High number of suicides among people under care of crisis teams

Every year, the University of Manchester publish their National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCISH) report.

This year marks the 20th anniversary, with the report drawing on two decades of evidence.

The main findings of the report are:

• Over 200 suicide deaths per year now occur in patients under mental health crisis teams, three times as many as in in-patients
• One third of patients under crisis resolution/home treatment (CRHT) who died by suicide had been using the service for less than a week, and a third had been discharged from hospital in the previous two weeks.
• Over half of the 1700 mental health patients per year who died by suicide across the UK had a history of alcohol or drug misuse. However, only a small proportion had received specialist substance misuse treatment.
• More patients who died by suicide were reported as having been unemployed or homeless, and 13% had experienced serious financial difficulties in the previous 3 months. There was a rising incidence of suicides by patients who had been in the UK for less than 5 years.
• There’s been a change in risk factors for poor mental health over the last 20 years, with higher rates of isolation, recent self-harm, alcohol and drug misuse and economic adversity in those who died by suicide. There have been improvements in some aspects of suicide prevention, such as ward safety and acceptance of medication.
• There has been a fall in patient homicides overall but a possible increase by patients with schizophrenia in England since 2009. The numbers are small, so it is difficult for researchers to confirm a clear pattern.

Responding to the report, Paul Farmer, Chief Executive of Mind, said:

“This is a comprehensive analysis of suicide not just in the last year, but over a 20 year period. It gives a clear indication of progress made, especially in reducing inpatient suicides. But the report also shows there is a long way to go in achieving a goal of zero suicides."

“Every year, hundreds of people under the care of mental health crisis teams are ending their lives. It’s a tragedy that anybody who is already in touch with services, and has asked for help, should reach this point. NHS mental health services need to be able respond when people reach out, from early treatment to help prevent people becoming more unwell, to an emergency response that can provide urgent, appropriate, local care when someone is at their most vulnerable."

“A new clear objective to reduce suicide levels by 10 per cent in the Independent Mental Health Taskforce’s Five Year Forward View for Mental Health has been accepted, and Jeremy Hunt has rightly put suicide prevention as a key patient safety issue for the NHS as a whole and beyond. It’s vital that the new strategy draws from the learning of this report to put in place a robust plan locally and nationally. There are still too many families who have lost loved ones and we need clear action to reduce these tragedies.”

For advice and information about suicide, contact us.