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World Suicide Prevention Day and our response to self harm

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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.

2015_wspd_banner_englishJust 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.

Professor Appleby: '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.'
Professor Appleby: '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.'

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

International Association for Suicide Prevention article

Talking openly about suicide is first step to helping says Alistair Burt, Minister for Social Care and Communities.

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  1. Comment by Johnny Partridge posted on

    Suicide is a taboo subject in society. Once this is taken on and changed then real change and improvements can happen, both in and outside of the NHS.

    This can only be achieved by education and high profile campaigns, esp. with at risk groups.

  2. Comment by Mrs J Biddiscombe posted on

    Some doctors and nurses just don't know how to treat people that have mental health issues. Some say there there attention seeking, some have said, you didn't take enough to tablets your still here and there are alway sly remarks. I've many a time heard nurses chatting to each other seeing who would treat that patient yet again!! A doctor been heard by other patients saying, "I'm not seeing her again" then I asked her for a name. I past this on and was told she had apologised, has she hell as like.
    I'm sorry to say my Granddaughter has now been in a private hospital in London under section three for her own safety for ten months. So thanks to people who have Not helped her along the way. It's Not dropping off, you just don't see it out there like us who help our loved ones in trouble, it's not funny when you have CID calling to let you know they have frogmen looking in the rivers!!! More money needs spending on mental health and why not train nurse and doctors in A&E a little more about it!!!

  3. Comment by Mark Woodward posted on

    I'm a man now in his early sixties, but for a period of about three years in my late teens I was self-harming on a regular basis, and was hospitalised for a short period. I think it is inaccurate and perhaps counter-productive to equate self-harm with the risk of suicide. I did it not because I wanted to die, but as my only way of staying alive - I still remember how this misunderstanding increased my sense of isolation and alienation. Whilst I'm sure that many people who self-harm are suicidal, I would hazard a guess that many are not - the only way I would have killed myself was by accident. Misunderstanding the motivation of people like me may make it harder to find effective ways of supporting us, and presenting us with a flawed analysis may make it harder for us to understand our own behaviour and find ways to address its causes. I now work in adult learning, mostly with people who are vulnerable and disadvantaged, and the co-productive values we seek to apply in our work are relevant to this area also. It would be helpful to actively engage people who self-harm in the design and delivery of the services intended to support them.

    • Replies to Mark Woodward>

      Comment by Joyce posted on

      It's true that many people who self-harm are not suicidal, they are trying to stay alive. It's the only way they know to ease their mental pain. People with Borderline Personality Disorder frequently self-harm but are not necessarily suicidal. What these people need is to learn new coping skills such as Dialectical Behaviour Therapy (DBT). And to be validated in their feelings. Please see my blog for more information on BPD here: