Health and Wellbeing Board	8^th May 2024
Report of the Director of Public Health

Update on Goal 7 of the Joint Health and Wellbeing Strategy 2022-2032: ‘Reduce Both the Suicide Rate and the Self-Harm Rate in the City by 20%’

Summary

1. This paper provides the Health and Wellbeing Board (HWBB) with an update on the implementation and delivery of one of the ten big goals within the Local Joint Health and Wellbeing Strategy 2022-2032. It also includes information on performance monitoring.

2. The Board are asked to note the report.

Background

3. At the January 2023 meeting of the Health and Wellbeing Board (HWBB) members of the Board agreed a framework for an action plan and a Population Health Outcomes Monitor for the Joint Health and Wellbeing Strategy 2022-2032. This was followed by agreement at the March 2023 meeting of a populated action plan and a Population Health Outcomes Monitor. Over the last six to eight months updates have been presented on Goals 1 to 6 of the strategy and their associated actions.

4. Today’s report provides an update on Goal 7 ‘Reduce Both the Suicide Rate and the Self-Harm Rate in the City by 20%’ and its associated 3 actions along with updates on the agreed key performance indicators associated with the goal. Annexes A & B to this report provide a detailed score card and trend data.

5. The agreed actions cover the first 24 months of the strategy’s 10-year life span.

Goal 7: Reduce Both the Suicide Rate and the Self-Harm Rate in the City by 20%’

6. Death by suicide is a tragedy which affects many people. Between 2018 and 2020, 70 people died by suicide in York, continuing a trend seen for a number of years of higher rates locally than the regional average. Males are four times more likely to die than females (although rates of attempted suicide may be more equalised between genders), and whilst complex reasons lie behind every death, there is a clear correlation with deprivation. In 2020/21 there were over 400 hospital admissions for self-harm in the city, with half of them in people aged 10-24. Self-harm admission rates in the city show a declining trend over time.

A large amount of human distress lies behind this data, and we want to work together to create the kind of mentally healthy city in which these trends are reversed.

Update on Health and Wellbeing Strategy Actions

7. Action A16: undertake a suicide audit and present a report with key findings to the Health and Wellbeing Board and other forums (Year 1)

Progress: York and North Yorkshire coroner granted the public health team access in 2023 to relevant files relating to death by suicide in the time period 2017-2021. An audit has been undertaken of this data, and the findings are being analysed and considered by a range of partners and will be published within year one of the Joint Local Health and Wellbeing Strategy.

8. Action A17: Roll out the YES campaign supported by the Humber and North Yorkshire health inequalities fund to screen the Suicide Prevention film in training across the city (Year 1)

Progress: The York Ending Stigma (YES) programme is a lived-experience-led programme which aims to end stigma and mental-health-based discrimination. According to the University of Manchester (CARMS Project, 2020):

‘Stigma attached to mental health problems and suicide can affect individuals in many different ways. Some consequences of stigma may be:

· A reduction in self-esteem and self-worth

· Hopelessness and shame

· Social isolation and impaired social networks

· Unemployment and/or discrimination when applying for jobs

· Bullying, harassment and physical violence

· may worsen individuals’ mental health problems and increase their risk to suicidal experiences’

The YES programme is led by YES champions, all with their own experience of poor mental health, and one of their projects is the WHY Suicide Prevention film, a powerful documentary which is presented alongside associated training and lived experience testimony. The contract runs until July 2025, this work has a steering group which has been formulating an action plan to guide the work across that time. This funding is specific to the ongoing promotion of the suicide awareness prevention training to accompany the roll out of the film.

9. Action 18: Refresh and relaunch the 2018-2023 Suicide Safer Community Strategy (Year 2)

Progress: Governance of the community suicide prevention work is ongoing with the relaunch of the community action group.

In addition, there has been the formulation of a York and North Yorkshire strategic governance group. This is to look across the commonalities and work cohesively with partners who span both local authorities such as the Police and Coroner on issues such as:

· Near real time surveillance of suicides in the area, in order to understand emerging trends and any links between deaths to prompt action

· Physical site work, e.g. preventing river related deaths

· Suicide cluster identification

· Engagement with NHS bodies working on a larger footprint e.g. our mental health Trust Tees Esk and Wear Valleys NHS FT.

In September 2023 the government published the national suicide prevention strategy, which identifies the following 8 areas for action over the next 5 years – partners locally are considering how each of these areas can be supported:

· Improving data and evidence to ensure that effective, evidence-informed and timely interventions continue to be developed and adapted.

· Tailored, targeted support to priority groups, including those at higher risk, to ensure there is bespoke action and that interventions are effective and accessible for everyone.

· Addressing common risk factors linked to suicide at a population level to provide early intervention and tailored support.

· Promoting online safety and responsible media content to reduce harms, improve support and signposting, and provide helpful messages about suicide and self-harm.

· Providing effective crisis support across sectors for those who reach crisis point.

· Reducing access to means and methods of suicide where this is appropriate and necessary as an intervention to prevent suicides.

· Providing effective bereavement support to those affected by suicide.

· Making suicide everybody’s business so that we can maximise our collective impact and support to prevent suicides.

10. Population Health Outcomes Monitor: this is linked to the ten big goals and is designed to provide board members with a holistic view of whether the strategy is making a difference to the health and wellbeing of York’s population, using outcome data rather than data on what health and care services are ‘doing’. Today’s updates at Annexes A & B to this report provide information on Goal 7 of the strategy.

Consultation and Engagement

11. As a high-level document setting out the strategic vision for health and wellbeing in the city, the new Local Joint Health and Wellbeing Strategy capitalised on existing consultation and engagement work undertaken on deeper and more specific projects in the city. Co-production is a principle that has been endorsed by the HWBB and will form a key part of the delivery, implementation, and evaluation of the strategy.

12. The actions in the action plan have been identified in consultation with HWBB member organisations and those leading on specific workstreams that impact the ten big goals.

13. The performance management framework has been developed by public health experts in conjunction with the Business Intelligence Team within the City of York Council.

Options

14. There are no specific options for the HWBB in relation to this report. HWBB members are asked to note the update and provide comment on the progress made.

Implications

15. It is important that the priorities in relation to the new Local Joint Health and Wellbeing Strategy are delivered. Members need to be assured that appropriate mechanisms are in place for delivery.

        Recommendations

16. Health and Wellbeing Board are asked to note and comment on the updates provided within this report and its associated annexes.

Reason: To ensure that the Health and Wellbeing Board fulfils its statutory duty to deliver on their Joint Local Health and Wellbeing Strategy 2022-2032.

Contact Details

Author:	Chief Officer Responsible for the report:
Tracy Wallis Health and Wellbeing Partnerships Co-ordinator	Peter Roderick Director of Public Health
	Report Approved	√	Date	25.04.2024
Specialist Implications Officer(s) None
Wards Affected:					All	ü
For further information please contact the author of the report

Annexes:

Annex A: HWBB Scorecard (for Goal 7)

Annex B: HWBB Trends (for Goal 7)