Mersey Care NHS Trust in Liverpool is to adopt a strategy similar to that introduced in Detroit to prevent suicide amongst patients in an at risk group.
In 2001 The Henry Ford Medical Group in Detroit began a pro active training and education programme for its staff on all issues surrounding suicide. It aimed to educate patients and their families and increased the contact staff had with patients and the families of those who were at risk.
By 2005 the suicide rate among Henry Ford’s patient population had fallen by 75%. By 2008, there were no suicides among patients of the medical group.
Mersey Care NHS Trust in Liverpool is now adopting a similar strategy.
The Trust has announced it is going to:
- create a “Safe from Suicide Team” which is a 24/7 group of experts which rapidly and thoroughly assesses patients who are having suicidal thoughts;
- improve the care of people who present with self-harm injuries at accident and emergency units, offering them therapies on the spot and following up with them when they go home;
- improve data collection on patients to get a better understanding of how and where patients are most at risk of suicide and then targeting resources at them.
Vicky Price, partner at PSG specialises in negligence in psychiatry:
“The moves this Trust is making will hopefully impact on the times when patients are in the acute stages of despair. It is not unusual for clients of mine to tell me they have gone to A & E, feeling very poorly, desperate, suicidal and have then had to wait hours in A &E, in that state, for a psychiatrist to come and examine them. Often they go home instead, without being seen. Sometimes they are assessed but are not admitted and they are sent home with follow up from the community mental health team. This could be days later if a weekend intervenes. In the meantime families and friends are left being constantly vigilant trying to support the patient, who can be highly agitated, distracted, suffering from insomnia, paranoid or extremely depressed. The only option if things do not improve is to take them back to A & E for the process to be repeated or to ring the Crisis Line or GP for advice.
A 24/7 team is crucial because many mental teams are under resourced and claim not to be able to cope with the number of patients they have to support. This can lead to a delay in assessment and leaves patients at risk. If the 24/7 team does assess patients “rapidly and thoroughly” this should improve admission times where needed and direct patients to appropriate treatment quicker. “On the spot” therapies in A & E will be beneficial, especially if they are followed up over the following days by the same team at home. Continuity of support is crucial.
I would add that educating and supporting families is also vital. Many families and friends are thrown in at the deep end with little or no understanding of mental illness. They can often feel inadequate and isolated. They need professionals to be accessible, “hands on”, guiding them on a daily basis until things improve. They need to know that they have support whenever they need it.
Mental health is crucial to everyone’s well being yet is the most under resourced and least supported area of healthcare. Suicide is the worst outcome. Hopefully the moves Mersey Care NHS Trust are making will save lives. It’s as critical as that.”