Agenda item

To consider an update presentation on suicide prevention work in Rotherham.

Consideration was given to an update presentation in respect of suicide prevention work in the Borough, presented by the Cabinet Member for Adult Social Care and Health and Consultant in Public Health. The presentation described how over the past year the Borough had seen a reduction in suicide rates for men in Rotherham, which brought the rate for Rotherham statistically similar to the national average. The rates for women had not decreased, however, since the last report in September 2022. The rates for women in the South Yorkshire and Humber region had increased, which was an area of concern. Rotherham’s overall position had improved when compared to statistically similar neighbours. The presentation noted that government had recently announced voluntary sector grants for suicide prevention work. The Service would work with the voluntary sector partners to support grant applications.

The presentation illustrated how the Service responded to risk factors with task and finish groups and how this focus is led by real time data provided by the South Yorkshire surveillance system that is coordinated by South Yorkshire Police. This system is a replication across South Yorkshire of good practice that originated in Rotherham. Bereavement support to families throughout South Yorkshire continued to be delivered through the Amparo Service, which would soon be recommissioned as it was nearing the end of the contract term. This Service going forward would be an all-age service. Monitoring of trends information provided by the coroner informed the local action plan. Sessions with the media and work with a group in Doncaster had been done to look at work within prisons.

South Yorkshire local authorities, Chilipep, Amparo, and South Yorkshire Police entered the Local Government Chronicle awards and won in the category for public partnership. The toolkit app they developed was seen as a scalable resource that can be used elsewhere. This was the first time a resource had been designed by speaking with young people about what would help support them when they are bereaved by suicide. This toolkit had been sent out to all colleges, schools, childcare providers, early help, and to the NHS.

In discussion, Members sought further insight regarding men who were previously unknown to services and those who were known to services but who may not have been sufficiently reached by them. Members requested assurances that early intervention was an approach being taken system-wide, as there were concerns that waiting times for therapies to nonmedical treatment could result in increased reliance on primary care. The response from the Consultant in Public Health described work to get the messaging right for men in particular in their 40s and 50s. Three men’s talking groups were active across the borough. It was known that some individuals were not even registered with a GP, particularly from Eastern European communities. This presented a challenge to their knowing how they can access services. The emphasis was on collective responsibility and getting people trained to provide that initial support which was very important to accessing services. Suicide Prevention training within organisations was ongoing to build up skill in knowing what signs to look for and confidence in having these important conversations.

Members also sought to understand the issues that led to the increase relating to women and the key services that people were interacting with. The response from the Cabinet Member and the Consultant in Public Health described that work was going on, but in some categories, the numbers were going up. It was felt that more information was needed, for example, in relation to work with people in and leaving prison. It was noted that suicide was an outcome that does not always follow on from issues. It was possible, for example, that there could be even more prevented than previously. A significant number of people who take their own lives had not had any contact with services, so initiatives like the ‘BE The One’ programme which increase involvement in the services were important. It was not possible to unpick any person’s situation and say what could have been done. It was very hard to get evidence of effectiveness, at a Rotherham, national or international level. The current data looks at the bigger cohort of cases. The presentation of data could also be very identifiable, so it was necessary to be circumspect about how information around suicide was presented. Something else that the Service was interested in was how people felt about their experience in contact with services.

Members sought additional information on whether data was captured regarding attempts. The response from the Consultant in Public Health noted that data limitations around groups, for example relating to geographical areas, which would be helpful. The Service was working with Local Authorities to achieve this. The National Strategy and data provided a sense of themes. It was noted that December was a time of the year when there is increased risk. Where the person had been in contact with services such as housing, Adult Social Care, or domestic abuse, there would be a serious incident review. Generic case studies were reviewed to help those services understand where additional support might be provided. Sometimes people are clear regarding their determination; asking people directly was important. There was a safeguarding lead for adult services within the Council. Members expressed interest in an additional session to explore where there could be additional interventions.

Members sought additional information around pathways for people who ring 999. The response from the Director of Public Health noted that since the last update, there had been a policy change. Assurances were provided that this pathway had been developed, and safeguards were in place. There had been a policy change to ‘Right Care, Right Person’ which was being implemented. Under the policy, the police response does not include following up when a person has made the decision not to attend an adult care appointment where this reflects individual choice and there is not a threat to life. The next phase of implementation was set to continue into early 2024, as timescales were being clarified. It was noted that this could be an area where scrutiny could add value as part of the next year’s work programme. The Deputy CEO also noted that people did come into the urgent and emergency care centre in some instances. South Yorkshire Police officers had been extremely supportive during the process of getting the patient into the right setting.

Members expressed interest in receiving more information which could inform delivery of council functions, such as licensing. There was a desire to know more about how the Service works with places attended by people who may not access services. The response from the Consultant in Public Health affirmed the importance of thinking outside the box to extend the reach of the offer into additional kinds of communities. For this reason, the Service had a coordinated strategy for targeted interventions. The Director of Public Health further noted that life events such as relationship breakdown, finances or homelessness were a few of the risk factors. Therefore, the awareness training was part of the Better Health and Work Programmes to extend the reach of the training as widely as possible. The Consultant in Public Health provided as an example the targeted work with retailers in the areas where there had been increasing numbers.

More information was requested around work with Housing Services. The response from the Director of Public Health noted that housing officers were skilled in understanding the challenges faced by many people who are in accommodation that was not ideal for them. Additional support provided by the Housing Service was described.

Members sought additional information around how the new national strategy would impact the local plan. The response from the Cabinet Member and the Consultant in Public Health noted that most of the things were included in the local plan, although, the local suicide prevention groups had not yet met since the national strategy was so recently published. Post-intervention and bereavement support was felt to be already strong locally, in line with the Strategy. The Strategy also addressed self-harm, which was included in the local action plan, with a framework currently in development. 

Members sought further understanding of local risks in Rotherham. The response from the Consultant in Public Health noted that the rate among males had come down, very close to the national average, which was felt to be significant and welcome progress in the right direction. There was less national research to explain the rise in the rate for women. It was understood that the pandemic had a massive impact on women’s mental health and in suicide where women have been under control and coercion. At the Place level and also across the Yorkshire and Humber Region, female deaths were a concern. This was not unique to Rotherham only, but it was a focus of the Service.

Members requested further clarification around how the figures of suspected suicides were compiled. The response from the Consultant in Public Health described the role of partners such as police or TRFT. Only the coroner was able to make the determination whether a death was a suicide. Prior to this, it could not be called or recorded as suicide. Furthermore, in any attempted suicide, the first intention was to help the person. A person may not declare their motives. This also applied to drug-related deaths. The data showing what was happening across South Yorkshire was helpful to the Service in enhancing understanding.

Members sought additional assurances around the response of the Service to help women, given that the numbers for women were the highest in 19 years. The response from the Consultant in Public Health noted this was something the Yorkshire and Humber Region were struggling with in the absence of national research. Themes of work in Rotherham had included raising awareness of domestic abuse. However, the long-term effect of the pandemic on women’s mental health could not be known. Areas of support work had focused on carers to promote wellbeing where there is risk of isolation. It was felt that more national evidence was needed, and it was believed that the wider implementation of the new national strategy would bring about more information.

Members proposed a workshop session to build in-depth understanding of the information and data basis for the interventions, noting the limitations around identifiable and attempted suicide. It was desired that housing, early help, homelessness and other services of the Council contribute to the workshop regarding their role in the interventions. There was also a desire for greater understanding of the equalities issues, and issues for younger community members, which could be contributing to the picture for Rotherham. The response from the Director of Public Health welcomed a further conversation around the scope of the workshop, and the Consultant in Public Health and the Cabinet Member welcomed the opportunity to provide further information around how the Service was delivering against the national strategy.

Resolved:-

1.    That the presentation be noted.

2.    That a workshop be planned within the next six months to explore the role of Council services in suicide prevention.