Agenda item

Purpose of report:

To provide assurance on the quality of the multi-agency Surrey Suicide Prevention Plan in response to the recommendation of the House of Commons Health Select Committee inquiry into suicide prevention.

Declarations of interests:

None

Witnesses:

Helen Atkinson, Strategic Director of Adult Social Care & Public Health, Surrey County Council

Nanu Chumber-Stanley, Public Health Development Worker, Surrey County Council

Billy Hatfani, Director of Quality Improvement, Surrey & Borders Partnership Trust

Helen Harrison, Public Health Consultant, Surrey County Council

Don Illman, Chairman, Surrey & North East Hampshire Independent Mental Health Network

Matthew Parris, Deputy CEO, Healthwatch Surrey

Key points raised during the discussion:

1.     Officers introduced the report to the Committee highlighting that the number of completed suicides in Surrey was lower than the national average. The risk factors that contributed to people attempting suicide were similar to those across the rest of the country with substance misuse and mental health among the most prevalent contributory factors. Members were advised that there were a range of partners involved in Surrey’s Suicide Prevention Framework and that these organisations worked together to address the risk factors that led to people attempting suicide. The Committee was further informed that initiatives were being planned with the Coroner’s Service and the Multi-Agency Safeguarding Hub (MASH) to improve safeguarding in relation to suicides.

2.     Members sought clarity on the role of data in helping agencies to identify those that may be at risk of suicide. Officers highlighted that data was an important tool but that the constraints on information sharing between public sector partners arising from the data protection act made it difficult to build an accurate picture of suicide risk particularly in relation to adults.

3.     The Committee inquired as to whether SCC seeks information from other organisations which help to identify those who may be at risk. It was highlighted that the Council does receive information from organisations that work with groups considered to be high risk such as the homeless and the Lesbian, Gay, Bisexual and Transgender (LGBT) community. Members were informed that officers had links into these hard to reach groups which helped to intervene with individuals where necessary.

4.     Discussion turned to the initiative that SCC had undertaken with Network Rail and Southwest Trains to reduce instances of suicide at specific train stations in Surrey. Officers stated that an inter-organisational group had been established to reduce instances of suicide at Woking Station, a location which had seen a growing number of people taking their own life in previous years. The inter-organisational group, which included a range of stakeholders, had educated those working within half a mile of the station, who someone on route to attempt suicide at Woking Train Station may come into contact with, training them to interpret or identify signs and to alert the appropriate agencies where they have concerns. Suicide prevention champions and Street Angels were also operating at Woking Station to help identify and intercept those seeking to attempt suicide. The plan was to introduce this at other train stations in Surrey which had been identified as having a high number of suicides.

5.     Attention was drawn to Figure 1 within the report which demonstrated that there had been no tangible reduction in completed suicides in Surrey despite a concerted effort by SCC and its partners to decrease this number. The Committee sought clarity on why the number of suicides had not reduced and asked whether officers felt that a dedicated resource would help. Members were advised that the trend in Surrey mirrored what was taking place nationally which had prompted the Government’s review into suicide prevention. In response to this review, the Government had produced a suite of measures in an effort to stop rising instances of suicide. Officers stated that Surrey was already doing many of the measures that the Government had introduced but acknowledged that these could be scaled up. The Committee was informed that it was hard to judge the extent to which a dedicated resource would help to reduce instances of suicide in Surrey.

6.     Members highlighted the role of training as a means of identifying those at risk of attempting suicide and stated that the money committed by Government was not sufficient to have a tangible impact on suicide rates. The Cabinet Member for Health highlighted that the House of Commons Health Committee inquiry report into suicide prevention had asked local authority health overview & scrutiny committees to review suicide prevention plans. The Health Committee’s report inquiry detailed that the Government had not dedicated sufficient resources to the initiative. The Cabinet Member highlighted that there was a need to consider how training could be delivered to those best placed to identify those at risk of taking their own life and stated that she would put herself forward as a Suicide Prevention Champion.

7.     The Healthwatch Surrey representative reported that of 189 students that they spoke to at Magna Carta School in March a third of those who experienced anxiety chose not do anything about it. This was considered to highlight the importance of the Targeted Mental Health in Schools initiative. However it had been reported to Healthwatch Surrey that fully funded training places were not being readily taken up by schools. He asked whether this was true and what was being done to encourage schools to take up the training. The Healthwatch Surrey representative further inquired as to what was being done to support or engage parents in having discussions about mental health with their children. The Strategic Director for Adult Social Care and Public Health highlighted that these questions were relevant to the provision of the Children and Adolescent Mental Health Service (CAMHS) and that officers would source a responsive to these questions for Healthwatch.

8.     Members highlighted cuts to services provided by the Council to help tackle substance misuse which was a leading cause of suicide and asked what impact this would have on prevention. The Cabinet Member for Health highlighted that there had been significant reductions to SCC’s ring-fenced Public Health funding which had a knock-on impact on the services that SCC was able to provide. The Council was, however, working with STP partners to agree funding to influence the wider determinants as this was the only way to reduce demand on health and social care services. The Strategic Director for Adult Social Care & Public Health drew attention to the brief interventions work with Primary Care which would provide an additional preventative safeguard.

9.     Officers were asked whether a more proactive approach could be made to offering suicide awareness training to organisations across Surrey. Members were informed that the Council is proactive in its training offer approaching partners to offer them training on suicide awareness and having conversations about mental health. The Council had also sought to get suicide prevention embedded within voluntary, community and faith sector organisations’ strategies.

10.  The representative from the Chairman of Surrey & North East Hampshire Independent Mental Health Network informed Members that he had had first-hand experience of suicide and felt that better support should be available for bereaved family members. He further highlighted the need for more effective cooperation between public sector agencies on developing a strategy to tackle suicide. The Committee was advised that the Coroner’s Service issued notifications to local authorities and partner agencies when it was felt that more could have been done to prevent someone taking their own life and it was suggested that more could be done to embed learning from these notifications. More work was also required with Primary Care on training GPs to be more responsive to patients who indicate that they have had suicidal thoughts. Officers stated that SABP does have a process in place to embed learning from prevention of death certificates issues by the Coroner’s Service.

Mr Graham Ellwood left the meeting at 12.28pm and returned at 12.38pm

11.  The Healthwatch Surrey representative raised the importance of good discharge arrangements and that, whilst inpatient services are an issue in Surrey, users of these services had clearly expressed dissatisfaction with discharge arrangements in a report published by Healthwatch Surrey entitled ‘Keeping the Light On’. For many this was the first step to becoming well and potentially, therefore, not requiring inpatient services again. The Healthwatch Surrey representative proposed this as an area for future scrutiny by the Committee.

12.  Officers emphasised the importance of having more open conversations about suicide within families and communities. The majority of people who take their own lives in Surrey don’t come into contact with SABP as a mental health service provider and so a more open dialogue on suicide was vital.

13.  Members stressed the need to for the response to House of Commons Health Committee to make mention of the Government’s lack of investment in local suicide prevention plans and the challenges this caused in delivering sustained reductions in the number of suicides which took place in Surrey each year.

Recommendations:

That the Adults and Health Select Committee:

i.       responds to House of Commons Health Select Committee citing concerns regarding national legislative constraints to proactive data sharing to enable local identification of someone who could potentially be ‘at risk’ of suicide. The response should also make mention of training on suicide prevention and mental health funding.

ii.      reviews progress of the next steps in 12 months’ time.