Suicide Prevention

Mark Durkan Excerpts

Wednesday 6th February 2013 Commons Chamber

[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 (Foyle) (SDLP)]

Will my hon. Friend give way?

[Mrs Moon]

I will certainly give way to the hon. Gentleman, who regularly attends the all-party group, for which I thank him.

[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.

--- Later in debate ---

[Mark Durkan (Foyle) (SDLP)]

Like other hon. Members, I congratulate the hon. Member for South Antrim (Dr McCrea) and his colleagues on giving the House the opportunity to discuss this very important issue, which, as we have heard, touches many people in many ways, and in ways that they find hard to express or represent. For all the reasons that we understand, it is important that we in the House—again, in our own inadequate and inarticulate way—not only try to express our feelings and represent the feelings of those who have lost people through suicide, but try to feel our way towards some sort of policy answer and structural response to a very serious problem that is growing in many ways.

It is not just because the statistics are better collated that we can say that the problem is growing. There are issues, and people can analyse and compare the different statistical bases over the years. It is a problem that has gradually been able to express itself a bit more. Reference has been made to the fact that it has been a taboo subject. The first time that I heard of suicide was when I was in primary school in the late 1960s, and a family friend committed suicide. She was a great friend of my mother—she was great to all my brothers and sisters whenever we were in her fruit and vegetable shop—and I remember that my mother’s distress as a friend was based not only on all the usual questions that arise from suicide and the loss of a lovely friend. It was also based on the fact that her friend was denied a Christian burial and denied the rites of her own Church. That is what taboo meant then. Luckily, Churches have become more enlightened and many people have helped them to become more enlightened. So we can celebrate the fact that spiritual enlightenment can inform Churches in different ways, and their response to something that they class as a sin can change and develop. That has been very positive and has helped all of us as a community in many ways.

I have found the debate hard. I agreed with many of the points, and I also felt many of the points. I have experienced suicide in my family more than once. I also have experience of suicide by people whom I regard as close—good friends, family friends and so on. All the things that all the right hon. and hon. Members have said are so, so true. We are stuck with that—the questions that will never leave, and the answers that will never come. There are people finding and developing answers, however. Maybe they are not answers to the particular suicide that has grieved me or grieves other members of my family and extended family, but answers as to how we may be able to get on top of the problem and as to how we can avert such tragedy and prevent it from afflicting other people as well.

In many cases some of those answers are being driven by the families and the very people who have experienced suicide, and by the professionals who have witnessed that, provided support and said, “There has to be a better way. There has to be more that we can do. There has to be more that we can do together.” The hon. Member for Bridgend (Mrs Moon) referred to the work of the all-party group and the report. I do not speak often at the all-party group, for reasons that people will understand; I find it hard to contain my emotions on these things. One thing struck me as I was listening to people give evidence to the group—people who did not know which area I represented. A few times when people from parts of England were giving evidence about their experience and the things that they were trying to do in their area with their trusts and well-being boards, they referred to what they called the Derry model, which they wanted to see in their area.

That is because in my constituency, in my city of Derry, as other hon. Members have said, we have grave levels of suicide, but there has been a strong community response and the local Western Health and Social Care Trust has tried to engage strongly on it. The trust has a suicide liaison officer, Barry McGail, who does not just work well locally, but is globally active and is part of progressive policy-pushing networks on the subject. When people spoke about the Derry model, part of what they meant was that suicide liaison service.

The service is notified of a suicide by the police within 24 hours and its staff make family contact. They are there at the wakes, able to talk to the family and friends. They are able to bring leaflets and draw attention to other services in a sensitive way, so the issues are immediately picked up and the people who might be most emotionally affected or vulnerable after the suicide—other family members, friends, classmates and so on—can be identified and supported. That has worked well and has helped families through and has helped them feel that they are helping others, which is so important.

More widely in Northern Ireland, we have a self-harm register, another positive development. It is run now by the Public Health Agency and is co-ordinated on a north-south basis. The register provides up-to-date information on people who may have attempted suicide or have self-harmed, so that the right services can be in touch with them or they can at least know that services such as counselling and other opportunities are available for them. Again, that is important in prevention. It is also important to learn the lessons of experiences and making sure that things that are known to one service are not lost to the knowledge and intelligence of another service that may be the right one to provide help.

Some hon. Members have referred to the media in this regard. Of course, the media have particular responsibilities. They need to be very careful and sensitive in how they present any film or TV storylines depicting suicide. If they make suicide simply the natural conclusion to a narrative, that is completely wrong. Unfortunately, too often in the media it seems as though the suicide itself makes the statement, and that is very dangerous. Equally, the media, whether the print media or any other kind, need to be very sensitive in how they cover deaths by suicide. If they treat speculation about clusters—the hon. Member for Bridgend, who is unfortunately no longer here, has experienced this directly in her constituency—in an insensitive, invasive, exploitative and sensational way, that can add to the problems. It can not only add to the suffering and stress of families, but put more families at risk of loss and distress.

Over a dozen years ago—this is not a new problem in Northern Ireland—people like Barry McGail worked on developing guidelines for the local media to use. One of the guidelines in circumstances where a suicide took place was for the media not to treat it in a way that linked it to a single dramatic event. I found myself in a situation where there was a suicide in another family that followed a death in my own family. With the support of education professionals, people like Barry McGail, and other people in the Western health board, I tried to prevail on the media not to treat the young man’s suicide as a “Romeo and Juliet”-type story. It was a struggle to get the media to comply with guidelines that had been drawn up sensitively with their own co-operation, and unfortunately we did not succeed in all instances. The media do have responsibilities in this regard.

Then there is the new media, with the digital age and all the opportunities that are there. In relation to the sites that offer methods and techniques of suicide and appear to be encouraging it, Barry McGail says that although most young people will engage in social media, most of them will want to do so positively. As well as trying to police and shut down all the negative, dark sites, we need to think of more ways of making sure that there are far more positive connections and real pathways of assistance and communication. We need to develop new things such as apps that will be suitable for young people, in particular, who could be at risk.

That is not to say that only young people are at risk of suicide. In my constituency and elsewhere, it affects the old and the young—mothers, fathers, and children. However, one of the things that gives me heart is that people who have been through these dark difficulties, and who are still not out of all that darkness, are desperately trying to remedy the situation through different networks, charities and support groups. In my town, they are supported by people such as those at Foyle Search and Rescue, who do such a good job in helping families who suffer following suicide in the river. When we were building the new iconic peace bridge in Derry, they worked with us to prevail on the architects to understand that it needed to be designed in a particular way with rails shaped so as not to lend themselves readily to suicide attempts.

Foyle Search and Rescue houses and accommodates various groups of families who have come together. We also have groups such as Zest for Life, which work so well to counsel people who are suffering from problems, and HURT (Have Your Tomorrows), which particularly helps people who have been suffering from addiction or dependency and have specific vulnerabilities. These groups are succeeding in helping to reduce and to solve the problems, but they constantly come up against funding difficulties. There is also the issue of making sure that all the policies and services can mesh together.

Finally, another positive feature in Northern Ireland is the ASIST—applied suicide intervention skills training— model, which has been borrowed from Canada and is working well where people engage with it. The big problem, however, is getting GPs to engage with it—they are not—because they are the vital cog and the key people. The issue has come up in the work of the all-party group on suicide and self-harm prevention. As the hon. Member for Bridgend will know, one of the questions that constantly comes up is: how do we get GPs involved in and engaged with this? Their input is vital and they are vital channels, but in their absence, people’s sense of purpose starts to wane and get weaker.

I am not blaming GPs. Obviously, there are a lot of pressures and demands on them, so they need time out of their practice to do this. We need to see what locum support and other things are available to allow them to play their part in the very good efforts that are being made and to make good the investment being provided by the Department of Health, Social Services and Public Safety. Other Members have been right to acknowledge the work of that Department, including that of the current Minister, Edwin Poots, and his permanent secretary, Andrew McCormick. We should also acknowledge the work of the previous devolved Ministers. It is a pity that the ministerial group did not meet for about 18 months, but that does not mean that other good work was not going on. For that work to be done, it needs to be supported, and I hope that today’s debate will help to support and encourage those people who deserve it in their important work on such a huge issue.

[Mr Deputy Speaker (Mr Nigel Evans)]

To resume his seat no later than 5.35 pm, I call Kevan Jones.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

I congratulate my hon. Friend the Member for South Antrim (Dr McCrea) on bringing this matter to the House. I also congratulate my hon. Friends and everyone else who has spoken. It is a pleasure to have the opportunity to sum up.

Today is an example of this House working at its best. All Members and all parties have come together and issued a joint call from the Floor of the House for better services. The contributions that Members have made have shown that the House is an immense fount of knowledge. In the short time I have, I intend to highlight the main issues that have been raised.

My hon. Friend the Member for South Antrim introduced the subject very well. He referred to the bereavement caused by suicide. That is an interesting point, because people have to come to terms with what has happened and how it affects them. I had not thought about that until my hon. Friend made the point and I realise that he was right. Other Members have talked about how suicide affects a person’s entire family and their friends. The hon. Member for Bridgend (Mrs Moon) spoke about anniversaries in particular. I will return to that point in a moment. Those issues have been raised over and over again.

My hon. Friend spoke about the vulnerability of people on coming out of prison. He spoke about the drug and alcohol culture among young men. That is not only an urban problem, but a rural problem. My hon. Friend’s constituency covers both types of area.

Members have said that this must not be a taboo subject and that it is time that we faced up to it. Hopefully we have faced up to it in this debate. The contributions have been immense. We have all met people who hide their depression and anxiety. Members have raised the fact that the suicide rate is higher in Northern Ireland than in other parts of the United Kingdom.

Prevention was a key theme in what my hon. Friend the Member for South Antrim said. He referred to the impact that computers and websites can have on children. He challenged us to address these issues. That set the scene clearly for me.

The Minister referred to the steps that are being taken to reduce suicide in England. He referred to the figures for the past year. His commitment to working with regional Assemblies is good news because it means that all parts of the United Kingdom, which are represented here today, are working together.

Some 75% of those who take their lives are not known to Government agencies. I did not know that before this debate started. We can look for the signs in people, such as whether they have depression. Like all hon. Members, I have met people over the years who unfortunately fall into that category.

The hon. Member for Bridgend gave a detailed, decisive and, I would say, masterful contribution to the debate and I thank her for that. She displayed great knowledge about the rates of suicide among 30 to 40-year-olds and among females.

The question that everybody asks themselves—I have asked myself this question when friends of mine have died—is, “What could I have done to prevent it?” You search your heart, you search your soul and you almost put yourself into the grave worrying about what more you could have done. Every Member who has spoken has mentioned that. Behind that question there is perhaps a bit of guilt as well.

The right hon. Member for Bermondsey and Old Southwark (Simon Hughes) spoke about the vital importance of support groups and Papyrus in particular. I am conscious that I am summing up and not making a contribution, but I just want to say that the LINK group in Newtownards does a magnificent job to help people who are considering suicide and those who have depression.

The hon. Member for North Down (Lady Hermon) spoke about suicide prevention and the moneys available in Northern Ireland, which gives that leadership, as well as the moneys that are set aside. The hon. Member for Beckenham (Bob Stewart) spoke on behalf of soldiers who leave the service and feel vulnerable, and as Members of Parliament we have all heard such cases.

In an intervention, the hon. Member for Foyle (Mark Durkan) mentioned the sensitivity surrounding the coroner’s report, and there is a lesson there for other parts of the United Kingdom after what has happened in Northern Ireland. The hon. Member for Bridgend spoke about the use of sport for young people and the importance of correct wording in dramas and soaps, and that valid point was also made by the hon. Member for Foyle in a passionate and real way. A “suicide champion” was referred to, and the need to extend that across the United Kingdom, and the comments and points of view expressed contain lessons for all regions in the United Kingdom.

[Mark Durkan]

I am entirely comfortable with everything the hon. Gentleman is saying about how we need better to co-ordinate and mesh this work across the UK and use all means to do that. Of course, the problem is wider in these islands. Recently, Shane McEntee, a Government Minister in the south of Ireland, took his own life, and there are serious problems that need to be addressed even at school level. Does the hon. Gentleman recognise that this issue should perhaps be prioritised at the level of the British-Irish Council? Perhaps a debate such as this could take place at the British-Irish Parliamentary Assembly so that we gather all the experiences and good practice that has come out of the bad experiences in all parts of these islands?

[Jim Shannon]

I agree, and I think all Members of this House feel the same. I commend the hon. Member for Pudsey (Stuart Andrew), who referred to bullying at school and the importance of family when he was working in a hospice. He mentioned the difference between death and death from suicide—both very tragic and real issues—and spoke about the red socialist and the blue Tory working together. That is good and the way it should be in this House, doing the best we can.

My right hon. Friend and colleague the Member for Belfast North (Mr Dodds) gave a detailed account of what happens in north Belfast which, along with west Belfast, unfortunately has a reputation for the highest suicide rates in Northern Ireland. He referred to the hard work done by many people in the PIPS group—the Public Initiative for Prevention of Suicide and Self-Harm—FASA, churches and many other groups that do tremendous work. Queen’s university has made a study of north Belfast, and if my right hon. Friend ever needs facts or evidence of what is wrong and how to address it, those are issues we must consider.

I have in my notes, “Coping with peace after years of violence”, and unfortunately in north Belfast, and perhaps west Belfast, that is one of the issues, and my right hon. Friend clearly addressed that point. He and other Members referred to copycat suicides, and the hon. Member for Bridgend mentioned anniversaries. The work done by the Samaritans in A and E was mentioned, and, as my right hon. Friend said, there are lessons to be learned for us all.

The shadow Minister, the hon. Member for Hackney North and Stoke Newington (Ms Abbott), said that although any death is tragic, suicide is the worst as it poses many questions for the family left behind, and she spoke about the issue very clearly and honestly. She referred to the good work done by Labour when it was in power. I know that to be the case and I look forward to more such work.

My hon. Friend the Member for Upper Bann (David Simpson) referred to the increased number of suicides in Northern Ireland—300—and mentioned Yellow Ribbon and the 400 people helped by that organisation in one year. Four hundred people sought help, and volunteers and groups were there to help.

I thank the hon. Member for Foyle for his passionate, powerful and revealing speech that moved us all, and he put forward a number of ideas. The Maiden City has a suicide awareness day; perhaps it could be a model for the rest of the United Kingdom. He also referred to a self-harm register. Although not many people mentioned that issue in Northern Ireland, the British Medical Association referred to the fact that a third of those who self harm commit suicide, so that issue is important. He mentioned the relationship between Northern Ireland and the Republic of Ireland.

Last but not least, I remember when the hon. Member for North Durham (Mr Jones) spoke about mental health in the Chamber some time ago—I have never forgotten that speech. He spoke again today with passion and belief, and with the inner knowledge that comes from his experience. He has been able to describe that for all hon. Members in the Chamber.

We should be clear that we need the voluntary services and the Government to work together. I thank everyone for their valuable and sensitive contributions in the Chamber today. The debate has been excellent.