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Safer services: a toolkit for specialist mental health services and primary care: 10 key elements to improve safety
- Author:
- NATIONAL CONFIDENTIAL INQUIRY INTO SUICIDE AND HOMICIDE BY PEOPLE WITH MENTAL ILLNESS
- Publisher:
- University of Manchester
- Publication year:
- 2017
- Pagination:
- 10
- Place of publication:
- Manchester
This toolkit presents quality and safety statements about clinical and organisational aspects of care and is intended to be used as a basis for self-assessment by specialist mental health care providers. This version has been updated to include evidence from most recent data, and new statements about working with carers. The statements cover: safer wards; care planning and early follow-up on discharge from hospital to community; no out-of-area admissions for acutely ill patients; 24 hour crisis resolution/home treatment teams; community outreach teams to support patients who may lose contact with conventional services; specialised services for patients with mental illness and co-morbid alcohol and drug misuse; multidisciplinary review (working with carers); implementing NICE guidance on depression and self-harm; personalised risk management, without routine checklists; low turnover of non-medical staff; psychosocial assessment of self-harm patients; safer prescribing of opiates and antidepressants; diagnosis and treatment of mental health problems especially depression in primary care; and additional measures for men with mental ill-health, including services online and in non-clinical settings. (Edited publisher abstract)
National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. Annual report: England, Northern Ireland, Scotland and Wales. October 2017
- Author:
- NATIONAL CONFIDENTIAL INQUIRY INTO SUICIDE AND HOMICIDE BY PEOPLE WITH MENTAL ILLNESS
- Publisher:
- University of Manchester
- Publication year:
- 2017
- Pagination:
- 132
- Place of publication:
- Manchester
Presents data and analysis on suicide, homicides and sudden unexplained deaths in the UK between 2005 and 2015, focusing on mental health. As well as providing data for the individual countries of the UK, it also provides UK-wide data for suicide in people with eating disorders, autism spectrum disorders, people living with dementia, carers and members of the armed forces. The report also makes recommendations for clinical practice to improve safety in mental health care. Key findings show that there were 1,538 patient suicides in the UK in 2015. Northern Ireland has the highest general population suicide rate, while the rates in the other countries have fallen. There have also been downward trends in the number of suicides by patients recently discharged from hospital in England and Scotland; and suicide by mental health in-patients. Messages to improve mental health care include a renewed emphasis on suicide prevention on in-patient wards; for services to build on the recent fall in suicide following discharge from in-patient care; and for a greater focus on alcohol and drug misuse as a key component of risk management in mental health care. (Edited publisher abstract)
National Confidential Inquiry into Suicide and Homicide by People with Mental Illness: making mental health care safer. Annual report and 20-year review
- Author:
- NATIONAL CONFIDENTIAL INQUIRY INTO SUICIDE AND HOMICIDE BY PEOPLE WITH MENTAL ILLNESS
- Publisher:
- University of Manchester
- Publication year:
- 2016
- Pagination:
- 107
- Place of publication:
- Manchester
Presents findings from 2004 to 2014 providing the latest figures on suicide, homicide and sudden unexplained deaths, and highlighting the priorities for safer services. The report shows that while suicide by mental health in-patients continues to fall, there are now around three times as many suicides by crisis resolution/home treatment patients as in in-patients, over 200 per year, although there has been no further increase in 2014. The report suggests that CRHT may not have been a suitable setting for care of some patients and raises concerns that CRHT has become the default option for acute mental health care because of pressure on other services, particularly beds. The report finds that the first three months after hospital discharge continue to be a period of high suicide risk. In addition, the analysis shows that many people who died by suicide had a history of drug or alcohol misuse, but few were in contact with specialist substance misuse services. More patients who died by suicide were reported as having economic problems, including homelessness, unemployment and debt. In England the number of homicides by people with schizophrenia appears to have risen since 2009, though the numbers are small. Most patients who committed homicide had a history of alcohol and drug misuse. This was found in all UK countries but was more common in Scotland and Northern Ireland. (Edited publisher abstract)
Suicide by children and young people in England
- Author:
- NATIONAL CONFIDENTIAL INQUIRY INTO SUICIDE AND HOMICIDE BY PEOPLE WITH MENTAL ILLNESS
- Publisher:
- University of Manchester
- Publication year:
- 2016
- Pagination:
- 20
- Place of publication:
- Manchester
An examination of suicides in England by people aged under 20 years who died between January 2014 and April 2015. This is the first phase of a UK-wide investigation into suicides by people aged under 25. The data was collected from a range of investigations by official bodies in England and no new investigations were conducted. The study identified relevant antecedents prior to suicide from these investigations. There were 145 suicides and probable suicides by children and young people in England in the study period. The suicide rate in this age group is low overall but is highest in the late teens. The majority of deaths were in males (70 per cent). Many young people who die by suicide have not expressed recent suicidal ideas and an absence of suicidal ideas cannot be assumed to show lack of risk. The ten common themes and associated factors in suicide by children and young people include: family factors such as mental illness; abuse and neglect; bereavement and experience of suicide; bullying; suicide-related internet use; academic pressures, especially related to exams; social isolation or withdrawal; physical health conditions that may have social impact; alcohol and illicit drugs; and mental ill health, self-harm and suicidal ideas. The study concludes that agencies that work with young people can contribute to suicide prevention by recognising the pattern of cumulative risk and ‘final straw’ stresses that leads to suicide. Improved services for self-harm and access to CAMHS are crucial to addressing suicide and there is a vital role for schools, primary care, social services, and youth justice. (Edited publisher abstract)
National Confidential Inquiry into Suicide and Homicide by People with Mental Illness annual report 2015: England, Northern Ireland, Scotland and Wales
- Author:
- NATIONAL CONFIDENTIAL INQUIRY INTO SUICIDE AND HOMICIDE BY PEOPLE WITH MENTAL ILLNESS
- Publisher:
- University of Manchester
- Publication year:
- 2015
- Pagination:
- 95
- Place of publication:
- Manchester
Presents data and analysis on suicides and homicides in the UK between 2003 and 2013, focusing on mental health. Suicide figures show different patterns across the UK countries, with higher rates in Scotland and Northern Ireland and a recent rise in England and Wales. Key messages include: the rise in suicide among male mental health patients appears to be greater than in the general population - suicide prevention in middle aged males should be seen as a suicide prevention priority; it is in the safety of crisis resolution/home treatment that current bed pressures are being felt – the safe use of these services should be monitored and providers and commissioners (England) should review their acute care services; opiates are now the most common substance used in overdose – clinicians should be aware of the potential risks from opiate-containing painkillers and patients’ access to these drugs; families and carers are a vital but under-used resource in mental health care – with the agreement of service users, closer working with families would have safety benefits; good physical health care may help reduce risk in mental health patients – patients’ physical and mental health care needs should be addressed by mental health teams together with patients’ GPs; sudden death among younger in-patients continues to occur, with no fall – these deaths should always be investigated and physical health should be assessed on admission and polypharmacy avoided. (Edited publisher abstract)
The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness: annual report: England, Northern Ireland, Scotland and Wales
- Author:
- NATIONAL CONFIDENTIAL INQUIRY INTO SUICIDE AND HOMICIDE BY PEOPLE WITH MENTAL ILLNESS
- Publisher:
- University of Manchester
- Publication year:
- 2014
- Pagination:
- 156
- Place of publication:
- Manchester
This report provides key figures on suicide, homicide and sudden unexplained death in patients under mental healthcare between 2002 and 2012 in the countries of the UK. The report examines rates and trends by country, gender, and diagnostic and treatment profile of patients. There were 18,017 patient suicides between 2002 and 2012 in the UK, 28 per cent of suicides in the general population during this time. The report shows that mental health patients are at their highest risk of dying by suicide in the first two weeks after leaving hospital. Hanging remains a common method for suicide with an increase in this method. Between 2002 and 2012 828 people convicted of homicide in the UK have been confirmed as mental health patients, on average 75 per year. The report highlights areas of mental health care where safety should be strengthened through the contribution of mental health providers, partner agencies, commissioners, education and training bodies and professional organisations. It suggests that care of patients on hospital discharge should be a priority; there should be a re-examination of the portrayal of hanging in the media; mental health services should play a stronger role in protecting victims of domestic violence by ensuring perpetrators receive treatment for mental disorder, including substance misuse; crisis resolution and home treatment should be a priority setting for suicide prevention; services should continue to address patients’ co-morbidities through the use of assertive outreach, and through better provision for alcohol and drug misuse and ‘dual diagnosis’; services should aim to reduce the need for restrictive interventions; and deaths and serious injuries caused by restraint should be considered as an NHS ‘never event’ in England and Wales. (Edited publisher abstract)
Patient suicide: the impact of service changes: a UK wide study
- Author:
- NATIONAL CONFIDENTIAL INQUIRY INTO SUICIDE AND HOMICIDE BY PEOPLE WITH MENTAL ILLNESS
- Publisher:
- University of Manchester
- Publication year:
- 2013
- Pagination:
- 18
- Place of publication:
- Manchester
The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCISH) aimed to examine the relationship between mental health service changes and patient suicide rates in the UK. The specific objectives were to investigate: the take up of service changes over time; the association between the number of service changes implemented and suicide rates; the association (Edited publisher abstract)