Health Committee

Baroness Keeley Excerpts

Thursday 16th March 2017 Commons Chamber

[Dr Sarah Wollaston (Totnes) (Con)]

(Select Committee Statement): The scale of the avoidable loss of life from suicide is unacceptable. In 2015, 4,820 people in England took their own lives, and across the UK 6,122 people did so in 2014. But those official figures underestimate the true scale of the devastating loss from suicide, which remains the leading cause of death in young people between the ages of 15 and 24, and it is the leading cause of death in men under 50. It is strongly linked to deprivation and is a major contributor to health inequality. However, the key message our Committee heard throughout its inquiry is that suicide is preventable, and we can and should be doing far more to make sure we reduce it. That was the key focus of our suicide prevention inquiry.

First, let me thank all those who contributed to the inquiry, particularly families bereaved by suicide, and those who had experienced suicidal ideation and been users of mental health services. Their evidence was courageous and compelling. I also thank all the voluntary groups and volunteers who are working to provide support for people in crisis, and all our front-line staff. Finally, I thank my fellow Committee members and our Committee staff, particularly Laura Daniels, Katya Cassidy and Huw Yardley.

I shall now move on to what we found in our inquiry. First, let me say to the Government that we welcome their suicide prevention strategy, but as with any strategy the key is implementation. We therefore call on them to go far further in implementing and resourcing it, and to give greater attention to the workforce in order to make the important improvements come forward. We also make further recommendations and we are disappointed that the Government have not gone further in a number of areas. We know that we can take actions to reduce suicide and we highlight a number of these in our report. For example, we know that half of those who take their own lives have previously self-harmed, and we feel it is really disappointing that the experience of so many of those who have self-harmed when they go to casualty departments is that they are made to feel that they are wasting people’s time. We know that liaison psychiatry makes an enormous difference, but there are resourcing issues on that.



We also know that those who have been in-patients in mental health settings should receive a visit within three days of leaving in-patient services, but there simply are not the resources available for that to be put in place. We call on the Government to go further in looking at the workforce and resourcing needed for that to happen. We know of other serious issues, for example, the fact that about a third of people who take their own lives are not in contact with either primary care or specialist health services in the year before their death. We feel that suicide is everyone’s business and we all have a responsibility to reduce the stigma attached to mental health so that it is easier for people to seek help. Again, I pay tribute to all those who are working in this field, reaching out to people in non-health settings and making a real difference. However, many of those voluntary groups are coming under great financial pressure. It is welcome that the Government have announced that there will be £5 million for suicide prevention, although that does not come in until next year, with £10 million in each of the subsequent two years. However, we feel that that is too little, too late, particularly given the cuts to public health grants and across local authorities to those services that can reach out to people who are vulnerable to suicide.

We would like the Government to put a greater focus on adequately resourcing the measures they set out in their suicide prevention strategy. We would particularly like them to look at how those plans are being implemented. It is very welcome that 95% of local authorities have a suicide prevention plan either in place or in development, but there does not seem to be sufficient quality assurance for those plans. We would therefore like a national implementation board to look at how we can move those plans forward, because any strategy, however good, cannot be effective if it is sitting on the shelf and not being implemented. That was one of the key messages we heard from our witnesses, and I know that the Minister will have heard it from the National Suicide Prevention Strategy Advisory Group loud and clear.

We also know that there are things that need to happen when people are in contact with services. It is disappointing that greater focus has not been put on the consensus statement for information sharing. On too many occasions, when someone hears that a loved one has taken their life it is the first time they have heard that their loved one had been in contact with services—nobody had let them know. Understandably, health professionals are concerned about issues of confidentiality and consent, but what the consensus statement makes clear is that if we ask people in the right way, they are much more likely to give that consent to information sharing. We would like to have seen the Government put a greater focus on how we can increase awareness of how health professionals go about sharing information with people’s loved ones, because we believe that will save lives.

We think that measures can be taken across the board both out in the community and within health care settings and specialist settings, but the Minister will know that our inquiry also examines the role of the media. Irresponsible reporting of suicide increases suicide rates, as we know, and far more can be done within the broadcast media, the mainstream media, on social media and on the internet to make sure that we save lives. I was very pleased that during today’s Culture, Media and Sport questions the Culture Secretary agreed to a meeting with me, but I hope that the Under-Secretary of State for Health, my hon. Friend the Member for Oxford West and Abingdon (Nicola Blackwood), will assure me that she will be liaising with colleagues in the Government to make sure we can save lives in that way.

Finally, I wish to touch on the issue of data. We know that there is an issue relating to the increasing use of narrative verdicts which are hard to code. That results in the official data we have on suicide under-representing the true scale of the avoidable loss of life, and with the huge variation we have around the country this makes it much more difficult to understand what works best in preventing suicide. We would like the Minister to revisit the recommendations in our report on how to provide better training to coroners and how we review the evidential standard and move from using “beyond reasonable doubt” to the “balance of probability” in recording suicide. Only in that way can we ensure that we are doing absolutely everything possible to protect families and individuals in future. I commend the report on suicide prevention to the House and call on the Government to go further in implementation.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Labour welcomes the recommendations in the report, and I join the hon. Lady in thanking Select Committee members and staff for their work.

The Committee visited the award-winning Salford mental health liaison team, which offers 24/7 mental health support at Salford Royal hospital and has been able to halve the admission rates for people with mental health problems. The Royal College of Psychiatrists reminds us that only 7% of emergency departments provide 24/7 liaison psychiatry services, and said it would be difficult to recruit enough psychiatrists and other staff to provide such a service in every hospital—the hon. Lady touched on that in her statement. What does she think the Government must do to ensure that there are enough trained staff to establish and sustain liaison psychiatry services in every acute hospital to help to deliver the suicide prevention strategy?

[Dr Wollaston]

We need to start right back at medical school recruitment and what happens in medical schools and beyond, to encourage more health professionals—not just doctors, but nurses as well—to consider psychiatry and mental health services as a career. One of the key issues is the lack of a workforce. I know the Government are working with Health Education England to improve the situation, but we would like to see them go further. Also, we need to ensure that resources get to the frontline.