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Well? Mental Health and Wellbeing in Scotland: September 2002

The rate of suicide in Scotland is higher than it's ever been. Taking collective responsibility is a key first step in working to make a difference.

Reducing suicide rates in Scotland
The Challenge facing the implementation of a new national framework

"Suicide touches the lives of many people. Many of us will know of someone who has attempted or completed suicide, maybe someone close to us. We may ourselves have contemplated it. Tackling suicide in Scotland is not only about providing better and more accessible help for people who are in distress. Nor is it only about putting safety barriers to stop people jumping from bridges, although these steps are both very important in themselves. It is also about creating a greater awareness of suicide as an issue of concern for us all that we need to bring out into the open. The development of the National Framework for Reducing Suicide as one part of the overall National Programme's work is a really significant opportunity for us to recognise what can be done to create a society in Scotland which is supportive and inclusive and enables people to thrive."
Mary Mulligan, MSP and Deputy Health Minister with responsibility for both Mental Health and Health Improvement

The suicide rate amongst men in Scotland is now 75% higher than it was at the start of the 1970s. Currently over 600 people kill themselves every year and there are around 10,000 admissions to hospital following episodes of deliberate self-harm.

These are startling statistics, which is why the National Programme for the Improvement of Mental Health and Well-Being in Scotland has placed the reduction of suicide as an issue firmly at the centre of its agenda.

There is currently no definitive answer as to why such a sharp increase has resulted over a relatively short period of time, but according to Pat Little, a member of the Scottish Executive's Planning Group for the National Framework for the Reduction of Suicide, increasing pressures and the changing structure of society are both significant factors.

"Life is very different now from the way it was 30 years ago," says Pat, who is also the Scottish development manager for Young Peoples' Services for Penumbra. "Back then, men in particular were more sure of their role, they were the breadwinner and most likely would work in manual or physical jobs. There's been a rapid change in the position of women in society, but no equivalent adapting for men."

This is highlighted by the fact that the suicide rate is higher for men than women. But gender is not the only factor and the inability to communicate and changes in social environments all play their part. "Family units are now much less structured, so there's less support for people who might be susceptible to mental health problems and be experiencing distress" explains Pat.

Reduced access to the means to take your own life has also had an effect. Changes to the packeting of paracetamol impacted on the number of suicides and attempted suicides by paracetamol overdose, while a similar effect was recorded when less noxious gas was introduced in domestic ovens.

But this is just the tip of the iceberg and the National Framework for the Reduction of Suicide puts forward a number of strategies to address these issues both at a national and local level. These include the promotion of good mental health and well-being, alleviating risk conditions, earlier identification and intervention and, of course, prevention.

Professor Stephen Platt, Director of the Research Unit in Health, Behaviour and Change at the University of Edinburgh stresses the importance of a broad-based approach to the problem: "There is no single way to reverse the upward trends in suicide amongst young men. Research evidence suggests that a collaborative effort and a range of actions and interventions at many levels - individual, family, community and society - is required."

Professor Platt is also a member of the Scottish Executive's National Planning Group on Suicide Reduction and is a member of the National Programme's Advisory Group. He has been closely involved in the development of the draft Framework issued for consultation in October 2001. Professor Platt has observed that:

"Following consultation on the draft national framework (which ended in January 2002) local agencies, statutory and voluntary bodies, health, social work and community workers and others have been continuing to meet, plan and develop measures to reduce suicide and deliberate self harm. This local activity is helping to bring the issues out into the open, enabling a more collaborative examination of existing services and supports, and a joint and integrated way of planning for the future."

Pat Little has also detected some positive action "I'm extremely heartened by the response to the consultation so far. People are realising that we can no longer leave the responsibility for this to a single agency or profession, like the NHS, psychiatrists or social workers, for instance. We have to take collective responsibility for this, a multi-level and multi-interest approach."

CONTACTS
The National Framework for the Reduction of Suicide
National Planning Group Secretariat

Gavin Russell
Scottish Executive Health Department, Public Health Division.
Tel: 0131 244 2588
E-mail: gavin.russell@scotland.gsi.gov.uk

Pat Little, Penumbra
Tel: 0131 475 2380

Penumbra is a Scottish Voluntary Organisation working in the field of mental health which provides a range of community-based services for people with mental health problems.
www.penumbra.org.uk

Professor Steve Platt
Director, The Research Unit in Health, Behaviour and Change, University of Edinburgh
University of Edinburgh Medical School
Tel: 0131 650 1000

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