Agenda item

To provide an overview of Haringey’s multi-agency suicide prevention plan.

Chantelle Fatania, Consultant in Public Health presented the update report on the Haringey Suicide Prevention Action Plan, supported by Professor David Mosse, Chair of the Haringey Suicide Prevention Group (HSPG), and Tim Miller, CCG commissioner for Mental Health. 

Chantelle Fatania said that 55 people had died by suicide in Haringey between 2014 and 2016 representing a suicide rate of 10.3 per 100,000 people. This was the fifth highest in London and higher than the overall rate for England of 9.9 per 100,000 people. A 2016 audit of suicides in Haringey found that 75% of people of deaths were male, the highest rate being those aged 25-44, which is similar to national trends. 66% of deaths took place in the east of the borough.

The factors leading to suicide are often complex and a result of multiple factors so no one organisation is able to influence them all. A collaborative multi-agency approach to suicide prevention is therefore required and so the HSPG coordinates a range of local organisations to reduce risk factors and reinforce protective factors, particularly by providing social support to vulnerable people, raising awareness around suicide and supporting people who have been bereaved by suicide. The HSPG meets on a quarterly basis and the membership includes Haringey Public Health, the Clinical Commissioning Group, Metropolitan Police, Barnet Enfield Haringey Mental Health Trust, British Transport Police and local charities. The Haringey Suicide Prevention Action Plan uses the national Suicide Prevention Strategy for England’s six “Areas for Action” framework as a best practice model. Actions within the plan include:

• A suicide prevention respite retreat provided by the Maytree charity supporting people in suicidal crisis in a non-medical setting.
• A psychiatric liaison service in the A&E department of North Middlesex Hospital, including peer support workers to support those in suicidal crisis.
• The Haringey well-being network led by the Mind charity which provides an integrated mental health support service.
• Mental health first aid training has been provided to over 200 front-line workers and residents in the last year.
• Suicide prevention fencing at Archway Bridge had recently been approved.

Professor David Mosse commented that, according to Public Health England guidelines the responsibility for local implementation of the national Suicide Prevention Strategy had been passed down to local authorities. While there was no mandatory requirement to do this, the recommendations were to establish a local suicide prevention plan, a local suicide prevention group and to carry out a suicide audit. This had happened in Haringey but what was different about the HSPG is that the lead is from within the community, hosted by Mind and with buy-in from a wide range of organisation, both statutory and non-statutory. There was almost no financial backing from the local authority – a small amount of funding provided one member of staff for one day a week but the rest of the work is done on a voluntary basis. The HSPG has put together a business plan for suicide liaison service in the North Central London (NCL) area which would provide timely practical and emotional support for people who have been bereaved by suicide. This type of support is currently unavailable and there is a well evidenced business plan but no money had been made available. While the HSPG is providing an exemplary example of what the government expects through its national Suicide Prevention Strategy it is doing so with very little financial backing. 

Responding to questions from the panel, Chantelle Fatania, Professor David Mosse and Tim Miller said:

• That the suicide data from coroners is a problem and that there is almost certainly a significant underestimation of the number of suicides in the official figures. The coroners’ data also does not provide details on sexual orientation or ethnicity so there are no national figures on these. Without this data it is more difficult to identify communities in need of particular support.
• Participation from LGBT+ groups in Haringey with the HSPG would be welcomed.
• An app called Kooth, which provides online counselling and peer-to-peer support to 10-16 year olds, had been operational in other boroughs and had been shown to be effective.
• Recent analysis suggests that men working in the construction industry, many of whom are of eastern European origin, are at particularly high risk of suicide. Addressing this requires a multi-agency approach including buy-in from the construction industry. Cllr Connor agreed to raise this with the relevant Cabinet Members. (Action - Cllr Connor)
• Peer-supported Open Dialogue (POD) is being trialled in the south-east of Haringey. The principles of a person-first rather than diagnosis-first approach can be applied to primary care settings as well as in A&E settings.

Cllr Connor welcomed the presentations and agreed to take up the issue of suicide liaison service business plan with the Chair of the Joint Health Overview & Scrutiny Committee for the NCL area, Cllr Alison Kelly. (Action - Cllr Connor)

Will Maimaris, Director of Public Health, commented that the issue of funding was a challenging one in the current circumstances but the suicide liaison service proposal and the Kooth app could both be looked at.