Agenda item

This paper provides the Board 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.

The Director of Public Health and Public Health Specialist Practitioner Advanced Partnerships and Early Intervention presented an 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%”.

The Director of Public Health introduced the item, stating that Goal 7 and therefore this report, addressed actions 16, 17 and 18 of the action plan. He noted that action 17 was being delivered by the York Centre for Voluntary Service (CVS) and invited the Chief Executive of York CVS to contribute in addition to the two presenters. He also stated that the first year action was around the audit and the second year would be around refreshing and relaunching the Suicide Safer Community Strategy. He noted that a year into the Joint Health and Wellbeing Strategy we are on course but are not fully making an impact yet; Childrens Mental Health, Alcohol and Suicide indicators within the JSNA which should typically show green, were currently showing yellow or red and these should remain a priority for partners.

Public Health Specialist Practitioner Advanced Partnerships and Early Intervention presented the update on actions noting that goal 7 suicide data was discussed on pages 42-43 of the report, and this showed reductions of just under 20% which while not statistically significant, were moving in the right direction.

She acknowledged that some typographical errors remained in the suicide audit - action 16 - which would be amended before this was published online.

She stated that this was deliberately a retrospective report, hence the figures dating from 2021-22. The reason for this was the need to look at situations specifically confirmed as suicides post-coronial report and not speculating whether or not any particular instance might be considered suicide. While the data may not seem that current she confirmed that these statistics reflected suicide figures post-covid.

She advised that the authority previously had one steering group for suicide and mental health, and that this had now been split. She also stated that work was being undertaken across North Yorkshire and the City of York, offering a combined approach which gave a broader holistic picture.

She also credited Menfulness, Healthwatch York and York MIND for their work on actions 16 and 18 and indicated that the intention was to assemble a tangible action plan going forwards.

She introduced the Yes Project (Action 17) conducted together with York CVS, as part of the forward strategy to reduce stigma and bring good mental health into the city.

The Chief Executive, York CVS further discussed the Yes Project, stating that it was about good mental health, and that a film (“The WHY film” www.WhySuicidePrevention.co.uk) had been made by champions with the message that talking about suicide saves lives. She urged partners to get in touch if they would like CVS to present the film for them.

The board asked for clarification about whether references to those in the report contacting their GP around the time of suicide represented a statistically significant/higher than average level of contact with GP.

The Public Health Specialist Practitioner Advanced Partnerships and Early Intervention stated that the audit sought to source markers and flags from the coronial report or police report – and whether someone had recently attended a Mental Health appointment counted as one of these; this was why this data was included. She conceded that the published data did not distinguish whether the GP attendance related to a Mental Health issue or any other (possibly unrelated) health issue and as such this should be considered a correlative rather than causative factor.

The board asked whether there should be a content warning on the audit before wider publication, and also signposting for bereavement support and to organisations such as Samaritans. The Public Health Specialist Practitioner Advanced Partnerships and Early Intervention advised that while there was already a general warning note within the report, some editorial alterations were already required and she would be more than happy to make the requested additions and to take guidance from partners regarding the wording.

The board asked whether more young people contemplating suicide had come forward for help specifically during the pandemic, and if so had the impact of Covid now lessened or ended? The Public Health Specialist Practitioner Advanced Partnerships and Early Intervention deferred to front-end responders, stating that she did not personally have this data. The Director of Operations and Transformation, TEWV NHS Foundation Trust responded that within the general population the majority of people who attempted suicide had not had recent contact with Mental Health Services, and it was really more about education and prevention. The Director of Public Health noted the lag due to retrospective nature of the audit needing to take into account the coronial report, meant that it was difficult to fully appreciate where we stand regarding statistics and people’s Mental Health post-pandemic.

The board asked whether the authority was still training people in Mental Health First Aid: The Chief Executive, York CVS responded that CVS was undertaking these and also ASIST training for the voluntary sector due to the work they undertake. The Director of Public Health added that suicide prevention training, ASIST (the full course) and SafeTALK (the shorter version) are still conveyed by York Mind but unfortunately they were no longer funded programmes.

The board raised concerns about young people’s mental health deteriorating over the past decade and how this may become a concern as these young people turn 18. The Director of Public Health advised that 2000s figures were 800,000 - 900,000 2010s up towards 1,000,000.

Addressing several points raised, the Director of Public Health clarified:

·        It was generally understood to be incorrect that people taking their life are at an acute point in a mental health crisis being seen regularly, and only 1 in 4 are under secondary mental health care (although a greater number may be on the primary care register).

·        41% of these people had seen their GP recently, but of the general population, many people see their GP regularly and it was important to distinguish causality vs correlation.

·        Income and background were significant contributory factors; suicidality increased the further down the income spectrum one was and ending stigma should be a focus here; communities such as Autism/ADHD spectrum and LGBTQ+ were also statistically more likely to commit suicide.

The board noted the Director of Public Health’s comments regarding the significant increase in neurodiversity among the population, particularly young people. The Corporate Director, Childrens and Education advised that the audit would be used to inform his team’s trauma informed practice.

The board asked whether there were any more predictive powers within the data in terms of looking at frequency of use of these services. The Director of Public Health stated that trying to predict here was not easy as suicide was an area where there are a lot of false positives; instead systems such as SafeTALK and ASIST engender a culture in which professionals have courage to talk. He highlighted that this was not just healthcare/medical professionals but also organisations such as Network Rail who do an exceptional job of training staff to talk to people. The Public Health Specialist Practitioner Advanced Partnerships and Early Intervention added that she was working with Network Rail and factoring their data into statistics.

Resolved: That the Health and Wellbeing Board noted and commented on the updates provided within this report and its associated annexes.

Reason: To ensure that the Health and Wellbeing Board fulfilled its’ statutory duty to deliver on one of the ten big goals within the Joint Local Health and Wellbeing Strategy 2022-2032.