How local authorities can prevent suicide

Over 6,000 people in the UK kill themselves each year. But suicide is not inevitable: it can be prevented with local knowledge, with involvement of local organisations, and, most importantly, with local action. That’s why Samaritans has launched its campaign Local Action Saves Lives.

We’re calling on all local authorities in England to make sure they have effective suicide prevention plans in place, in line with the Government’s National Suicide Prevention Strategy.

Read about our campaign calls in Scotland and Wales

We believe that every local authority should:

  • Have a clear suicide prevention plan, supported by a suicide prevention group which includes representatives from all the relevant local organisations, including the voluntary sector.
  • Have cabinet level leadership to ensure suicide prevention is a top priority and that the plan leads to real action
  • Identify the most at-risk groups and ensure that its approach is tailored towards them.

Each plan must respond to local need, but all local authorities will need to ensure that their plans: 

  • ensure that the help and support which is available in the local area is promoted effectively so that all who require it are aware of it and able to access it when in need. One effective way to do this is through community programmes aimed at those least likely to seek help.
  • work in partnership with hospital trusts in order to ensure that people who attend A&E and are at risk of suicide are always provided with follow-up support
  • ensure that services are available to support everyone bereaved by suicide – a particularly high risk group

Promotion of help and support

Stigma and negative attitudes around mental health are a major problem in preventing people from talking about suicidal feelings and seeking help. Local authorities that have established local multi-agency groups to tackle suicide in their area should consider developing local campaigns that raise public awareness about suicide, break down taboos and provide information about how people can get help.

Successful community-based campaigns that have been developed previously have aimed to expand suicide prevention awareness beyond the NHS to involve other services such as police, paramedics and housing associations but also by communicating through social media and involving parts of the wider community not usually associated with this kind of work such as local sports teams, universities/colleges or pubs. This helps in getting information through to ‘hard to reach’ groups unlikely to seek help from their GP or anywhere else. 

Working in partnership with hospital trusts

National suicide prevention strategies recognise that Accident & Emergency services have an important role in treating people who have self-harmed or have made a suicide attempt. At least half of people who die by suicide have a history of self-harm and one in four have attended hospital for self-harm in the preceding year.

Existing NICE guidelines state that people who have self-harmed should receive a ‘psychosocial assessment’ which involves an evaluation of the social, psychological and motivational factors specific to the act of self-harm as well as current suicidal intent. This may then be followed by further assessment or treatment.

A University of Manchester study in 2013 found that only 57% of people who attended A&E departments following an episode of self-harm received a psychosocial assessment before being discharged. For those that did receive an assessment the average waiting time before an assessment was carried out was 11 hours.

Given the particularly high suicide risk of people who attend A&E after harming themselves it is essential that rapid follow-up care is always available. Local authorities that have established local multi-agency groups to tackle suicide in their area need to ensure that all relevant NHS and other services work together to ensure that this is addressed in the local suicide prevention plan.

Services for everyone bereaved by suicide

While bereavement of any kind can cause intense feelings of grief and loss, bereavement following a suicide can be particularly traumatic because of the often sudden and unexpected nature of the death and because of the knowledge that it was a deliberate act. The stigma that can still be associated with death by suicide can mean that people who have been bereaved by suicide can find it more difficult to talk about the death with the people around them and to get support. In addition to the traumatic emotional consequences that people bereaved by suicide suffer, research demonstrates that they are themselves at increased risk of dying by suicide.

The availability of services aimed specifically at people who have been bereaved by suicide is too limited across the UK. Local suicide prevention plans should include a specific objective of supporting people bereaved by suicide which involves the commissioning of suitable services. These type of services include:

  • self-help and peer support groups organised by voluntary and community groups
  • one-to-one support provided by qualified practitioners and trained facilitators
  • in-depth psychological support provided by mental health services

People bereaved by suicide also need to be provided with information about sources of help and support at the earliest opportunity. Help is at Hand is a Public Health England resource for people bereaved and affected by suicide. A frequently raised concern is that many people bereaved by suicide are unaware of the resource and are not signposted to it by services that they come into contact with. Samaritans believes that coroner’s offices, the police, health and social care services, funeral directors and faith and other community organisations could help by signposting people bereaved by suicide to Help is at Hand. Local authorities can help to promote these actions through the multi-agency suicide prevention groups that they coordinate.

Find out more about support after suicide and Help is at Hand.

Suicide prevention in Scotland

672 families and communities in Scotland suffered the devastating loss of a loved one taking their own life last year. It is with local knowledge, local organisations and local action that we can try to ensure fewer families suffer in the future.

Local Choose Life groups are rightly held to have played an important role in the real progress we have made in reducing suicide rates in Scotland. They do this by bringing a range of organisations together in each local authority to ensure a coordinated approach to reducing suicide.

Scotland led the way when this local programme was introduced and other UK nations are now seeking to emulate it. Focus on local work in Scotland has, however, been lost over the years. Successive Scottish Governments have shown real commitment to reducing and preventing suicide generally, but we need to ensure that focus is on the right areas.

With over 60 years’ experience, Samaritans believes that local work is crucial to continuing our success in reducing suicide rates. As part of our Local Action Saves Lives campaign, we are calling on the Scottish Government to make specific commitments to reinforce and support local action as part of their forthcoming suicide prevention strategy.

 

Specifically:

  • Commit sufficient resources to address risk of suicide in local areas
  • Specific work should be carried out on an on-going basis to ensure that best practice can be shared amongst local areas
  • There must be support to ensure effective evaluation and use of data to inform local priorities

Preventing suicide and reducing the rate of suicide in Scotland is an urgent public health issue, one that goes to the heart of our efforts to create a healthy, fairer and more equal Scotland. Without renewed commitment, we face this life-saving resource becoming weaker.

In the run up to the Scottish local elections on 4th May 2017, we’re asking all candidates to show their support for Samaritans’ calls by sharing the message that #LocalActionSavesLives over social media and including @sams_scotland

Suicide prevention in Wales

Local councils have a responsibility to prevent suicide. They need to work with health, drug and alcohol services, community groups and others to make this happen.

All regions (Mid and West Wales; Cardiff and Vale and Cwm Taf; South East Wales; North Wales) have established multi agency suicide prevention forums which are required to report to the Welsh Government’s national advisory group on suicide and self-harm prevention. These regional forums should support Directors of Public Health, Health, Social Care and Wellbeing Networks (HSCWB) and the third sector in building and developing strategies and forums in local areas.

Every local area in Wales has a unique profile: a unique geography, economy, and population. It follows that a profile of deprivation and associated suicide risk will also vary between local populations. We believe that local suicide prevention plans should be established consistently across Wales.  They should be clear, comprehensive and sit within the context of the national plan (Talk to Me 2). We need to act locally to make sure the most effective ways of reducing suicide are in place across Wales.