Suicide Prevention and the National Curriculum

Debbie Abrahams Excerpts

Monday 13th March 2023 Westminster Hall

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Stringer, and I congratulate the hon. Member for Don Valley (Nick Fletcher) on introducing the debate, but I pay particular tribute to Andy Airey, Mike Palmer and Tim Owen, whom we know collectively as 3 Dads Walking. My hon. Friend the Member for Blaydon (Liz Twist) summed it up brilliantly: there could be no greater tribute to your beautiful girls than the work you are doing in raising awareness, in fundraising and in getting this petition. I agree with my hon. Friend the Member for York Central (Rachael Maskell) that the Minister will probably not attend a more important debate in his career. We have already heard personal stories of people who have been affected by suicide, and I think we will be hearing more as the debate proceeds.

I fully support the proposals set out in the petition to make suicide prevention a compulsory part of the school curriculum. My hon. Friend the Member for York Central also made such an important point about converting walking to talking. I think we should bottle that phrase; it sums up where we need to go.

We know that 90% of suicides are associated with mental health issues but that 75% of people who take their own life had no prior contact with mental health services, so the earlier that children and young people are aware of and understand their feelings, but also where to access mental health services when they need them, the better. I would like to raise a few more points specifically in relation to deaths by suicide. In 2021, 5,583 people died by suicide.

[Mike Kane]

My hon. Friend is making a very powerful speech, particularly in the light of her excellent health service background, long before she came to this House. I hope that I have now stood on my feet long enough to bring her back into the debate.

[Debbie Abrahams]

My hon. Friend is very kind, and I thank him.

Unfortunately, our much-loved 20-year-old nephew, Jack, died when he took his life. Jack was a lot younger than his 11 cousins and was doted on by all. At our regular Sunday morning breakfasts, he would be in the centre of the room, laughing at someone’s joke or telling everybody about the week that he had had at school. He was gentle, bright and kind. We are a very large family—my husband, John, is the eldest of seven and we all have our children; of course, Jack’s mum is John’s baby sister—but we are a very close one, and 19 months on from Jack’s death and a month after his inquest, to say we are all still devastated would be no exaggeration. This is absolutely nothing compared with the heartbreak his mum is going through. She has given me her permission to speak about the context of Jack’s suicide, in the hope that that may help others.

At 17 and without his mum’s knowledge, Jack was prescribed Roaccutane. Roaccutane is the trade name for isotretinoin, a medicine prescribed for severe acne, and has been available in the UK since 1983. It was also approved for use in the USA, under the trade name Accutane, in 1982. However, in July 2009, following the filing of thousands of lawsuits in which Accutane use was said to be associated with severe, life-changing health problems, both physical and psychological—in some cases many years after Accutane use—it was withdrawn from sale in the US.

In November 2020, the UK’s Medicines and Healthcare Products Regulatory Agency announced that the Commission on Human Medicines had established an isotretinoin expert working group. This evidence review was prompted when the highest levels of fatalities associated with Roaccutane use was recorded in 2019 by the MHRA’s yellow card reporting scheme—an online portal for reporting adverse drug reactions. In total, 12 fatalities were reported in 2019—10 by suicide—and there were 85 serious incidents and 19 non-serious ones.

At Jack’s inquest last month, the coroner requested that the MHRA present evidence about the review’s findings. The scandal is that the review had been completed at the end of 2021, but the findings and recommendations had not been published because of “complications associated with Brexit”. It transpired that the recommendations, which 15 months on still have not been published, included requiring two doctors to agree to Roaccutane being prescribed to under-18s and prescribing it only after all other acne treatments had been tried. It is a serious drug, and it needs to be closely monitored.

The MHRA representative attending the inquest revealed that, since the completion of the review in 2021, there had been a further 81 adverse psychiatric events, including one suicide and one attempted suicide. On this issue, the family were pleased that the coroner had issued a prevention of future deaths report to the Health and Social Care Secretary, and the family looks forward to his early response and the publication of the 2021 review on isotretinoin. However, we believe that there needs to be an immediate awareness of the dangers of this group of drugs so that more of our young people and their families do not go through what we have been through.

The family also want to raise issues about the suicides of university students. Every year, three students per 100,000 will take their own life. Despite Universities UK’s “Suicide-safer universities” guidelines, there seems to be an ad hoc approach to how they are implemented. Prior to his death, Jack had been a first-year student at the University of York. In March 2020, he expressed concerns about his mental health to his departmental support officer, but although Jack was signposted to mental health support, this was not followed through. What Jack displayed was more or less word for word what was in the Universities UK’s guidelines on recognising signs and vulnerabilities, but it was not responded to as such, and it certainly was not flagged centrally.

We believe that, at registration, universities should get students to identify an individual—a parent, guardian or named advocate—for university staff to get in touch with if they have health concerns about a student. We also believe that there needs to be training for all university staff regarding suicide prevention. At this stage, I also pay tribute to Papyrus for its work on awareness training, particularly its campaign #SpotTheSigns, and similarly to the Samaritans for its training. That needs to be widespread not just in schools but in higher education institutions, so there is an understanding of the signs and symptoms.

We will never know exactly why our Jack took his life. We miss him every day, and want to do all that we can to prevent others from feeling that suicide is the only way out of the pain that they feel, because it is not.