Eleven years since the publication of the suicide prevention strategy for England, the government finally has an updated policy.
“Suicide prevention in England: 5-year cross-sector strategy”, released on Monday 11 September, boasts that there has been considerable progress since its 2012 predecessor. One of the lowest years ever for suicide rates was 2017, and there has been a 35 per cent decline in suicides in mental health in-patient care between 2010 and 2020.
But the refreshed plan comes at a crisis point. Suicide is the biggest killer of men under the age of 45, and the rate across England and Wales remains stagnant, with 5,583 suicides registered in 2021. Experts fear that figure may worsen. In an open letter to the Prime Minister in December last year, 19 charities warned that the rising cost-of-living crisis could lead to a significant increase in people taking their own lives. Aside from the moral and public-health case for the government to address suicide rates, there is an economic impact to this mental health crisis. It costs more in the long term to not tackle it.
The prevention plan also made proposals for how to reduce those rates further. The government is to expand its list of priority groups for suicide prevention to include young people, autistic people, pregnant women and new mothers. The government has also noted the link between suicide and harmful gambling (which has been welcomed by gambling charities who have been campaigning vociferously on this issue), domestic violence and online safety.
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A broader cross-departmental approach is another welcome step. The government is pledging action from a number of departments in addition to the Department of Health and Social Care, including the Ministry of Justice, Department for Education and the Department for Work and Pensions. Julie Bentley, CEO of the Samaritans said the strategy “should now act as the driver to ensure this coordinated approach happens across all government departments”.
For some, however, the strategy lacks ambition. The government says it wants to reduce the suicide rate over the next five years, but has not committed to a target. Some charities remain concerned over the ability of departments to enact their pledges. Commitments to engage with experts on teaching suicide prevention in schools and training prison and parole staff are positive, but with considerable resource and staffing shortages there is a question mark over how successfully these policies can be implemented. Mark Rowland, CEO of the Mental Health Foundation, said there was a “lack of real boldness” in the strategy, and that it is in need of a “properly joined-up approach across government”.
The biggest concerns, however, are around funding. No extra money has been announced. The new strategy references an injection of £150m in mental health crisis support, including improvements to mental health infrastructure, which was announced back in January and will only last until April 2025. Further, the investment of £57m for wider suicide prevention activity through the NHS Long-Term Plan had also been previously announced. That funding will end in March 2024.
Charities are therefore unconvinced by the government’s level of commitment. Bentley dubbed the plans “a car with no petrol”, saying that “it may look great but it’s not going to get you where you need to be”, while Rowland said that “without funding, there is a real risk that this is going to be a wasted opportunity to save lives”.
The former mental health minister and architect of the original strategy, Norman Lamb, criticised the lack of priority that suicide prevention has been given over the past decade. “We have the know-how and understanding of how you can reduce suicide rates,” he said, “and yet our governments and our institutions have not given sufficient attention to it.”
Unless the implementation of such policies is prioritised, Lamb added, “nothing ever changes and people become very disillusioned with strategies that aren’t really effectively implemented.”