Report of the Director of Public Health
The Committee received information on the results of an Audit of Suicide and injury and undetermined deaths in Gateshead for the 2018 calendar year as part of its second evidence gathering session for its 2019-20 Review of Suicide. The audit identified key themes from local data and identified risk factors and high-risk population groups for suicide in Gateshead.
The Committee was advised that the updated trend data shows a positive downward direction with the release of the 2016-18 figures in September 2019. Rates per 100,000 population are falling in the three categories; Persons, Males and Females since the 2014-16 reporting period. However, the evidence suggests that there is still a lot of work to be done around performance in relation to the risk factors of suicide, as described by PHE, to ensure that less residents feel that the only way out of their situation is to take their own life.
The Committee noted that Gateshead has lower than regional rates of suicide and similar rates to England.
The Committee was informed that a number of risk factors of suicide are known and include: social isolation, certain mental health issues; bereavement; loss of employment; substance misuse and deprivation.
The Committee also learned that the PHE Fingertips online suicide prevention tool collects data on a wide range of risk factors for suicide including the following:-
· Depression recorded prevalence (aged 18+)
· Estimated prevalence of common mental health disorders
· Estimated prevalence of opiate and / or crack cocaine use
· Long term health problem or disability (%of population)
· Children in the Youth Justice System
· Children in care and children leaving care
· People living alone
· Admission episodes for alcohol related conditions
The Committee learned that for all the above measures, Gateshead has higher numbers than national (England) and regional benchmark figures. There is therefore a need for engagement of a wide range of partners in helping to reduce the risks of individuals ending their own life.
The key themes emerging from the audit were that:-
· A high number of individuals died in their own home making preventative initiatives targeting those at high risk difficult.
· The most common cause of death was self -poisoning with the second most common being hanging (predominantly in their own home)
High risk population groups are Males (in line with national data) and being Single and this is linked to another high-risk population group which is those Living Alone. A further high-risk population group is people who are unemployed and having relationship/ family problems is seen as the biggest social risk factor.
The Committee also had regard to the evidence that suicide is the leading cause of death among young people aged 20-34 years in the UK and it is considerably higher in men, with around three times as many men dying as a result of suicide compared to women. It is the leading cause of death for men under 50 in the UK. Those at highest risk are men aged between 40 and 44 years who have a rate of 24.1 deaths per 100,000 population.
The Committee also noted that the number of people who are confirmed to have died as a result of Suicide is only a fraction of the people who are classed to have died from Suicide and injury undetermined deaths in Gateshead. Only 6.4% of cases in Gateshead had a suicide verdict with 62% being classified as misadventure and a further 26 % having a narrative verdict.
Taking account of the profile of people who died from suicide/ undertermined deaths in Gateshead in 2018 it is considered there are opportunities for preventative interventions via partnership working across the health and social care system with a focus on the following areas:-
· People with existing evidence of risk i.e. Alcohol/Drug use, Self-Harmers and those who have had previous suicide attempts.
· Review of prescribing practices. With the high number of deaths being linked to drugs use there is scope to ensure that individuals only obtain and continue to receive drugs for personal use.
· Working with Drug and Alcohol services to ensure their staff know the increased risk in their client group and where possible to provide Mental Health support alongside the therapy for the physical addiction.
· Working with GP Practice staff to raise the opportunity for intervention as 29/47 visited their GP within the 3 months prior to death for physical issues.
· Working with providers of support for people with Depressive illness
The Committee was informed that suicide prevention work impacting on Gateshead is being taken forward at Regional, Northumberland Tyne & Wear and Gateshead level and information on this would form the basis of future evidence sessions.
The Committee queried how many of the cases reviewed as part of the audit involved individuals receiving NHS input for mental health issues. The Committee was informed that only 20% cases had involvement from NHS secondary care with the majority of those identifying as having mental health issues seeking interventions via their GP and the majority having a diagnosis of depression. The Committee considered that this highlighted the need for further education on this issue.
The Committee noted that one of the risk factors was deprivation and queried whether the impact of universal credit was increasing the levels of deprivation and increasing the risk of suicide in deprived areas. It was also queried whether there was any evidence of patterns of increased suicides in areas of deprivation.
The Committee was advised that suicides in Gateshead had been plotted over the last three years and there was evidence of higher levels of suicide in areas with greater deprivation levels. It was also highlighted that work to tackle poverty is a key focus for the Council and it was hoped that this along with other initiatives would reduce numbers of suicides going forwards.
The Committee noted that accessing mental health services might not be a quick process and recent articles in the press had highlighted issues of significant numbers of individuals being kept on hidden waiting lists and individuals being rushed through the system in order to meet targets. The Committee sought reassurances that this was not happening in Gateshead.
The Committee was informed that a response would be sought from Newcastle Gateshead CCG, as commissioners of these services, which would be fed into the review.
The Committee sought information on what families, suffering economic hardship, could do when family members committed suicide and insurance companies would not cover the cost of a funeral. The Committee was advised that applications can be made to the Council for a Council contracted funeral but generally these are only provided where there are no relatives who can fund a funeral and there is a set process which has to be followed.
RESOLVED That the Committee consider the information presented as part of the Review of Suicide.