The city that wants to stamp out suicide
The number of people taking their own lives is "unacceptably high", MPs say. Does one city which plans to eliminate suicide altogether have the answer?
Is it possible to reach even a day when no one kills themselves?
A mental health trust in Liverpool - which pledged in September 2015 to bring its suicide rate down to zero among its patients - thinks so.
The commitment, the first of its kind in the country, was inspired by a health centre in Detroit, Michigan, which has reported not losing a single patient to suicide in two-and-a-half years. In 2015, the centre saw 74,000 patients.
Dr David Fearnley, Mersey Care's medical director, admits it will take time to see change, but says: "The first step is to accept it [a zero suicide rate] is possible. This is something that actually can happen."
He says measures including new suicide prevention training for staff and offering on-the-spot therapies to patients in A&E who have self-harm injuries will help the trust, which supported more than 41,000 patients in 2015/16, achieve this.
Other trusts are following suit, with the east and south west of England trialling the policy.
Indeed, MPs say the number of people taking their own lives in England - 4,820 in 2015 - is "unacceptably high".
They say GPs need more training in spotting people at risk of suicide and there should be more support after psychiatric patients are discharged.
A government plan for preventing suicides is expected in the New Year.
'Making a start'
For Rebecca Gibson, whose husband Andy, 54, took his own life in October 2014, the answer is simple.
"He didn't need anti-depressants - he needed somebody to talk to," she says.
"I never, never thought my husband would take his own life.
"If my husband had spoken to somebody [who had been in a similar situation]... I think my husband would still be here."
Rebecca and her two sons - who were 14 and 18 when their father died - live in Liverpool, but she is sceptical of Mersey Care's zero suicide policy.
"I laughed when I heard it - it is like saying there is never going to be another traffic accident," she says.
"It is all very well them having this policy, but how are they going to implement it?
"They [Mersey Care] are making a start but I think it will take a good 20 years."
- A total of 6,188 people were recorded as taking their own lives in 2015
- The suicide rate in the UK rose slightly to 10.9 deaths per 100,000 people, up from 10.8 in 2014
- In England, Yorkshire and The Humber had the highest suicide rate at 11.6 deaths per 100,000 and the East of England had the lowest at 9.3 deaths per 100,000
- Across all age groups, the rate for men was about three times higher than women
- The highest number of deaths was in the 45-49 age group, at 721 - 545 men and 176 women
The inspiration behind Mersey Care's policy, the Henry Ford Health System in Detroit, screens every patient for risk of suicide, not just those who have mental health problems.
It began the programme in 2001 that included improved staff training, increased contact with patients and better education for the families of people who were deemed to be at risk.
The suicide rate among its patient population fell by 75% within four years and by 2008 they had stopped all suicides among the group's patients.
This inspired Mersey Care - which provides specialist inpatient and community mental health for adults in Liverpool, Sefton and Kirkby - to:
- Launch a new suicide prevention course for staff
- Give every patient who has had a history of intent or self-harm a personalised "safety plan" and a specialised team continually monitors the highest risk people
- Aim to complete post-suicide reviews within two weeks
- Offer patients who have self-harm injuries therapies on the spot at A&E and follow up with them when they go home
- Develop a suicide prevention mobile phone app with Stanford University, which would provide round-the-clock support. The trust hopes to trial it in 2017
The policy is funded from the trust's existing finances and it hopes to continue funding it through savings from preventing suicides.
Dr Fearnley says Mersey Care loses about 30 people to suicide per year. A total of 135 deaths were recorded on Merseyside in 2015, 39 of those were in Liverpool.
Samaritans CEO Ruth Sutherland says the term "zero suicide" raises "unrealistic expectations".
She says the "signs are encouraging so far" from the pilot programme and believes the government should roll it out across the country if it is successful.
The "intensive follow-up care" provided by Mersey Care after patients have been discharged was important in preventing suicide as that is a "particularly high risk time", she says.
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