1. Themes for the KMPT Suicide Prevention Strategy 2016 - 2019 Informed by local and national data, with particular reference to the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCISH) Mike Kingham, November 2015 Chair, Prevention of Suicide and Homicide Group

2. Suicide in the general population in England

3. NCISH, 2015 (England)

4. Rates of suicide per 100,000 population by NHS area of residence (average rate 2011 – 2013) NCISH, 2015 (England)

5. Suicide in the patient population in England

6. NCISH, 2015 (England)

7. Suicide in patients of Kent and Medway NHS and Social Care Partnership Trust (KMPT)

8. NCISH Trust Benchmarking Exercise KMPT 2011 – 2013 * Denominator data used to calculate the suicide rate was the number of people in contact with secondary mental health services.

9. NCISH KMPT data, 2011 - 2013 with England & Wales context

10. NCISH, 2015 (England) NCISH clinical message – closer working with families and carers would have safety benefits, through consultation and making it easier for families to pass on concerns about suicide risk.

11. NCISH, 2015 (England) NCISH clinical message – do not use CR/HT as default for patients at high risk or who lack social support; CR/HT should be an intensive community- based alternative to inpatient care; acute admissions out-of-area should be avoided.

12. Primary diagnosis Mood disorders (especially depression with psychotic symptoms and when associated with agitation/anxiety), including mixed mood states in bipolar disorder. Schizophrenia and delusional disorders. Drug and alcohol misuse. Personality disorders. Note conditions that occur at the same time as other mental disorder, particularly drug and alcohol misuse.

13. Suicide Prevention Strategy 2016 - 2019 Further embedding a patient safety culture into processes and practice at KMPT. Ensuring lessons learned from incidents are disseminated to and understood by all clinical teams. Incorporate safety into Single Point of Access initiative and Community Mental Health Team reorganisation. Greater priority to high risk groups and high risk diagnoses, with use of guidance and precedents on standard approaches to care and treatment. Transformation of clinical risk assessment and management – both in practice and recording (including training, electronic prompts and reformatting of the electronic patient record). Highlighting certain risk scenarios: transitions in care; care interfaces; inpatients (particularly ligatures within the ward and patients absenting themselves); selection of patients for CRHT as opposed to admission; non-compliance and disengagement; access to lethal means; Mental Health Act assessments (including section 136); co-existing substance use. Greater engagement of patients, families and carers in “safety planning”. Training and supervising staff; managing caseloads; identifying struggling clinical teams. Emphasis on operationalising the Suicide Prevention Strategy.

14. Thank you for listening.