Suicide awareness: everybody's business

This isn’t intended as a comprehensive guide, but a conversation starter, which we hope you will find helpful – personally and professionally.

The scope of the problem 

Death by suicide is on the rise in the UK. As both global citizens and members of the CSP, we need to be aware of the potential risk factors and support options available to us and for those who need support.

The Office of National Statistics (2019) reported that there were 6,507 deaths by suicide registered in the UK in 2018, significantly higher than in 2017, and up by 10% on 2018 figures. More than three-quarters of recorded deaths by suicide occurred in men, with those aged 45-49 reported as the highest rate according to age bracket. However, suicide rates among women young people are also rising. Death by suicide is a nationwide problem, and entirely preventable.

Research tells us that people who experience physical or mental health concerns or intellectual disability are at higher risk of death by suicide, as are those people who live with persistent pain (Khazem, 2018; Calati et al, 2015). It is because of this that we advocate that everyone should build their knowledge and skills around this difficult and emotive issue.

Have the conversation - your duty of care 

It’s really important that you explore the feelings of someone who has told you or who you suspect is having suicidal thoughts and act on what they share with you. 

You don’t need to fear using the word suicide as part of your conversation. It doesn’t make the person more likely to consider taking their own life and it’s important to ask whether the person has made an active plan. Often the person who is expressing suicidal thoughts or plans might ask that you don’t tell anyone. You might feel that, as they have not given consent to tell anyone, you can’t or that it would damage your relationship but your professional duty of care overrides this.

Registered members are bound by the Health and Care Professions Council (HCPC) Standards of Conduct, Performance & Ethics. Standard 7.4 states: ‘You must make sure that the safety and well-being of service users always comes before any professional or other loyalties.”

General Data Protection Regulations (GDPR) do not apply where there is a specific need to share information about a vulnerable person.

Acting on what you’re told

Whether you are part of a large team or a sole trader working independently, when faced with a person who expresses a desire to end their life, you are not alone. The NHS has dedicated safeguarding support available regardless of what sector you work in. This is accessible via your organisation’s safeguarding teams, the persons GP, the local mental health crisis team or duty social worker. 

If you believe there is an immediate risk to their life, the emergency services will respond to a 999 call.

If it is a patient that you are having this conversation with, you must also to remember to document all your discussions and actions. 

Support yourself to have the conversation 

We suggest that every registered physiotherapist, student, and support worker undertakes voluntary training on suicide awareness. There is free on-line training available to everyone by the Zero Suicide Alliance and E-Learning for Health.

When doing an assessment or working with patients, listen out for these factors.

They may indicate an increased risk of suicidal thoughts:

• Relationship breakdown
• Bereavement
• Academic/work pressures
• Physical/mental ill health 
• Financial pressures
• Social deprivation

We are asking you to commit to three things that will support you in keeping your patients, colleagues, friends, family and yourself safe:

1. Engage in suicide awareness and prevention training. 
2. Familiarise yourself with your local procedures. We recommend keeping the contact details of your local crisis team and the Samaritans free helpline number: 116 123 to hand. 
3. Check-in with yourself: are you okay? 

Resources to support you and others

• Training links: Zero Suicide Alliance and e-LH;  elearning healthcare
• Helpful resources: Hub of hope; Samaritans;  Mind.uk the Mental Health charity
• CSP resources: Suicide awareness - a briefing for CSP members and Duty of care
• HCPC Standards of conduct, performance and ethics
• Staying Safe

References:

Calati, R., Bakhiyi, C. L., Artero, S., Ilgen, M., & Courtet, P. (2015). The impact of physical pain on suicidal thoughts and behaviors: meta-analyses. Journal of psychiatric research, 71, 16-32.

Khazem, L. R. (2018). Physical disability and suicide: recent advancements in understanding and future directions for consideration. Current opinion in psychology, 22, 18-22.

Office of National Statistics (2019). Suicides in the UK.