The Minister of State, Department of Health (Norman Lamb)
I shall try to behave, Mr Deputy Speaker, and to address the Chair, as you rightly instructed us to do.
We in the House of Commons frequently find ourselves at loggerheads, and common ground is often hard to come by, but we unite—as a Parliament and as a country—in lamenting the number of people who die by suicide every year. I pay tribute to the hon. Member for South Antrim (Dr McCrea) and his colleagues for selecting this issue for debate, because it is so easy to go for other less difficult issues. The hon. Gentleman has done the House a service by choosing this subject and giving it a proper airing so that we can debate it and demonstrate to the country that we are focusing on things that matter a great deal. I thank him genuinely for that.
I noted what the right hon. Member for Wythenshawe and Sale East (Paul Goggins) said about the importance of families and their role. As he said, it is important to listen to them, to understand their perspective, and to recognise what they go through. Once someone has taken his or her own life, the impact of that lost life lasts with the family for the rest of their lives. We owe it to families to listen to them, and to do better in preventing suicide.
The hon. Member for South Antrim produced the shocking statistic that 1 million lives are lost globally, and told us that in many countries young people are now the highest-risk group. He also told us that males are more susceptible to suicide—both middle-aged and young men—and that suicide is the biggest single killer of men under the age of 35. That in itself is deeply concerning. We need to stop and think about the turmoil that is often associated with individuals in the lead-up to the moment when they make their decision. We have a responsibility to do all we can to address that.
The hon. Gentleman spoke of the importance of recognising the prevalence of self-harm and the disturbing trends that we are seeing. That is of real concern, and, as the hon. Gentleman said, it is a serious problem in Northern Ireland. My hon. Friend the Member for Beckenham (Bob Stewart) wondered whether it was sometimes a post-conflict issue. I know that a lot of work has been done in relation to post-traumatic stress following conflict, wherever it takes place in the world, and the risk that young men and young women may take their own lives as a result. I join others in paying tribute to organisations such as the Samaritans and Papyrus for their work in helping people at moments of real risk.
Simon Hughes
I think it is important to provide signposting, so that young people, from secondary school onwards, know where they can go for help. It should not necessarily lead to teachers, family or pastoral care workers, because young people may not want to share their problems with them, especially when the first signs of self-harm appear. We should also do much more to ensure that university health services provide cognitive behavioural therapies and similar services much more quickly than many are able to at present, because the lack of such services has been a real cause of crisis, tension and, indeed, increased suicide risk.
Norman Lamb
One of the things that I am determined to do while I am in this job is give mental health services, and access to them, the real priority that they deserve. Our first mandate to the NHS Commissioning Board gives mental health a much higher priority than it has ever had before. In establishing the principle of parity of esteem, we have asked the board to pay particular attention to access to mental health services in order to ensure that people with those problems have the rights of access that people with physical health problems have had for some time. Every life taken by suicide is one too many.
Lady Hermon (North Down) (Ind)
I am grateful to the Minister for taking a second intervention so soon after the first. He has rightly paid tribute to the work of the Samaritans, who undoubtedly prevent a huge number of people from taking their own lives and who do tremendous work in Northern Ireland. What public funding do groups such as the Samaritans, who do such tremendous work, receive from the Government?
Norman Lamb
I cannot give the hon. Lady precise figures here and now, but I will write to her and make sure she gets a full response to that legitimate point.
This debate serves as a timely reminder that suicide continues to be a major public health issue, particularly at a time of economic and employment uncertainty. The suicide rate in England is relatively low on international comparisons, and good progress has been made in reducing the rate in England over the past 10 years. That is something to be proud of, but it must not be the end of the struggle. We must be vigilant. About 4,500 people took their own lives in England alone in 2011, an increase on the previous year of about 6%. Although the three-year average suicide rate has remained steady since 2005-07, the rise in the number of people dying by suicide in 2011 is deeply worrying.
We know that suicide rates vary across the UK, and the hon. Member for South Antrim made the point that the suicide rate in Northern Ireland is higher than in England. In fact, it is the highest in the United Kingdom, and Scotland and Wales also have their own very real challenges. The coalition Government are working with the devolved Administrations to share evidence on suicide prevention and effective interventions. Suicide is still a major taboo. The hon. Gentleman highlighted the importance of our collectively speaking up about the subject. The way to reduce the number of suicides is not to comply with that taboo and keep it under wraps; on the contrary, we must tackle the problem and the surrounding issues head on.
We published a new suicide prevention strategy for England in September last year. It was written to help to reduce the suicide rate and it prioritises the importance of supporting families, so that those who are worried about a loved one know where to go for help, and supporting those who are bereaved as a result of suicide. They must receive help. There are excellent organisations such as Cruse Bereavement Care—I should declare an interest as my wife works for it—that provide support for people who are bereaved.
The strategy is backed up by up to £1.5 million for research, and it highlights the importance of helping the groups at highest risk of suicide by targeting interventions in the right way and at the right time. In-patient services are getting better at that. The most recent national confidential inquiry into suicide and homicide shows that the long-term downward trend in patient suicides continues.
Giving greater priority to mental health services is also critical. We are championing parity of esteem for physical and mental health, and through our improving access to psychological therapies—IAPT—schemes we are treating more people than ever before for mental health problems. Through the Government’s NHS mandate, we have gone much further than ever before in emphasising the priority the NHS must give to mental health. The mandate also makes specific reference to the need for mental health services to seek to reduce the suicide rate among users of their services, although I take on board the point made by the hon. Member for Bridgend (Mrs Moon): we must also be acutely aware that many people—I think she gave the figure of 75%—who take their own lives are not known to the statutory services. It is very important that the statutory services do everything they can, but that is not the whole problem; there is a very significant issue beyond that.
We also need to make sure there is enough information about treatment and support, and that it is freely available to those who need it, including those who are suffering bereavement following a suicide. A lot of that planning and work will happen locally, with local agencies deciding on how best to reduce the suicide rate and support families. Our recent strategy is not an instruction manual; it is more a tool to support local agencies in working out what is needed.
Suicide prevention will also be a priority for the new public health system. The public health outcomes framework has the suicide rate as an indicator. That is a horrible piece of jargon, but this project addresses what outcomes and results the whole system is trying to achieve, and one of them is the need to reduce the suicide rate. A shared indicator with the NHS outcomes framework also focuses on reducing the number of premature deaths of people with serious mental illness—such deaths also, of course, include suicides.
We are tackling stigma in relation to mental health, which the hon. Member for South Antrim rightly mentioned, with the brilliant Time to Change programme led by the charities Mind and Rethink Mental Illness, which is designed to reduce stigma and break isolation. A few months ago, we had a brilliant debate in this House when Members talked about their own experiences of mental health. That, in itself, was very important in bringing the issue out into the open and recognising that successful people, as well as many others, suffer from mental health problems and it is nothing to be ashamed of.
Children and young people have an important place in the new suicide prevention strategy. The suicide rate among teenagers is below that in the overall population, but that does not mean it is not a problem. For example, suicide is still the most common cause of death in young men, as I mentioned earlier. In addition, about half of mental health problems begin to emerge by the age of 14.
Bob Stewart
I apologise for intervening, as the Minister was perhaps going on to deal with this matter. We have now heard four or five times that the level of suicide among young men is much higher than that among young women, but nobody has said why that might be. Is there an answer to that question?
Norman Lamb
I thank my hon. Friend for that intervention. I would not want to indulge in cheap speculation about that. The statistics are clear on the prevalence of suicide among young men and clear that it is significantly higher than among young women. It is important that we carry out the research, which is why the Government have also committed to that as well; it is so that we gain a better understanding.
Mrs Moon
The Minister will be aware that research suggests that women and young girls are less vulnerable to suicide because they are help seekers, whereas young men are not and they will not articulate the problems they are facing. That is the major difference. Women and girls will go to their friends and talk about their problems, whereas men bottle things up so that they grow and grow and they can no longer manage them.
Norman Lamb
I thank the hon. Lady for that helpful intervention. What she says makes sense and I am most grateful to her for coming to my rescue on that—
Simon Hughes
I am always ready to try to rescue, but on this occasion that was not necessary. If sufficient research does not exist on the extent to which people know where to access services, it would be really helpful if the Minister worked with local government and the health and wellbeing boards to try to ensure that such research was carried out. I have a strong feeling that lots of young people, including young men, do not yet know where to go. If they did know, there would be a much better chance that they would do something about their problems and not keep them all inside, with the worst consequences.
Norman Lamb
I am grateful to my right hon. Friend for that intervention, and he is right to say that ensuring that youngsters know exactly where to go to find help is really important. Gaining a better understanding of that must be a priority.
Mr Nigel Dodds (Belfast North) (DUP)
I wish to support the point made by the hon. Member for Bridgend (Mrs Moon) a moment ago about the reasons why suicide is more prevalent among men. It was backed up for me by a recent piece of work carried out in my constituency that showed it is much more difficult to get young and middle-aged men to visit a GP or confide in someone about their health problems than to get women to do the same. The work showed exactly the same problem: a lack of willingness to seek out help early enough. That is a major problem and it needs to be dealt with by more education and information, particularly for young men.
Norman Lamb
I thank the right hon. Gentleman for that constructive intervention, and he is absolutely right.
The suicide prevention strategy also recognises that the media have a significant influence on what children do and think. As well as promoting responsible reporting in the media, the strategy emphasises the importance of working with the industry to tackle websites that encourage suicide. That is, in a sense, at the heart of the motion and of the points raised by the hon. Member for South Antrim.
Misuse of the internet to encourage vulnerable people to take their own lives is utterly wrong. It is deeply worrying that young people can easily be exposed to such pernicious material, but we should not dismiss the internet as a source only of harmful material. It also provides an opportunity to reach out to vulnerable people who might otherwise refuse support or information, including those young men who might not come forward. It is worth remembering that when used well the internet can be an incredibly valuable way of helping vulnerable people.
Only last week, I convened a meeting bringing together internet security companies, charities and Departments to explore how to protect children and young people from harmful suicide-related internet content. The industry representatives at the meeting told me about some of the good work they are already doing. For instance, McAfee informed me that it has valuable learning to share from its work with the Australian Government on an online safety campaign in schools. I think my right hon. Friend the Member for Bermondsey and Old Southwark (Simon Hughes) will be interested to hear about that. McAfee has campaigned to get the message out to schools in Australia so that youngsters have information about how to seek help. There is a lot we can learn from that.
At that meeting—
Lady Hermon
I am grateful to the Minister for giving way; it was terribly rude of me to interrupt and I apologise. Will he reassure us that when he convened that critical meeting with those who provide internet services, representatives from the devolved Administrations and from the Health Departments in Northern Ireland and Scotland were invited to attend? When we debate the United Kingdom, even though we have a devolved Administration in Northern Ireland I like to know, as someone who feels passionately about remaining in the United Kingdom, that we have joined-up government.
Norman Lamb
I am very grateful to the hon. Lady for her intervention. Those representatives were not invited to the meeting, but let me make a clear commitment that we will work with the devolved Administrations. I mentioned that earlier and it is in all our interests that we tackle the problem together.
At that meeting, I urged the security companies, such as McAfee and Symantec, to work collaboratively with interest groups who were present, such as Samaritans and BeatBullying, and internet service providers to sign up to a concordat that would help to speed up the process for reporting harmful content and the blocking of harmful websites. They gave me positive assurances that they would explore such a concordat, and in turn we as a Government would be willing to facilitate and support such an initiative however we can.
The UK Council for Child Internet Safety is already making parental controls more accessible so that children can access less harmful content. The Under-Secretary of State for Education, my hon. Friend the Member for Crewe and Nantwich (Mr Timpson), who is the Minister responsible for children and families, will explain more about the work his Department has been doing when he sums up.
As I said at the outset, this is one of the issues that unite us all.
Tracey Crouch
I thank the Minister for giving way, as he has been very generous in doing so. We have heard that there are a host of reasons why people are driven to suicide, one of which is alcohol dependency. Is the suicide prevention strategy working alongside the alcohol strategy so that there is a holistic, joined-up approach to dealing with some of these complex issues?
Norman Lamb
Yes, very much so. I am grateful to my hon. Friend for her intervention. In each area in England, the health and wellbeing boards will be able to co-ordinate all that work. In considering their strategic needs assessments, they will be able to identify issues relating to suicide and alcohol and drug dependency.
I hope that I have satisfied the House that the Government take suicide extremely seriously indeed and that we are taking real action to help. I am grateful to the hon. Member for South Antrim for bringing the matter to the House’s attention.
The Parliamentary Under-Secretary of State for Education (Mr Edward Timpson)
I have a short 10 minutes to close the debate. I thank all hon. Members who have spoken—they have made well informed, serious contributions to this excellent and deeply insightful debate on this hugely important subject. As the Prime Minister said today at Prime Minister’s questions in commending DUP Members for tabling the motion, we, as a society, do not talk enough about suicide and the impact it has on families. By being up-front about its often complex causes, we can be better at recognising the signs that lead to suicide and at preventing more lives from being taken in future.
As my hon. Friend the Minister of State, Department for Health, said on behalf of the Government, every life taken by suicide is one too many. When that person is a child, the tragedy is merely multiplied. I am speaking as the Minister with responsibility for children and families as well as a co-chair of the UK Council for Child Internet Safety. I shall briefly explain what the Department for Education is doing to help children as part of a cross-government outcomes strategy to prevent suicide, but before I do so I wanted to mention one or two of the contributions to the debate that have been thought-provoking not just for me, but I am sure for many of the people watching and listening.
I acknowledge the brave and touching speech made by the hon. Member for Foyle (Mark Durkan), who said that suicide has deeply affected not only his community, but his family. I know it was a difficult speech for him to make, but those suicides have left a lot of unanswered questions for him and many others. It leads to the conclusion that we must do more. We must acknowledge that we need to place huge importance on ensuring that the support made available to families who are grieving the loss of someone in such circumstances is at the heart of the services and support we offer in our communities.
The hon. Member for South Antrim (Dr McCrea) made a powerful and compassionate speech to open the debate. He said we should not sweep suicide under the carpet—that we cannot run away from it and must face up to it. The situation in Northern Ireland is particularly concerning. He highlighted the fact that 289 people took their own lives in 2011. As he said, it is a personal tragedy for anyone who comes to that decision. We must bear in mind that it can often be triggered by what can seem like a minor or innocuous event. This is a complex issue, and there is very rarely a single factor, although mental health is often a central feature of suicide cases. We need to understand and be better aware of all the different events and pressures on people’s lives that can contribute to them coming to that state of mind.
The hon. Member for Bridgend (Mrs Moon), the chair of the all-party parliamentary group on suicide and self-harm prevention, made, as usual, a highly knowledgeable speech and asked the question we should all ask ourselves: what causes suicide and self-harm to feature in people’s lives in the first place? Her point about raising awareness across agencies—she mentioned the Department for Work and Pensions as one such agency—was absolutely right. I will take it away and ensure that other Departments think carefully about how they train their staff so they understand the signs they need to look for and can point people in the direction of the support that we know is out there.
On the hon. Lady’s point about the coroner’s narrative verdicts, the Ministry of Justice is, as she said, looking into the matter. I understand that the Office for National Statistics and the chief coroner will attend the next meeting of the Government’s national suicide prevention strategy advisory group—narrative verdicts are on the agenda—which is coming up next month. Hopefully, therefore, progress can be made.
She also mentioned the “Help is at Hand” resource for people bereaved by suicide and other sudden traumatic deaths. It is an excellent piece of work that is clear and accessible for those who want support. We are distributing it, and it is on the Department of Health website. I think that approximately 1,000 copies are going out each month, but we need to do better and improve distribution. We are working with coroners’ offices to make sure we achieve that.
My hon. Friend the Member for Pudsey (Stuart Andrew) talked about the moving memory he has of someone he lost at school through suicide. He also talked about his work with the hospice movement. We need to ensure we understand that attitudes to suicide sometimes impact more deeply than we realise. Cyber-bullying is a particularly new phenomenon and it is more and more difficult for young people to escape its awful bearing on their own lives. To understand it better, we need to work closely with young people, and to listen to them and their experiences, rather than assuming that we know the answers ourselves.
In the five minutes I have left, I want to touch on what the Department for Education is doing to try to raise awareness and improve our response, particularly with regard to child internet safety. The new suicide prevention strategy for England, which was published last September, has already been referred to. It is right that children and young people have an important place in that strategy. We should all be extremely concerned about the suicide rate among teenagers, even though it is below that of the general population.
To help young people get the support they need and to be able to talk through their problems, we continue to support, to the tune of £11.2 million between 2011 and 2015, the valuable work done by ChildLine in providing children with free and confidential support in conjunction with the National Society for the Prevention of Cruelty to Children helpline.
The strategy recognises—a point raised by a number of hon. Members—that the media have a significant influence on behaviour and attitudes, particularly for teenagers. In 2009—the hon. Member for Bridgend will be acutely aware of this—the Press Complaints Commission highlighted the impact of insensitive and inappropriate reporting of suicides. We all have to take children’s safety extremely seriously, particularly to protect them from any harmful or inappropriate online content. We are clear that we favour a self-regulatory model for the internet industry, but that is as much a pragmatic response as a philosophical response. We have heard today that the law makes it clear that people who intentionally encourage suicide via websites hosted in the UK are at risk of prosecution, and, to be absolutely clear, what is illegal offline is illegal online.
We need to do more, and through the UK Council for Child Internet Safety board we are trying to make sure that all internet service providers step up to the plate and realise their responsibility. They need to ensure that these types of sites are kept away from young people, and that young people’s ability to have direct contact with them is removed altogether—they are truly horrible sites to have anywhere near one’s home.
As the Minister with responsibility for UKCCIS, I am leading the work looking at how ISPs, filtering companies, device manufacturers and public wi-fi, which we find in our local coffee shops and retailers—all the information and communications technology industries—can work together to make sure harmful content is filtered out wherever our children are. With nine out of 10 children having access to the internet in their own home and with children aged between 12 and 15 proportionately more likely to own a smartphone than their parents, this issue is only going to get bigger rather than smaller.
There are good examples of the internet industry working with the charitable sector, and that will be a key element as we go forward. As the hon. Member for South Antrim said, Google searches on the word “suicide” will return details of the Samaritans at the top of the results—a real step forward—and Facebook has teamed up with the Samaritans to make it easier to report concerns about a friend who might be considering self-harm or suicide. We must do more, however. As the hon. Member for Hackney North and Stoke Newington (Ms Abbott) mentioned, yesterday was the 10th safer internet day. I met a group of young people who were discussing the excellent “Have Your Say” survey. Some 24,000 school-aged children contributed to the largest ever survey about what they expect online. The thing they wanted most was to be safe. That is something we need to deliver for young people, because they are the ones exposed to what adults provide for them.
In conclusion, this has been an excellent debate. I am sure that many people will be encouraged that the House takes the issue extremely seriously and can work together to keep people as safe as possible from the ravages that suicide can bring to families.
Question put and agreed to.
Resolved,
That this House recognises that the number of suicides in the UK, particularly amongst young people, represents a major challenge for government and society; acknowledges the work that is taking place to address the issue; calls for even more urgency to be shown in seeking to reduce the rate of suicides; notes the danger posed in particular by websites which promote or give information about harmful behaviours such as suicide; and calls upon the Government to adequately resource and promote child and adolescent digital safety.