Delivering for Mental Health: plan

Early detection and intervention in self-harm and suicide prevention

A key skill for all staff working across the NHS and social care system is their ability to identify and assess individuals using their services who may be at risk of self-harm or suicide and to be aware of how to provide and obtain help and support for people.

Much has already been done to help prevent suicide in Scotland and the Executive's 10-year 'Choose Life' national strategy and action plan, which was launched in December 2002, has added additional impetus, momentum and support. The first phase of this strategy has recently been independently evaluated. The progress being made is encouraging and there is a good infrastructure both nationally and locally to build on. But there is still much to do. The evaluation highlights the importance of concentrating additional efforts on those groups at highest risk of suicidal behaviour. This includes people with mental illness.

Evidence shows that people with a mental illness are the highest 'at risk' group for suicide, with a rate of suicide 10 times that of the general population. In terms of diagnosis and risk, the most at risk groups are those with a diagnosis of severe and/or enduring clinical depression, followed by bipolar affective disorder, schizophrenia and other psychoses.

The other commitments outlined in this plan will play their part in helping preventing suicide amongst those experiencing mental illness. However, we wish to go further. In addition to this, work will also take place to extend and target suicide prevention training to those working in the frontline of mental health care services, primary care and accident and emergency services. This will concentrate on improving the assessment and management of risk of suicidal behaviour and self-harming behaviour, particularly people whose self-harming behaviour puts them at high risk of suicide. The training will provide staff with the skills and competencies to assess and respond to people at risk of suicide.

Commitment 7: Key frontline mental health services, primary care and accident and emergency staff will be educated and trained in using suicide assessment tools/suicide prevention training programmes. 50% of target staff will be trained by 2010.

National and local work will continue on suicide prevention through the continuing implementation of the Executive's 'Choose Life' strategy. The target set is to reduce the national rate of suicide in Scotland between 2002 and 2013 by 20%.

Work across the NHS helps contribute to this target and continuing support will be given by the NHS through the existing NHS Performance target for reducing suicides through Local Delivery Plans and through the NHS's role as part of local Community Planning Partnerships.

Target 2: Reduce Suicides in Scotland by 20% by 2013.

Progress is already being made towards achieving a reduction in Scotland's suicide rate. Between 2000 and 2005, there has been a 12% decrease in the overall national rate. While this figure is encouraging, it is too early to tell if there is a longer-lasting downward trend. There are still significant challenges. Scotland has a higher rate of suicide than the other countries within the United Kingdom and rates of suicide in areas of social and economic disadvantage in Scotland are almost twice those of more affluent communities. That is why the Executive and its many national partners and local Community Planning Partnerships are committed to continuing work on suicide prevention over the next few years.