Local authorities must have suicide prevention plans, says parliamentary report

BMJ 2013; 346 doi: (Published 30 January 2013) Cite this as: BMJ 2013;346:f645
  1. Ingrid Torjesen
  1. 1London

The government should require the public health teams of local authorities to develop and implement strategies to prevent suicide, a parliamentary report has recommended.

Currently local authorities are under no obligation to take action on suicide. More than a quarter (27%) of local authorities in England do not have a specific suicide prevention strategy, found an investigation by the All-Party Parliamentary Group on Suicide and Self-Harm Prevention. Meanwhile the suicide rate in England is rising as a result of the economic downturn, the group said.

The group’s report, launched at parliament on 29 January, recommends that local authorities should be required by the government to develop a suicide prevention plan, led by the director of public health or a senior member of the public health team.1 The plan should include provisions for prevention of self harm and for dealing with people bereaved by a suicide.

The MPs and peers also recommend that suicide prevention groups be established by local authorities to help develop suicide prevention programmes that are tailored to local needs. Nearly half of local authorities surveyed for the report did not have such a group, and only a third (50 of 152) fund specific suicide prevention programmes.

Madeleine Moon, the Labour MP for Bridgend, who chairs the group, said, “The report highlights the degree to which local suicide prevention plans across England have been left to chance since the publication of the first National Suicide Prevention Strategy in 2002.”

The Department of Health published an updated national strategy in September 2012,2 but Moon said that its failure to make development plans mandatory and to set ringfenced funding to implement them was a “major barrier.”

Suicide prevention risked being sidelined as public health teams concentrated on other more high profile areas, such as smoking and obesity, while trying to make efficiency savings, Moon said. The lack of a dedicated communication link between the existing suicide prevention groups and the new health and wellbeing boards, which will set local priorities for local authorities and the NHS, added to this risk, she said, because the groups could not ensure that suicide was on the boards’ agenda.

Figures published by the Office for National Statistics last week show that there has been a significant rise in suicides, from 11.1 to 11.8 deaths per 100 000 population between 2010 and 2011.3 In 2011 there were 6045 suicides among people aged 15 years or over in the UK, an increase of 437 on 2010.

Researchers at the University of Liverpool suggested that the economic crisis and the recession were responsible for the rise. They calculated that more than 1000 suicides between 2008 and 2010 could be attributed to unemployment.4

“Without a legal requirement for local authorities to implement strategies in their areas or establish suicide prevention groups, it’s unlikely that there will be a substantial reduction in the number of lives lost,” Moon said.

At the report’s launch, Norman Lamb, the minister for care and support, promised to look at the issue of whether local suicide development plans should be made a statutory requirement. But he added, “Sometimes there are dangers in that it is a paper exercise . . . You have to make sure that the money is actually working in the system.”

Lamb said that he wanted to see mental health services better integrated with acute care services. Changes were also needed to targets on patients’ access and on the payment system for mental health services. A combination of a meaningful tariff, Payment by Results, and the 18 week access entitlement had ensured that money was sucked through to acute hospitals, he said.

“Once you create a greater equilibrium in the system, it might start to ensure that the money goes to where it is needed into these sometimes politically unsexy areas,” he added.


Cite this as: BMJ 2013;346:f645