rate of deaths from suicide and undetermined intent 8 per 100,000 General downward trend from 1998-2000 has tailed off with small rise in last 4 years but 2010-2012 rate is 17% lower than in 1998-2000 Suicide 3 times more common in men than women Numbers and rates vary between age groups with rates amongst men highest for those aged 35-54 years and among women highest for those aged 40-59 years Hanging, strangulation and suffocation account for 60% of suicides in men Hanging and drug related poisoning account for 38% of suicides in women Continued fall in in-patient suicide Rise in overall suicide largely attributed to current economic difficulties

4. Suicide Prevention National Strategy Preventing suicide in England : One Year On” January 2014  New messages from research International and national trends show increase linked with economic crisis but affecting employed and unemployed Mental health service reforms and improvements in community care linked to lower rates New NICE guidance on self-harm and helpful therapies Continued strong evidence of effectiveness of reducing access to means at hotspots Clinical depression a strong confounder for increased risk in physically ill people Lithium an effective treatment for reducing the risk of suicide in people with mood disorders

5. Suicide Prevention National Strategy Preventing suicide in England : One Year On” January 2014  Areas for attention Self-harm Supporting mental health in a financial crisis Helping people affected or bereaved by suicide Middle-aged men Children and Young People Working with Coroners

6. Suicide Prevention National Strategy Preventing suicide in England : One Year On” January 2014  What local areas should consider Develop a local suicide prevention action plan DsPH lead data monitoring and surveillance Engage with local media Work with partners on mapping hotspots and taking appropriate actions Working on local priorities to improve mental health

7. Suicide Prevention Local Strategy  Suicide Prevention Steering Group (chaired by Public Health)  Strategic statement supporting national strategy aims and objectives and recommendations of the All Party Parliamentary Group on Suicide and Self-Harm  Developing a local action plan Information sharing Media awareness Training and awareness Awareness of services  Improving the mental health and resilience of our population is very important in preventing suicide  Informed by national research and local suicide audits

8. Why do a local suicide audit?  Monitor the number of deaths by suicide and undetermined injury in the city over time  Gather information about each person and the circumstances of their death  Identify unusual patterns (over time/ compared to the rest of the country/ in behaviour/ services)

9. Follow national guidance

10. Plymouth Suicide Audit process  Regular monitoring of local data Weekly, monthly and annual data concerning unexplained deaths in the city.  Request additional info about each confirmed case Visit the coroner’s office, request information from GPs, mental health services and the hospital  Annual Suicide Audit report Similar to Summary Report (Distributed)

11. RESIDENTS are the focus  Audit includes only Plymouth residents  Person may/ may not have died in Plymouth  Audit excludes residents younger than 15 years old  Suicide is a rare event Numbers vary from year to year (change best assessed over a longer time period)

12. Plymouth summary report  80 deaths registered 2010-2012 (63 men & 17 women; rate 10.8 ) Source: PHOF Update Feb 2014  83 deaths registered 2009-2011 (63 men & 20 women; rate 11.2 ) Trends 1986-2010 Source: Compendium of Clinical & Health Indicators  Average over time 25 (~10 per 100,000 pop)  Peak years: 1999; 2009

13. Trend data: 1986-2010

14. Abstract individual coded in national data = a specific person, a Plymouth resident with local ties. Suicide is an issue across the city  South West locality  City Centre neighbourhood A city-wide perspective

15. Where the residents lived in the city (83 deaths 2009-2011)

16. Plymouth Suicide Audit process Focus on deaths that have already occurred. Identifies & responds to local concerns that arise. Reacts to events. Finally… Plymouth Suicide Prevention strategy Wider focus on reducing suicides in the future. Draws on national/ international evidence about what is effective. Strategy group takes this forward locally.