The tenth of September marks World Suicide Prevention Day. On this day people are united through a global flow of energy focussed to raise awareness of suicide in an effort to save lives. Alongside this positive effort is a sad reminder of the many lives lost in the preceding year. Globally, the World Health Organization estimates around 1 million deaths by suicide per year equating to one death every 40 seconds (WHO, 2014).
The potential to come into contact with a suicidal person inside or outside of the healthcare arena is significant, given that approximately
75% of people who die by suicide are not in contact with mental health services (DH, 2014). Recognition and response to suicide therefore extends beyond the sole responsibility of mental health services requiring an appropriate interdisciplinary and community response.
In everyday situations people are silently struggling, too frightened or even ashamed to speak of their internal pain manifesting as suicidal thoughts and feelings. Primary care and community nurses are at the forefront of everyday care and are, without a doubt, in a valuable position to notice and reach out to those who are in danger of taking their own lives. Suicidal patients can hide behind a smile, conceal it in a health check or disguise it during a familiar home visit. Asking about suicide in the moment can be life changing.
However, conversations around this subject are not easy and nurses may need support. The Suicide Prevention Strategy for England specifically refers to building staff capability to respond to suicidal behaviour and thoughts. In addition Preventing Suicide in England identifies suicide prevention and awareness training in primary care, emergency care and general hospital staff as an important contribution to suicide prevention.
Although the subject is high on the public health agenda, there is no uniform approach to the implementation of recommendations throughout the UK. Recent guidance from Public Health England (PHE) regarding development of local suicide action plans suggests courses such as ASSIST, Mental Health First Aid, and STORM should be accessed. Whereas the main caring principles are shared, the focus and intensity of the training varies.
Last year PHE’s workforce development plan recommended creating a workforce committed to suicide prevention and awareness; a shift in focus as to where suicide exists or should be treated. While it is arguably the duty of every nurse to respond to human crisis however it manifests, a committed workforce requires nurturing through the correct training and care and respect of the nurses’ own lived experiences and a shared attitude that suicide is everyone’s responsibility.
Annessa Rebair is a senior lecturer in Mental Health at Northumbria University, PAPYRUS Trustee and Board member of the National Suicide Prevention Alliance Steering Group
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