Towards Zero Suicide: Preventing Suicide, Saving Lives
Chaired by Lawrence Moulin Author Centre for Mental Health: Aiming for ‘zero suicides, this conference focuses on Suicide Prevention and moving towards Zero Suicide as the ambition.
Lawrence initially trained as a Clinical Psychologist, and spent over 30 years working in the NHS and the Department of Health. His primary focus was on working with people with mental health problems, learning disabilities, and older people, and he worked as a clinician, service manager, commissioner, and strategically in the Department of Health, and in a leadership role across the West Midlands.
Since leaving the NHS he has been involved in a number of projects, including working for the Centre for Mental Health on the evaluation of the whole system approach to suicide prevention in the East of England.
Following the Chair's introduction Dr Rebeca Martinez Consultant Psychiatrist Mersey Care NHS Foundation Trust opens the conference with an update on Striving for zero suicide.
In her presentation Dr Martinez stated:
'Mersey Care has publicly committed to a “zero suicide strategy”
'Suicide trends globally hit an all time low in 2007, since then they have been on the rise'
'Approximately 1 million people die by suicide each year across the world, and approximately 6,000 in the UK. Most are men (75%) and it is estimated to be the leading cause of death in men under the age of 50, and one of the leading causes of premature death.'
'Suicide is an avoidable death. It is both preventable by wider public health interventions, but also amendable to high quality evidence based care.'
'Competency based training will be mandatory for all staff in the assessment of suicide risk.'
Pre conference abstract:
Mersey Care agreed an ambitious 'Zero Suicide' Policy in September 2015. The implementation plan includes new training and safety planning, better measurement of self-harm, and creating a supportive culture to maximise learning (MCT, Zero Suicide Policy, 2015).
The Zero Suicide approach aims to improve the care provided and outcomes for people at risk of suicide under the care of Mersey Care NHS Foundation Trust (MCT). This approach was adopted by the Trust and was inspired by the pioneering approach of Dr Ed Coffey at the Henry Ford Hospital System, Detroit, Michigan (USA) (Coffey, 2006, 2007).
The key priority areas are:
- Engagement with Stakeholders and Partners
- Safe and Effective Care and Treatment
- Competent and Skilled Workforce
- Analysis of Data, Research and Innovation
The Zero Suicide initiative is an ambitious five-year improvement programme that uses systematic quality improvement methods, co-production, measurement and culture change to attempt an unprecedented reduction in suicide within the Mersey Care patient population. During the programme, learning cycles enable improvements across a range of activities, drawing upon best practice and feedback. The ambition is matched by support for people after self-harm or suicide so that all opportunities to learn are harnessed and shared quickly.
Dr Martinez' Biography:
Dr Rebeca Martinez, is a Consultant Psychiatrist and Associate Medical Director for Suicide Prevention at Mersey Care NHS Trust. She has worked on the Suicide Prevention group for the Trust over the last 5 years, and has led the Zero Suicide Program since its launch in September 2015.
Dr Martinez has a research interest in early detection and interventions for common mental health problems in the interface between Primary and Secondary Care services.
She has been involved in the training of psychiatric trainees and is currently a College Tutor.
Dr Mike Doyle Deputy Director Nursing Clinical Governance and Safety South West Yorkshire Partnership NHS Foundation Trust continues the morning sessions with a presentation on 'Developing zero suicide in a Mental Health Trust' and will cover:
• review prevalence of suicide in West Yorkshire
• consider implications of suicide in West Yorkshire Vanguard partner agencies
• describe West Yorkshire Urgent and Emergency Vanguard Mental Health Workstream
• highlight progress of the West Yorkshire Vanguard Suicide Reduction and Prevention Group
Dr Doyle stated:
'Suicide rates in the general population vary between different countries. Some of the highest rates are in countries of the former USSR, africa, North and south Korea and the indian subcontinent in particular sri lanka. The highest rate is in Guyana.'
'The international review of existing studies, published in the Lancet Psychiatry journal on Wednesday, also found other prevention methods which encourage people to seek help or increase third-party intervention to be effective.'
'Risk is proportionate to the level of intervention and support received by the person at risk, so if the risk is identified and the care, treatment and engagement provided is high quality, timely and appropriate, and matched to the individual’s needs, then the risk of suicide is lower.'
'Suicide is not a terminal prognosis or inevitable for any individual and can be prevented. It is not a foregone conclusion for anybody and there is always hope that things will improve.'
Pre conference abstract:
This presentation will consider suicide risk in crisis services and before focussing on the development of a West Yorkshire suicide prevention strategy that is guided by the zero-suicide philosophy. The West Yorkshire STP/urgent and emergency care vanguard will be described and the importance of mental health and suicide prevention will be highlighted. The prevalence of suicide nationally and locally will be considered and best practice solutions to suicide prevention, including the zero suicide philosophy will be summarised and the progress made in developing the West Yorkshire suicide prevention strategy will be discussed. Objectives of the presentation are to:
- Review recent trends in suicide across services in England
- Consider implications of suicide in West Yorkshire STP/Vanguard partner agencies
- Describe West Yorkshire STP/Urgent and Emergency Vanguard Mental Health Workstream
- Highlight work and progress of Vanguard Suicide Prevention Group
Dr Doyle's Biography
Dr Michael Doyle is a Deputy Director of Nursing, Governance and Safety at South West Yorkshire Partnership Trust and an Honorary Senior Lecturer in Health and Risk Sciences at the University of Manchester. He has worked in mental health services for over 30 years. Previously accredited by the BABCP as a CBT therapist and worked as Nurse Consultant specialising in Clinical Risk in Forensic Services. He is currently the President of the International Association of Forensic Mental Health. Services. He has attracted significant research funding and published widely on psychosocial risk assessment, formulation and interventions, forensic mental health nursing and related subjects. He currently chairs the West Yorkshire vanguard suicide prevention strategy group
Joy Hibbins Founder and CEO UK Suicide Crisis Centre updates delegates after lunch on 'A new approach to supporting people at risk of suicide' inlcuding:
• using lived experience of crisis and mental health issues to create a service which would allow other people to survive
• The Suicide Crisis Centre: How it operates and the reasons why clients survive
• Men: The reasons why so many men feel able to access the service
• the Trauma Centre and early intervention
Pre conference abstract:
Joy runs a Suicide Crisis Centre in Gloucestershire, UK. The Centre provides face to face support to people who are at risk of suicide. They have been providing services for three and a half years and have never had a suicide of a client under their care.
In her presentation, Joy will explain why and how she set up the Suicide Crisis Centre. She will explain how it differs from other services.
She has identified many of reasons why all their clients survive, and will share these during her presentation.
She will explain that the particular way their services are set up places a “safety net” around clients, and that their ethos and approach enables clients to engage with them, even if they have found it difficult to engage with other services.
A high proportion of their clients are men and Joy explains some of the reasons why men feel able to access their service and why they say they felt unable to access other services.
Joy will also explain why they set up a separate Trauma Centre, providing early intervention for people who have experienced trauma.
Joy says “I didn’t set out to achieve zero suicide. My approach has always been to do everything I can to help each client to stay alive. That is surely the approach that we should all take. We need to be tenacious in helping people to survive.”
Joy Hibbins is the Founder and CEO of the charity Suicide Crisis. The charity runs a Suicide Crisis Centre in Gloucestershire which has achieved zero suicide. They have been providing services for three and a half years and have never had a suicide of a client under their care.
Joy is an Oxford University graduate, having previously attended a state school in Gloucestershire. She subsequently taught at Higher Education establishments and later worked in the community. She had a particular interest in working with refugees and asylum seekers and set up a community teaching project to focus on this.
In March 2012 she had an extremely traumatic experience which she says “fractured her life”. Within days of the incident she developed symptoms of Post-Traumatic Stress Disorder. Unable to process what had happened to her, she experienced suicidal crisis and was placed under the care of the NHS crisis team. She attempted suicide twice in that year.
The available services didn’t work for her and she realised that something very different was needed for people in crisis. She resolved to set up a Suicide Crisis Centre which would provide the kind of service which would have helped her.
In autumn 2013 the Suicide Crisis Centre opened. It serves the whole of Gloucestershire and is open to anyone who is suicidal. Five months earlier in the spring of 2013 their Trauma Centre opened, providing support for people who had experienced traumatic events, to help prevent them from going into crisis
Joy says she did not set out to achieve zero suicide at the Suicide Crisis Centre. She set out to do everything she could to help each client to survive. Her belief is that we need to be pro-active and tenacious in helping people to survive.
Although she has received professional training to do her work, she believes that her lived experience of suicidal crisis has been a vital part of her learning.
The work of the Suicide Crisis Centre has gained national attention in the past year. It has been featured on BBC national television news, Sky news and in national newspapers. It has also been featured in USA Today.
Luciana Berger, former Shadow Minister, has visited the Centre. Norman Lamb introduced Joy to the Government’s adviser on suicide, who invited her to give a presentation about the work of Suicide Crisis to the national suicide prevention advisory group which he chairs.
The work of the charity has been described as “inspirational” and “extraordinary” by the steering group/reference group of the South West Zero Suicide Collaborative.
She has written articles about suicide for The Independent and The Telegraph and writes regularly for The Huffington Post. Her blog pieces about mental health have been regularly featured on the front page of The Huffington Post.
Her book “Suicide Crisis: The Story” is an account of her own suicidal crisis, her journey through mental health services, the setting up of the Suicide Crisis Centre and its first two years in existence. It includes case studies of clients, which have been included with their permission. All proceeds from sales of the book go directly to the charity.
In 2015 Joy was diagnosed with Bipolar Disorder type 2. One of the assessing psychiatrists commented that it is possible that the traumatic event in 2012 “uncovered” the condition.
Joy says that she has been profoundly changed by the trauma which she experienced in 2012. “The traumatic experience had an extremely detrimental and damaging impact upon me. However, it also had an entirely unexpected consequence. It changed me in ways that I couldn’t have foreseen. The person that I was before 2012 could not have developed this charity or our Suicide Crisis Centre. The difficulties and huge challenges would have defeated my previous self. The experience of trauma has given me a determination and a tenacity that I didn’t have before.
We know that this charity is offering something different. We are being accessed by clients who say they would not have used other services. They are exactly the clients that we wanted to reach – those who were not accessing help and whose silence about their suicidality put them at greater risk.
The charity is no longer just about my experience. We constantly listen to our clients, and the charity has evolved to provide the kind of additional services that they want.”
Future conferences of interest:
Psychological Therapies in the NHS
Improving the Physical Health of Adults with Severe Mental Illness
Safeguarding Vulnerable Adults in Mental Health Services
Achieving Better Access for Mental Health Crisis Care
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