Suicide Prevention Debate
Full Debate: Read Full DebateDepartment: Department of Health and Social Care
Madeleine Moon
Main Page: Madeleine Moon (Labour - Bridgend)Department Debates - View all Madeleine Moon's debates with the Department of Health and Social Care
(11 years, 10 months ago)
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Mrs Madeleine Moon (Bridgend) (Lab)
Is the hon. Gentleman aware of research carried out by Louis Appleby, the suicide tsar, showing that 75% of those who commit suicide have had no connection with mental health services, and that it is dangerous to focus suicide help and support only on mental health teams? If we do that, we risk failing to protect many of those who need our help.
Dr McCrea
I thank my right hon. Friend for that intervention. In fact, the motion
“calls upon the Government to adequately resource and promote child and adolescent digital safety.”
The motion goes wider than that, but resources are certainly a problem that such organisations need help with.
The internet and new media are prominent features in youth culture nowadays. Young people see the use of technology as a vital part of their social lives, and the online environment has created unique opportunities for learning, connection and communication. Almost 99% of children aged between eight and 17 access the internet, and 90% of children aged five to 16 have a computer at home. Although the risks created by the internet and new media have yet to be properly assessed, there is growing concern over the use of the internet for cyber-bullying and for normalising and encouraging suicide and suicidal behaviour.
The Byron review, conducted in 2008, entitled “Safer Children in a Digital World”, found that
“there is a range of material on the Internet that may present particular issues for specific groups of children and young people. This includes content or sites that promote or give information about harmful behaviour such as suicide and self harm”.
The report found that, although some children might be deterred from harmful behaviours by witnessing such content, or might find emotional and social support from others experiencing the same feelings, it was clear that for some children there were major risks. Sites providing information about suicide techniques, for example, could increase the chance of a suicide attempt being successful and decrease the chances of a young person receiving help.
Mrs Moon
The hon. Gentleman will be aware that the hosting of such sites is illegal in the United Kingdom, thanks to the Coroners and Justice Act 2009. The problem is that many of those sites are hosted outside the UK, where they are not illegal. Internet providers need to block access to the sites. They move them down the access chain when people google them, but they do not block access to them altogether. How can we ensure that access to those sites is blocked?
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—
Mrs Madeleine Moon (Bridgend) (Lab)
I add my congratulations to those given to the hon. Member for South Antrim (Dr McCrea) on calling for this debate, along with his colleagues.
This is one of the few opportunities to address this important issue in the Chamber. There have been Adjournment debates and Westminster Hall debates, but a full Chamber debate is not a natural occurrence for this subject, so I very much welcome it. I begin with a quote from a recent inquiry undertaken by the all-party group on suicide and self-harm prevention. Someone working on suicide prevention in England said:
“So when you are having a discussion”—
as we are today—
“about what does suicide mean, and the numbers are very small compared to smoking or obesity, what is this about, well our deaths by suicide show…the ultimate loss of hope, the ultimate loss of meaning of purpose, yet they are an indicator. They may be small numbers, but they have a very big ripple impact and they are an indicator of what is happening further down that pyramid.”
This debate, as has been said, is timely, because of the publication of statistics by the Office for National Statistics which show that there has been an increase in suicides in the United Kingdom. In 2011, there were 6,045 suicides—an increase of 7.8% on the previous year. Across the United Kingdom, suicides have increased at different levels. In Wales last year, there was an 18.4% increase, and in Scotland, a 13.8% increase. However, Scotland has changed the data on which it bases its statistics, and it argues that if it had not changed statistical gathering information and the classification of deaths by alcohol, there would have been a small decrease.
In Northern Ireland, the figure is down slightly by 7.7%, from 313 to 289 deaths from suicide, but in 2009, it was as low as 260, so over that period there was an increase. In England, however, there is a 7.4% increase, but the figure varies across the country. In the south-east, it is 6%, but in the north-west, it is 9.3%, which will be of particular interest to you, Mr Deputy Speaker. The highest risk group—and there has been a lot of talk about young people, particularly young men—is men aged 30 to 44, with 23.5 deaths per 100,000. The 45 to 59 age group has the highest rate of suicides among women, and there is also an increase in deaths for men in that group.
When the ONS says there has been a significant increase, it means that we can be 95% confident that the increase has occurred because of an underlying reason, and not just by chance. Our job is to look at that underlying reason. What is driving these increases?
Mr Gregory Campbell (East Londonderry) (DUP)
Does the hon. Lady agree that when Members and others deal with families who are trying to come to terms with a suicide, very often there is a lack of help when those families try to identify within the family circle a behavioural change and problem that led up to the suicide? Sometimes they are racked with guilt because they cannot identify the problems that ultimately led to the suicide. Perhaps that is where attention and resource can be deployed.
Mrs Moon
I apologise to the House. I have lost a contact lens, and I have to wear spectacles. I cannot read my papers when I am wearing them, and I cannot see all hon. Members in the Chamber when I take them off. If I am not wearing them, hon. Members must alert me if they wish to intervene.
The hon. Gentleman is absolutely right. Families tear themselves apart over the question of why. They try to analyse behaviour, particularly in the weeks leading up to the death, to seek an understanding of it. Only if there is a suicide autopsy can one begin to look at the reasons behind a death. That is a complicated procedure that cannot be carried out for every death, but it can give some understanding of the wider reasons behind such deaths. I totally agree that the distress for families as to why the suicide has happened is horrific.
That is why the research to which we have access is important. Haw, Hawton, Gunnell and Platt found that the economic recession had a clear impact on suicide. However, the increase in the suicide rate may be offset by adequate welfare benefits; their finding was very clear on that. Other measures likely to reduce the impact of recession included targeted intervention for the unemployed and membership of social organisations. They found that responsible media reporting was also important. Research at the university of Liverpool found that more than 1,000 people took their own lives during the 2008-10 economic recession in the United Kingdom.
There are ways in which we can begin to look at some of the problems that are staring us in the face and that may be causing some of the increase that is becoming apparent. Suicides began to rise in the UK in 2008, following 20 years of decline. Figures rose almost 8% among men and 9% among women in 2008, compared with 2007. The figures reflect the increased effect of the recession. I want to reiterate that research has found that there are risks associated with failure to provide adequate welfare benefits. There are currently high levels of distress and hopelessness caused by the changes in benefit that are about to come into force.
Jim Shannon
I am sure the hon. Lady is aware that the Prince’s Trust recently released figures which show that one in four of those who are in work are almost always or very often depressed. Among those who are unemployed the rate rises as high as 50%. Does she feel there should be a focus on young people, who are suffering more than most? Her colleague—I cannot remember his constituency—had an Adjournment debate in the Chamber on that very topic and he highlighted the issue as well.
Mrs Moon
The figures show that the increased number of deaths are among an older group of men, largely those who have not experienced unemployment before, who find unemployment very difficult to deal with and who despair about being able to maintain their family lifestyle, pay their bills and see a future where they can again be economically successful. We must be careful that those who are unemployed and who need to survive on benefits for however short a period are not made to feel failures, a burden on the state or pariahs in our society.
I know that Ministers will probably argue that the Government are doing wonderful things in relation to benefits but the Office for National Statistic figures highlight a very worrying trend. I hope there will be discussions between the Department for Work and Pensions and the Department of Health to highlight the importance of Jobcentre Plus staff in particular being aware of claimants coming in who may well be suffering from depression and exhibiting signs of hopelessness and despair, and being able to take suitable preventive action.
Although the numbers are small compared with cancer, heart disease and dementia, suicide is a reflection of the overall health of a country and a community, and the ripple effects on the health of those impacted by it are very great. Other Members have spoken about the impact on families, but communities, schools and workplaces are also affected. There is an impact on people who have known the individual and people who identify themselves with that individual, which is where the risk is most dangerous.
Geraint Davies (Swansea West) (Lab/Co-op)
May I return to my hon. Friend’s point about the age profile of recent suicide victims? In going through the research, has she found that, in particular, men of a certain age, perhaps in their late 40s or early 50s, who have young children and who suddenly and unexpectedly lose their job, lose their self-esteem and cannot reposition themselves in what has traditionally been the caring-for-children role in the family setting? Does she think that there is a role for providing support to such people in regaining their self-esteem and repositioning themselves in order to get across to them that they have value in their new position, even if they do not get back their previous one, and to get them back on to a positive track rather than a downward spiral towards possible suicide?
Mrs Moon
My hon. Friend asks a complicated question. The research that I have looked at has considered the impact of suicide figures in recessions, not only in the UK but across the world, and it goes back in time to look at the great depression and recession that we had in the 1930s. As far as I am aware, no work has been done, certainly by that research group, on the impact on men’s self-esteem in assuming a caring role and responsibility within the family. Should I come across it, I will certainly pass it his way.
Last year, the all-party group on suicide and self-harm prevention, which I chair, considered a number of issues that we have to address in relation to suicide. Every meeting brings the best authorities that we can find into the corridors of Westminster to explain and talk about the work that they are doing.
Michael Ellis (Northampton North) (Con)
I congratulate the hon. Lady on the excellent work that she does in her all-party group. Has it looked into the specific issue of suicide in Her Majesty’s prisons and young offender institutions? Coming from a legal background, as I do, I am aware of that issue and wonder whether she has any observations to make about it.
Mrs Moon
I thank the hon. Gentleman for his intervention. We have not yet looked at that issue, but I pay close attention to it because I have Parc prison in my constituency. I hope at some point to secure an Adjournment debate on work that people are doing there on the Invisible Walls project, which builds and re-establishes links between prisoners and their families—their partners and children—because the best sense of rehabilitation that can be given to someone serving a sentence is the feeling that there is hope for a family life once they leave prison. That extremely important work is one of the ways we could focus on improving outcomes for people once they leave prison.
Bob Stewart
I suspect that the most vulnerable people are those who leave prison without a place to go to, in much the same way as, in my experience, soldiers who leave the armed forces go back to nothing if they have no family. Does the hon. Lady agree that we must take a great deal of interest in the people who have nothing, when they have a break from routine, such as leaving prison or the armed forces?
Mrs Moon
The Ministry of Defence commissioned a study by Dr Nav Kapur of Manchester university on suicide in the armed forces. He found that the largest number of suicides were by young people leaving the armed forces, usually without having completed their basic training or shortly after they had passed it. Further research is needed to confirm this, but the indications were that there was a feeling of hopelessness with regard to attempts to build a family in the armed forces, that a sense of success and of identity had been lost, and that that was perhaps one of the motivations towards suicide. Additional funding is needed for that research to be completed, but that was the outcome of the best study that I have seen so far of suicide in the armed forces.
The all-party group has discussed how coroners record suicide and the importance of accurate suicide reporting. I cannot stress that enough. One of the problems is narrative verdicts, which were introduced as an addition to a statutory verdict. If someone died in the custody of the Crown, for example, they allowed for a narrative of that death to teach lessons about how it had happened. Instead, however, they have replaced the verdict and become a verdict in their own right. Often, the death of someone who takes their own life by tying a ligature around their neck is not recorded as a suicide, because the appropriate word has not been used. The Ministry of Justice needs to work on this area. I know that it is doing so and I hope to meet the chief coroner soon to see how we can make progress.
Mark Durkan
I thank my hon. Friend for giving way. The number of narrative verdicts in England is growing. One of the ways in which they are avoided in Northern Ireland is the decision taken five years ago by the coroners service not to hold inquests on suicides, but to just record them and not put the families through an inquest unless the public interest or another family requirement demands it. That means that there has been more sensitivity than the false sensitivity accorded to narrative verdicts, which then lead to flawed statistics.
Mrs Moon
I thank the hon. Gentleman for his intervention. I was not aware of that development in Northern Ireland, and I would like to spend some time examining it. The root trauma for many families who have experienced such a death is sometimes renewed, along with the publicity, up to a year later, which makes it very difficult for them to cope and which sets them back in the progress that they have made in grieving. Many have found it extremely difficult, so I will look at the information he provides, for which I thank him.
The all-party group has looked at the cross-Government strategy to prevent suicide in England. I will come back to that later, because it is a most important issue. We have also looked at suicide and bereavement. We talked to a number of families who have been bereaved by suicide and every one of them mentioned the importance of a Department of Health document called, “Help is at Hand”. Sadly, many Members do not know about this fantastic resource; it is not appropriately distributed and many families never get access to it. We have to find a way of getting that booklet out to people. The Welsh Assembly is looking to translate it and produce a Welsh language edition for Wales. We are also considering whether coroners and the police force would be appropriate groups to distribute that information.
We have also looked at the impact of police investigations. As Members will be aware, when a sudden death is reported, the police investigate initially under the murder manual. Families are therefore further traumatised by the feeling that they are under suspicion for the death. Once it is decided that it is a suicide, the police sometimes walk away and the family are left with no help or support and no sense of where they are supposed to go.
A suicide death is a lonely death because people stay away; they do not know what to say or how to approach the family. Often, the support that families desperately need is not there. That isolation and lack of information add to the risk of further suicides. It is important that people have ongoing support from within their community and from statutory services to see them through the grieving process.
We have also looked at the use of sport to reach out to young men. This point refers back to the question asked by the hon. Member for Beckenham (Bob Stewart) about the deaths of young men. It is important to give young men role models who have had difficulties in their life and who have contemplated suicide, despite success. Sports personalities have been particularly effective. We spoke with Ernie Benbow from State of Mind Rugby and Greg Burgess, the Choose Life co-ordinator for north Lancashire. They demonstrated how successful the use of sportsmen had been.
Jim Shannon
The hon. Lady’s eyesight is better than she thinks. Does she agree that TV soaps can play a key role in highlighting the issue of suicide and prevent viewers from committing suicide?
Mrs Moon
I thank the hon. Gentleman. There is a risk in how suicide scenes are written in soaps. There have been incidents in which a death by suicide in a soap opera has led to copycats and social contagion. The writing must be extremely careful. I know that many soap opera writers take their responsibility extremely seriously because they are aware of that risk.
There has been much talk about recipe websites. This week is internet safety week. It is extremely important that every Member of this House goes into schools in their area and talks to young people about staying safe on the internet. I went to Bryntirion junior school in my constituency last week and I asked a group of youngsters how many of them had ever received offensive material on the internet and how many of them had felt frightened, bullied or scared by what they saw. Every hand in the class went up. That is a world that we all escaped, but it is our duty to build awareness and protection in that world.
The work of the Samaritans is second to none. I want to highlight the work that it has done with British Transport police and Network Rail on the prevention of suicide on the railways. They have identified areas that have particular problems and trained their staff to be highly vigilant. They now provide support to people who enter their railway stations if they feel that there is a risk. That is a fantastic move forward.
I want to consider briefly the impact that the health and social care changes will have on the new suicide prevention plan for England. The all-party group carried out an inquiry into that. We issued a call for evidence that went out to all local authorities and directors of public health, via primary care trusts, local authorities and PCT clusters. That was followed by four evidence sessions in which we took evidence from representatives of the devolved nations, six areas of England and the voluntary sector.
The report concluded that the future of local suicide prevention plans in England depends on leadership and local champions, the identification of suicide prevention as a priority, availability of resources, and the long-term survival of suicide prevention groups already in place. The future of local suicide prevention plans in England is fragile and often relies on committed and dedicated individuals. That such plans are not a statutory requirement of the new national suicide prevention strategy is a major barrier to their survival, and that is particularly true when entering a time of restricted spending within local authorities. If something is not a statutory responsibility, often it will be bypassed or shelved.
There is no guarantee that health and wellbeing boards will address suicide prevention, or that existing plans will survive or be replaced. What will happen in areas where there is no suicide prevention plan and no history of taking an interest in the issue? In areas with no local champion, suicide prevention might be overlooked completely. We are talking about a suicide prevention postcode lottery, which is, in part, reflected in figures that show increases in suicide, differentiated across the United Kingdom.
There is no formal mechanism in the suicide prevention plan for England for suicide prevention groups to report directly to health and wellbeing boards. Without such a link, suicide prevention might not reach the agencies, and groups will be working in isolation, undermining their value and jeopardising their future. Engagement with the police, GPs and coroners is vital, yet in many areas such engagement is poor, patchy and inconsistent. Self-harm prevention and specialist bereavement services remain poor in many areas of the country.
Evidence from Northern Ireland demonstrates the importance of involving community organisations and the voluntary sector in suicide prevention. The existence of suicide prevention implementation groups in every locality was critical to Northern Ireland’s success and ensures that suicide prevention is not left to chance. The leadership at Government level highlighted by the hon. Member for South Antrim is also critical. Northern Ireland is making a difference.
In Wales, sadly, ministerial statements allocating responsibility for suicide planning were not published, and mandates were passed to local authorities but not implemented. That highlights the importance of national leadership, which comes up time and again in ensuring consistent implementation and showing what can result where no suicide prevention plan is in place. My local authority in Bridgend, however, is an exemplar of best practice and best planning. It learned a salutary lesson of the importance of such planning, which it now does excellently.
Evidence from Scotland highlighted the strength of a co-ordinated national approach to implementation—the Choose Life strategy—with the appointment of a co-ordinator in every local authority together with national funding and national leadership. The Minister of State, Department of Health, kindly gave an address at the launch of the report by the all-party group on suicide and self-harm prevention, and has agreed to respond to that on behalf of the Government.
Health and wellbeing boards need direction because otherwise we will end up with a hotchpotch of disorganised and unconnected policies, many of which have no evidence base. The National Institute for Health and Clinical Excellence is commissioning guidance for commissioners of self-harm services, and perhaps the Department of Health could look at doing the same for suicide prevention.
Workers in the field of suicide prevention are dedicated and committed, but isolated. Our inquiries showed the need to share best practice nationally, and in the near future we hope to hold a conference in the House of Commons to facilitate networking so best practice can be shared and so that we do not constantly expect people to reinvent the wheel. We will go back and look later at the effect of the suicide prevention plan for England and the impact of the reorganisation in England.
I mentioned briefly the importance of not linking suicide just to mental health services. The Appleby report of 1999 suggested that 75% of those who commit suicide are not known to services. That is important. We must not always look for a mental health link. If we do so, we will neglect to provide services that address a large number of people who take their own lives.
The debate is important. Suicide reflects on society as a whole. It can affect any hon. Member and any family. As the hon. Member for South Antrim has said, it can affect people whether they are rich, poor, successful, young or old. The sad tragedy that unites them all is that they are lives wasted, and lives we should set out to save.
Mr Dodds
It is difficult to be too specific, as every individual’s case is different. Undoubtedly, however, one of the biggest factors, particularly in my constituency, is loneliness and isolation, along with drugs and alcohol. That combination, together with the context in which people have grown up, can often become a too powerful and overwhelming set of circumstances with which to cope.
Particular issues, then, arise in Northern Ireland and my constituency, and they might be different from many cases in England, Wales and Scotland. We have this added problem and pressure of coming out of the period of awful violence that we suffered. Only today, as we look back at the research and work done, do people realise that that period was so awful that we are still living with the consequences. Indeed, people are still dying, even today, as a result of what happened in that period. The hon. Member for Beckenham (Bob Stewart) talked about the experience of soldiers—he was right to highlight that—and it applies to people who served in the security forces, too.
On the issue of how this affects family members, I am thinking particularly of a dear lady who had lost a number of her family members, including two children, to suicide. She told me that she feared for other members of her family because of the increasing prevalence of family members copying what other family members or their close friends had done. The problem is exacerbated not only by sites on the web that encourage suicide but even by Facebook, when an insidious form of peer pressure can be applied.
Mr Dodds
The hon. Lady is absolutely right, and some families have told me that they dread an anniversary coming up. They sometimes sit up for days on end watching over their loved one in case something happens. They are very aware of this problem as anniversaries are approached.
I want to mention the excellent work done by the integrated services for children and young people programme on the Shankill road in my constituency. The Secretary of State for Northern Ireland visited that project just last week, and the shadow Secretary of State, the hon. Member for Gedling (Vernon Coaker), who I am pleased to see in his place on the Front Bench, has also visited the Spectrum centre in the Shankill, and is aware of the great work done by Nicola Verner and others. Immensely important work is being done trying to help families that have all sorts of problems and needs. Intervention at an early stage is carried out, helping and supporting families as youngsters go through school and into the teenage years. Excellent work is being done by many organisations, much of it helped by Government. We just want to see that work consolidated and, if possible, increased.
I am conscious that other Members want to contribute, so I shall make my last point. A number of families raised with me the point that when young people go to an accident or emergency centre or to their GP and are concerned about their state of mind and vulnerability, it would be a good idea for them to have somewhere like a place of safety—somewhere they can go to and be put in contact with others who understand what they are going through. They should not just be given a piece of paper as a prescription and told to come back in a week’s time. They need somewhere to go to where they can talk to people; that is vital. I commend the Minister from the Northern Ireland Department of Health, Social Services and Public Safety for taking this issue on board.
Mrs Moon
One of the most helpful developments has been the engagement of the Samaritans in A and E departments. That has really made a difference, especially in self-harm cases. Where the nursing staff might be too busy to give up time, the Samaritans might be able to provide that time and support, which would be an excellent move forward.
Mr Dodds
I agree. That shows the importance of the excellent work the hon. Lady does as part of the all-party suicide prevention group to share best practice, as there are bound to be lessons we can learn from each other.
I commend the work that is being done. The Health Minister in Northern Ireland, Edwin Poots, has taken a close personal interest in the issue. He recently held a workshop for workers in the community and voluntary sector, and he has also met a number of family support groups. He has tried hard to raise the profile of this issue. It is now taken very seriously across the board in Northern Ireland—by all the political parties, and in the community and voluntary sector—and I think it important for Members to take the opportunity to highlight it here as well. It is one of the biggest problems that we face, certainly in my constituency.
I commend and thank everyone who has taken part in the debate, and all those, in my constituency and elsewhere, who are dedicated to trying to prevent suicide.