No More Suicide in Bolton How Can you make a difference No More Suicide in Bolton How Can you make a difference? Michelle loughlin, Assistant director of public health May 2017

Today’s Discussion… Suicides in Bolton, what do we know? What are we doing about it? How do we make a difference?

Suicides in Bolton What do we know?

Suicide as a local priority Every Suicide represents a personal tragedy and a potentially preventable loss of life In Bolton Suicide Prevention is a Priority for Health & Wellbeing Board Locality Plan – Population Health Programme Safeguarding Children’s Board Local Partners Greater Manchester Suicide Prevention Programme People’s familes, friends, partners, colleagues….

Data: Official Suicide Rate in Bolton Recent peak 2006-2012; Now comparable to England – around 26 per year; Fallen from 3rd highest to 58th highest suicide rate in the country - Improving.

Audit: Who? 75% are Men; BME- No specific pattern; Widening Inequality - Twice as many suicides from most deprived communities! MOST DEPRIVED LEAST DEPRIVED

Audit: Suicides by Age Average Age is around 45 years; Under 18s – a high priority for local Children's Safeguarding Board and the Suicide Prevention Partnership.

Who’s at Risk? Risk factors associated with local suicides History of mental health problems (54%); Self-harm (40%); Living alone (39%); History of violence (27%); Unemployed (20%); Alcohol misuse (22%); Drugs misuse (14%).

Audit: The geography of Bolton’s Suicides Areas of Deprivation White British Communities No evidence of ‘Hot Spots’ The influence of deprivation and the under-representation of Bolton’s BME groups, means the pattern geographically is focused on our most deprived areas that are also predominantly White British.

Audit: The Method of Bolton’s Suicides Hanging/strangulation - just over half, varies by gender; Overdose accounts for a fifth; 77% of suicides occur at home. Male Female Historically, hanging/strangulation is generally associated with male suicides. In Bolton hanging/strangulation has accounted for 40% of female suicides, but over the last three years this has increased to around 80% with an associated reduction in female overdoses.

Audit: Primary Care contact Approx. half of people made their last primary care contact <1 month before suicide

Audit: Secondary care contact 44% had some contact with secondary mental health services; Evidence of previous self-harm and past suicide attempts is found in the hospital records of a significant number of people.

Audit: Trigger events Most suicides are associated with being male and or deprivation; ‘Trigger events’ in an adults life immediately prior to suicide in Bolton cases included: Break-up of a serious relationship; Redundancy/recent unemployment; Child taken into care; Key points of interaction with secondary care mental health services – admitted onto caseload, discharge from services; Bereavement; Terminal diagnosis. Children & Young People – eg Exams, bullying, abuse, family illness, bereavement, loss, isolation

Suicide in Bolton - What Are We Doing About It? Analysis of data to identify local priorities Establishment of a multi-agency suicide prevention group. Development of a suicide prevention strategy/action plan; ALL in progress in Bolton

Discussion: How Do We ALL Make a Difference? Some Emerging themes for action: Local Ambition – No More Suicide in Bolton! Targeting our support High Risk Men in deprived areas with risk – job loss, bereaved, previous attempts Children and Young people ‘at risk’ Children and Young People’s Mental Health & Resilience Training for front line staff – primary care, MH services Communication, campaigns and pathways to support Data and Info sharing