This year I have attended and spoken at or participated in a large number of events relating to the problems of suicide. This is a much larger problem than people might think although ‘only’ about 6,500 people die by suicide each death and attempted death leaves behind fractured families and friendships. I have sat and listened to parents who years after their children have died by suicide still ask themselves why it happened. What did they do wrong? How did they not see what was happening?
Others complain of a failure to join up services and information. Information does not pass its way round the system in the most logical way to maximise a full programme of activity when possibilities of suicide become clear.
This meeting was an opportunity for Sarah Wollaston to speak to the group about progress on the National Suicide Prevention Strategy and some of the issues raised during the Health and Social Care inquiry and follow-up session on suicide prevention conducted by the Health Select Committee in January which I addressed. Both Sarah and the Minister responsible for suicide prevention have shown a real commitment to this work and have made it a high priority within the pressing needs of health and care services.
Every suicide is a tragedy. Although local councils and the NHS are making progress, too many people die by suicide. This has a devastating impact on the families, friends and the people they work and live with.
Suicide prevention is a public health priority for local government and our partners. Councils are leading many excellent initiatives to help drive down suicide rates. Every council has a multi-agency suicide prevention plan inplace, despite this not being a statutory responsibility. Many also have suicide prevention partnerships, which work with public health teams, CCGs, primary and secondary care, the voluntary sector and those affected by suicide.
Councils are working with the Association of Directors of Public Health (ADPH) on a suicide prevention sector-led improvement offer for councils that will further help local areas. While councils are already learning from each other, we need funding to turbo charge this activity. Because of problems between the Department of Health and the Treasury finance agreed for a programme of training and support agreed in January has yet to be provided.
I welcome Ministers’ recognition that mandatory national monitoring of voluntary local suicide prevention plans will not improve the quality of services in itself. The challenge is not a lack of local or national oversight, but the need for a whole system focus on prevention and to stop the false economy of cutting public health budgets. It is crucial that we have the necessary investment in mental health, social care and wider local services if we are to prevent people from experiencing suicide risk factors. Further cuts to local government budgets, especially public health, will make it ever harder to address suicide risk factors and the wider determinants of wellbeing.
It in important that there is in place since 2012, a cross-Government National Suicide Prevention Strategy which was updated in 2017 to expand the scope of the strategy to include addressing self-harm as an issue in its own right. The 2012 strategy placed responsibility on councils to draw up voluntary suicide prevention action plans in partnership with Health and Wellbeing Boards. Every council now voluntarily has a plan in place.
The work includes:
- Quality assurance of local plans through local scrutiny – every council now has a local plan in place and the SLI offer will support further improvement in the delivery of those plans.
- The LGA has worked with ADPH and the Centre for Public Scrutiny to publish a guide for councillors to assist with scrutinising local plans.
- National oversight of implementation with a possible role of the National Suicide Prevention Advisory Group in quarterly monitoring of local plans – national oversight of voluntary local suicide prevention plans would not work, because councils and local partners, through Health and Wellbeing Boards, are accountable for the plans and have the local knowledge needed to oversee progress in a meaningful way.
- Pressing for better funding. I welcome the NHS Long Term Plan’s focus on mental health, but funding for suicide prevention in community settings should be allocated to local government public health teams, because it is councils and their partners who are leading the majority of local suicide prevention activity. Funding should be spent in line with local suicide prevention plans or approaches, agreed through health and wellbeing boards. The fact councils face an overall funding gap of £3.2 billion in 2019/20 threatens services such as housing, culture, growth and transport which have a wider impact on people’s mental health and wellbeing. It is vital that this year’s Spending Review delivers a truly sustainable funding settlement for local government and we would welcome the Committee’s support in arguing for this.
- LGA / ADPH Sector Led Improvement. Understandably, the voluntary sector has pressed Ministers to ensure that local areas are doing as much as they can to prevent and reduce suicide. There have been numerous calls for national oversight of voluntary local plans. On behalf of the LGA I have been clear that introducing a new national performance regime for suicide prevention won’t in itself reduce suicide rates and is also contrary to the national Service Level agreement between councils and other partners and central government. The findings from our self-assessment show that councils want and need additional support to deal with challenges such as real time data collection and working with primary care, and to increase capacity to learn from each other on issues like bereavement support.
Regrettably, I doubt that we can ever achieve a zero-suicide rate. I do believe that we can achieve much reduced levels of death by suicide and much better for support of those who are left behind who seek answers and struggle to recover from cruel losses.