On a recent visit to an A&E department, Professor Louis Appleby, Chair of the National Suicide Prevention Strategy Advisory Group, was shown where people are seen after overdose or self-injury. It was bright and private, with space for a patient's family, separated from the corridor by a door, not a curtain. The mental health team, explained the staff, come over promptly to carry out assessments. To mark World Suicide Prevention Day, Professor Appleby asks if the tide could finally be turning on how we respond to self-harm.
Just three months ago a report from the Care Quality Commission highlighted the poor experience of many people in mental health crisis: only a third said they were treated with warmth and compassion in A&E, and most felt judged for what they had done. Patients who self-harm are often viewed as wasting the time of busy staff, who - under pressure themselves - may see the self-harm but not the distress that lies behind it. Only 60 percent are fully assessed - no higher than a decade ago.
The World Health Organisation says there are 800,000 suicides each year worldwide and for every death, there are at least 20 suicide attempts - a total of 16 million annually. In England hospitals see over 200,000 self-harm episodes per year, making it one of the commonest reasons to seek urgent health care. Most patients are teenagers or young adults. Within a year, 1 in 50 will have died - they have high death rates from suicide, accident and natural causes.
Improving the care of those who self-harm will take training for front-line staff and therapy services to refer people to. It will also take a change in attitudes across the NHS - here are three examples:
- Don't see people who self-harm as having caused their own problems - they are often victims of abuse, depressed or in family crisis.
- Don't dismiss them as time-wasters, even when they keep coming back - suicide risk goes up, not down, with repeated self-harm.
- And remember that self-harm starts to drop off in the mid-20s - support people into early adulthood and many will put their traumas behind them.
Further information and links
Talking openly about suicide is first step to helping says Alistair Burt, Minister for Social Care and Communities.