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Abstract
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Recent data indicate that there were 5275 deaths by suicide in England in 2022 (at a rate of 10.6 per 100,000 (95% CI: 10.3-10.9)) with no evidence of declines since 2020, a year after the publication of the 2019 Long Term Plan, which made suicide prevention a priority for the National Health Service (NHS).1,2 This has led to the Department of Health and Social Care publishing a new cross-sectoral strategy for suicide prevention for England in September 2023.3
This new strategy aims to reduce the rates of suicide in England over the next five years, targeting an initial reduction within half this time.3 It was informed by discussions with key stakeholders and seeks to reduce suicide rates by supporting investments through the NHS, voluntary sector and community sector in population-level interventions addressing social isolation and loneliness, targeting support to high-risk groups, reducing access to means of suicide and the provisioning of real-time clinical and social data to support frontline decision making for at-risk patients. The strategy is much broader than those previously formulated as evidenced by, for example, plans to support employers in prioritising employee wellbeing, unlocking investments from the private and third sectors, and improving training across the justice system.
Primary care is highlighted as a setting where people at risk of suicide need to be better supported, echoing calls from the World Health Organization, which has emphasised the vital role primary care has in reducing rates of suicide.4
But how can primary care help lower suicide rates? The National Confidential Inquiry into Suicide and Safety in Mental Health identified that suicides recorded in primary care records were associated with high consultation rates and undiagnosed mental illness.5 A study of linked electronic healthcare records (EHR) across primary and secondary care in Wales found that in 71% of deaths by suicide the last healthcare contact was in general practice.6 Of middle-aged men who died by suicide, 43% had a general practitioner consultation in the three months before suicide, and over half presented with a mental health problem.7 Rates of self-harm coded in UK general practice EHR have been increasing over time, in particular for young people, and especially teenage girls in early coronavirus disease 2019.8,9 This evidence indicates an opportunity to identify high-risk individuals in the primary care setting early, and target personalised support to unmet need. ...
Language: en |