Agenda item

The Committee considered a report of the Director of Transformation and Partnerships and presentation by the Principal Overview and Scrutiny Officer that provided supporting information on the findings, draft report and recommendation from the Committee’s working group review into Suicide rates and Mental Health and Wellbeing in County Durham (for copy see file of Minutes).

The Principal Overview and Scrutiny Officer gave a detailed presentation that highlighted:-

·         The Focus of the Review

·         What the working group did

·         Key findings:

·         Suicide Rates – Statistical Analysis (2012-2014)

·         National and Local Strategic Context and recommendations below:-

Recommendation one

That the County Council develop and implement a suicide prevention strategy and action plan as part of the refresh of the Public Mental Health Strategy for County Durham and that progress against the action plan be monitored by the AWHOSC.

Recommendation two

The existing suicide early alert system, whilst providing excellent support and interventions for those affected by suicide after the event, needs to develop appropriate systems to flag up those at risk of suicide and which could be used to target preventative mental health services and support to such individuals

·         NHS policies, processes and services and recommendations below:-

Recommendation three

A multi-agency approach to develop learning from suicides is needed with case conferences introduced for each incident with shared learning across partner agencies including adult and children’s social care and health services, NHS services and those within the criminal justice system.

Recommendation four

The introduction of an appropriate coding/flagging system for self- harm/attempted suicide across all A&E department attendees should be promoted which identifies those potentially at risk of suicide and allows for proactive offers of access to mental health services and support.

Recommendation five

The current processes for referral into mental health services be reviewed to ensure that there is clarity available to potential service users to help them to identify the range of services available, whether the services allow for self-referral as well as referral by health professionals and the associated target timeframes for accessing services.

Recommendation six

The accessibility of the out-of-hours mental health crisis service be reviewed to ensure that individuals suffering from crisis episodes have timely access to support and

interventions.

·         Safe Durham Partnership policies, processes and services and recommendation below:-

Recommendation three

A multi-agency approach to develop learning from suicides is needed with case conferences introduced for each incident with shared learning across partner agencies including adult and children’s social care and health services, NHS services and those within the criminal justice system.

·         Community and Voluntary Sector involvement and support and recommendation below:-

Recommendation 7

An audit of current health and wellbeing support and services within the Community and Voluntary sector be undertaken to evaluate their effectiveness and enable resources to be targeted at those interventions where demonstrable outcomes for improved mental health and wellbeing and reduced suicide risk are evident.

In summary, the Principal Overview and Scrutiny Officer highlighted that:-

·         The Review is a point in time analysis of the Suicide Rate in County Durham (2012-14)

·         Whilst the trend in respect of Suicide Rates within County Durham continue to be higher than the National Average and North East Average the gap is narrowing

·         Since the Review there have been a number of key developments in respect of work to reduce suicides and increase and promote better mental health and wellbeing across County Durham

He went on to inform Members that should the Committee approve the proposed recommendations the service grouping would be asked to respond to the findings and make further recommendations before submission to Cabinet and the Health and Wellbeing Board.  It was also suggested that the report and the recommendations be fed into the Safe Durham Partnership Board.

Councillor L Brown asked if risks had been identified where there was a family history of suicide and therefore a greater likelihood of it happening again.  The Principal Overview and Scrutiny Officer explained that the working group had identified this risk and the importance of shared learning and case conferencing with key partners.  He pointed out that the findings had shown that there was not one single identifiable risk but that this was one of many.

With regards to social isolation and the early alert system, Councillor Darkes asked where the stakeholders would pick this up.  The Principal Overview and Scrutiny Officer explained that this was the rationale behind the case conferencing with a multi-agency approach.  He added that the Fire Service could contact key partners should they identify anyone at risk.  The Chairman added that a lot of work is carried out by the Fire Service with regards to people who were isolated and lonely with links to mental health and hoarding.  This mirrored the findings within this report.

Mrs Hassoon pointed out that even when lead professionals identify those at risk and put into place care plans some service users would not take up the help and support available.

Referring to the single point of contact for children, Councillor Crute commented that the 16-24 age group was vulnerable with the transition to adulthood and the review group had found that it was difficult to signpost people to the right service.  He said that the multi-agency hub would be beneficial.  The Principal Overview and Scrutiny Officer referred to evidence presented to the group from Mike Brierley, Head of the Concordat, who referred to the need to develop the single point of contact however highlighted the complexities of navigating through the system of services available.

The SAB Business Manager welcomed the case conference approach as there was an opportunity for the Safeguarding Adults Board to link in to this piece of work.

The Director of Public Health reported that there were a huge range of issues to prevent suicide and her team were looking at the rates in key risk groups and developing in depth areas of work.  She added that it was important to support mental health and wellbeing via a wide range of specialist services.  She reported that feedback on these areas would be included within the response to the recommendations.

The Chairman commented that a lot of concern had been expressed during the review, experienced by all agencies, about crisis interventions.

Referencing the Safe Durham Partnership, Councillor Crute said that there had been greater integration with the Probation and Prison services and he asked if they were involved with the review.  He was concerned about those services not commissioned.  The Principal Overview and Scrutiny Officer confirmed that at the time of the review national changes to the Probation Service meant that they had not been included within the review. However, they were a key partner within the Safe Durham Partnership and would be engaged through that mechanism.

The Chairman was concerned about the figures relating to young men committing suicide and understood one of the reasons to be around relationship breakdowns.

The Director of Public Health advised that one the prevention methods was to carry out activities within schools to make young people aware that they could talk about their feelings.  The Wellbeing for Life Service also carried out a broader piece of work which would be covered in the response to the review.  She added that funding to AAPs had been increased to support this area of work.

Councillor Quinn commented that drugs and alcohol were a common problem with those people who felt that suicide was the only option.  The Principal Overview and Scrutiny Officer confirmed that this was included in the main body of the report and had been identified as a factor in the TEWV report.  Street triage had been introduced to specifically deal with people who were incoherent due to drugs and alcohol and at risk of harming themselves.  Mental health and physical health were identified in the review as a real issue and was linked to the key findings.

The Chairman commented that this triage service was working well in the Durham area, which helped people into hospital rather than being in the justice system.

The Director of Public Health gave a detailed presentation highlighting the update of current activity in relation to suicide prevention (for copy see file of Minutes):-

·         Where are we at now – graphs including information on

·         Mortality from suicide and undertermined injury

·         Suicide rates over time

·         Information on the current activity

At the conclusion of the Director of Public Health’s presentation, members were advised that the information detailed therein would be incorporated into a detailed service grouping response which would be included in the report to Cabinet.

The Chairman thanked the Director for Public Health for her presentation and placed on record his thanks and appreciation on behalf of the Committee to the Principal Overview and Scrutiny Officer for the superb work carried out in finalising the key findings and recommendations.

Resolved:

(i)            That the report be received;

(ii)          That comment on the report and the presentation including the key findings and draft recommendations be noted;

(iii)         That the report be submitted to Cabinet and the Health and Wellbeing Board for consideration, and the Safe Durham Partnership Board for information, be agreed.