One step at a time…

primary care training_NHS_One step at a time...

World Suicide Prevention Day has come and gone. It’s a World Health Organisation initiative.

In past years, over 300 activities in around 70 countries were reported, including educational and commemorative events, press briefings and conferences, as well as Facebook and Twitter coverage.

If it interests you, there is a very good web-portal here.

Maybe it’s me being dim, but I didn’t see anything on the ‘day’. Although, I’ve since discovered Jonathan Ashworth, shadow health secretary, in Old Palace Yard, Westminister, was at an event, that laid out 200 pairs of shoes to represent the lives, of young people, lost to suicide, in a year.

There is an overall increase in the number of suicides… but it is more complex than that.

The ONS tell us something quite radical has changed. Whereas suicides used to be in decline, they are now on the increase. The reasons are unknown.

I think we should lift every stone to find out… but who is on the case? Dunno…

The latest data also show that something has changed for young people, those aged 10 to 24 years.

While this group continue to have low numbers of deaths and the lowest rates of suicide when compared to other age groups, in recent years they have seen some of the largest increases in their rates.

The rate among 10 to 24-year-old females has increased by 83% since 2012, to its highest recorded level in 2018. Males of the same age also saw a 25% increase in their rate from the previous year.

I can’t imagine how difficult it must be, when a relative decides to take their own life. But, when a child does it, it must be unbearable.

Unravelling young people’s suicide is hugely complicated. Life’s experiences and pressures build. Buried in the complexity there are often three root-causes; an adverse experience, such as abuse, pressures at school or a recent bereavement.

Self-harm bears a strong relationship to suicide. In England, the proportion of young women who said they had self-harmed increased by 13%, between 2000 and 2014.

The Mental Health Five Year Forward View made a commitment to reduce suicides by 10% nationally by 2020.

In 2018/19, local communities, that are worst affected by suicide, are being given additional funding to develop suicide prevention and reduction schemes.

The investment marks the start of a three year programme worth £25 million that will reach the whole country by 2021.

Well, what ever they’re doing I’m not sure it’s working, judged by the simple yardstick… suicides are on the increase.

There is a National Confidential Inquiry into suicide, which is on-going and has been collecting evidence for 20 years. There’s a comprehensive web-site.

They examined 391 suicides by young people under 25. Guess what they found?

Main causes are; bereavement, school pressures and bullying particularly around gender identity. That takes us full circle.

Suicide is on the increase and the kids are at a special risk. I guess the smart question is, which kids?

Previous attempts at suicide is a good guide. A family history of suicide. We know many adolescents, who take their own lives are lesbian, gay, bisexual, transgender, or questioning their identity.

When young people demonstrate mood or eating disorders or depression, behavioural problems, they are at risk. As are those who use drugs. Indeed, it plays a part in 1 in 3 suicides.

In the US there is evidence that one suicide can lead to another, contagious. There is universal evidence that bullying and cyberbullying play their part and so does easy access to the means of suicide… guns, pills.

In the US, suicide is now the second most common cause of death, among young people between the ages of 10-24yrs.

Beware, so often, what happens ‘there’, manifests as an unwelcome visitor ‘here’.

What to do? I guess the schools and parents need to listen better? Particularly when the teens stop talking. Don’t let things snowball and don’t expect too much.

Lack of success doesn’t mean failure and not achieving expectations doesn’t mean the end of fulfilment.

Being loved for what we are is important to us all, whatever our age.

Ashworth’s shoes were a good idea but they do more than remind us to count the deaths. They tell us, life is mostly manageable, one step at a time.

Contact Roy – please use this e-address – roy.lilley@nhsmanagers.net

Know something I don’t – email me in confidence.

Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.