Suicide Prevention Strategy

Lord Markham Excerpts

Thursday 26th October 2023 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

The actions in the new suicide prevention strategy for England are informed by the existing and emerging evidence, by engagement with people with expertise in suicide prevention, including people with lived experience, and by the mental health call for evidence. This strategy is population-wide and the actions within it aim to support as many people as possible, including those on out-of-work disability benefits.

[Baroness Thornton (Lab)]

I thank the Minister for that Answer, but I am not sure that clarifies this issue. This issue concerns one bit of government not heeding the research of another bit. NHS Digital’s Adult Psychiatric Morbidity Survey clearly shows that more than 43% of ESA claimants—that is employment and support allowance out-of-work disability benefit claimants—have considered suicide, compared with 7% of non-ESA claimants. The argument that this group should be included in the NHS suicide prevention strategy was made five years ago, and it was not included with no explanation. We now have the new suicide prevention strategy, and they are omitted again. I would like the Minister to clarify whether this group will be included in the Government’s—actually rather good—suicide prevention strategy or not, and if not, why not?

[Lord Markham (Con)]

What the strategy is trying to do is to look at those high risk groups and the risk factors behind them. One of the biggest risk factors causing suicidal thoughts are financial difficulties, which of course out-of-work disability benefits come into. One of the highest groups in terms of priority are middle-aged men, who are often the people suffering in this space. There are other groups as well, such as children and young people, pregnant women, new mothers and autistic people. There is a range, and what we are trying to do in this strategy is hit those areas of highest risk. To put this into context, those people on all DWP benefits in the reviews done on suicide make up less than 1% of the population of suicides. What we are trying to do is hit the major risk groups.

[Lord Allan of Hallam (LD)]

My Lords, the suicide prevention strategy says that DWP staff will be trained to identify benefit claimants who express suicidal thoughts and escalate these appropriately. Can the Minister confirm that the DWP will collect data on out-of-work disability benefit claimants who are caught or flagged by the system, so that we can understand whether or not this new policy is as effective as we would all want it to be?

[Lord Markham (Con)]

Yes, and I had the opportunity, because I used to be the lead NED at DWP, to go along to a number of jobcentres and see the sorts of work that they do. They have two things. They have an independent review of each of these, and those are the stats I was using: they get about 50 cases a year in these categories. Where there is a serious case they have a serious case review, independently chaired with a Permanent Secretary on it as well.

[Baroness Browning (Con)]

I remind the House of my personal interest: I have family members claiming ESA. I advise my noble friend the Minister that I am awaiting an appointment with DWP Ministers following Questions that I tabled before the Summer Recess about the suicide rate among disabled benefits claimants—in fact, among all benefits claimants. My concern is not only around the way the DWP collects data but around the way it sometimes does not disseminates the information that it has. Will my noble friend pause in relying totally on the way in which the DWP produces data at present? For example, I am particularly concerned about how it collects information from coroners’ courts. This is something that I think is ongoing; I hope that my noble friend regards it in that way as well.

[Lord Markham (Con)]

We are definitely always looking to improve, get access to better data and learn lessons from that. I will make sure that that is understood and follow up with DWP Ministers accordingly.

[Baroness Finlay of Llandaff (CB)]

My Lords, I declare my interests in medicine. The new suicide prevention strategy is most welcome, but do the Government recognise that the ONS data shows that the time of diagnosis and first treatment of those with severe health conditions can be a high-risk time when they feel devastated and often do not have adequate support? The way in which news is communicated and bad news is given to them alters their risk of suicide, particularly in those who have been bereaved by suicide previously. Will the Government therefore put pressure on NHS England and the GMC to ensure that communication skills are included in revalidation and appraisal processes so that patients get better support and are steered towards the new SR1 benefit, which is designed specifically for people with poor prognoses and can play a really important role in relieving financial pressures?

[Lord Markham (Con)]

I thank the noble Baroness for her support for the suicide prevention strategy. It tries to look at the themes behind this issue, of which working to give effective support, communication and training is absolutely key—as is making sure that that is followed up on. The other thing that I want to pull out from the report is the real feeling, in terms of the seven key themes, that suicide prevention is everyone’s business and is something that we all need to be aware of and could learn more about.

[Baroness Brinton (LD)]

My Lords, the Minister has outlined how important it is to learn from the experience of people who have considered suicide. Last week, an Information Rights Tribunal asked the DWP to publish its secret report on suicide rates among vulnerable claimants; it has not yet been published despite the fact that it was written in 2019. Can the Minister explain why it still has not been published? If not—I appreciate that this falls under the DWP—can he write to me, because it is clear that we need to learn the lessons of what went wrong?

[Lord Markham (Con)]

Absolutely. I would be happy to write to the noble Baroness.

[Lord Davies of Brixton (Lab)]

My Lords, on the suicide prevention strategy more generally, does the Minister share my concern at the figures published today by the ONS showing that the suicide rate among offenders in the community is six times that of the general population and the suicide rate among female offenders in the community is 11 times that of the general population? Surely this points to the need for priority action.

[Lord Markham (Con)]

The noble Lord is absolutely correct. The priority groups identified include people in the justice system for exactly that reason; likewise, as I mentioned, middle-aged men, who are three times more likely to commit suicide. There is a strategy behind each priority group—people with poor mental health, people on the autistic spectrum, pregnant women, people who self-harm, children and young people, as well as people in the justice system—in terms of how we help and support them.

[The Lord Bishop of London]

My Lords, as we have heard, our financial situation has a serious impact on our health and mental well-being. This is supported by recent polling commissioned by Christians Against Poverty. This issue is not just about more disease; it also includes malnutrition, mental health and failing to take time off when sick due to financial insecurity. What assessment have the Government made of the impact of the cost of living crisis on people’s mental health, particularly in our most deprived and vulnerable communities? What steps are the Government taking to reduce health inequalities, specifically those related to suicide?

[Lord Markham (Con)]

It is understood that people’s financial well-being—or lack thereof—is one of the key causes here. Interestingly, as I looked at the statistics, there was a big jump up in the suicide rate from 2008 onwards, following the financial crisis. It is about making the point that, when people feel under more stress, they are, unfortunately, more likely to commit suicide. However, if you look at the statistics over the past five years, the rate has been pretty flat; so far, there is no evidence to show that, in the past year or so, the cost of living crisis has caused more suicides. None the less, it is something that we absolutely need to stay on top of and ensure that we are monitoring closely, as the right reverend Prelate the Bishop of London mentioned.

[Lord Kamall (Con)]

My noble friend the Minister rightly said earlier that suicide prevention is all our responsibility—or something like that—and that we need more awareness. Can he enlighten us on some programmes to increase awareness of suicide prevention so that we recognise that it is the responsibility of someone’s wider family, wider community and others and so that they are aware of the signs to look for?

[Lord Markham (Con)]

Yes. Effective bereavement support comes into this in a similar way. There are a number of communication methods, which I will happily share in writing so that noble Lords can see them, but there is also a full marketing and support plan around them.

[Baroness Watkins of Tavistock (CB)]

My Lords, can the Minister assure us that DWP staff are being trained properly in recognising the suicide risk of such claimants? One of the most important things is that people largely want to work and getting rejected following job interviews is a huge risk for that particular population.

[Lord Markham (Con)]

Absolutely. It is my understanding that all front-line DWP staff have two days of mental health training in precisely this area. Also, their stated objective is to support people in what they can do and support them into work based on their abilities. We all know that work gives people a big feeling of self-worth and confidence and is a key to both physical and mental health.