Recent research into suicide risk and prevention in specific vulnerable groups

Transcription

1 Recent research into suicide risk and prevention in specific vulnerable groups NSPA Members Meeting 2 May 2018 Dr Alexandra Pitman Senior Clinical Lecturer UCL Division of Psychiatry

2 Suicide prevention strategy U.S. Department of Health & Human Services, 2001 Department of Health, 2002 Department of Health, 2012

3 National Suicide Prevention Strategy for England (DH, 2012) Objectives: A reduction in the suicide rate in the general population in England; Better support for those bereaved or affected by suicide.

4 National Suicide Prevention Strategy for England 2012 Areas for Action 1: Reduce the risk of suicide in key high-risk groups 2: Tailor approaches to improve mental health in specific groups (CYP, LGBT, BAME groups) 3: Reduce access to the means of suicide 4: Provide better information and support to those bereaved or affected by suicide 5: Support the media in delivering sensitive approaches to suicide and suicidal behaviour 6: Support research, data collection & monitoring.

5 Suicide prevention priorities specific occupational groups (AfA 1) LGBT youth (AfA2) people with access to lethal means (AfA 3) people bereaved by suicide (AfA 4; Objective 2)

6 SPECIFIC OCCUPATIONAL GROUPS

7 Occupational groups at risk: men (ONS, 2017) Low-skilled labourers esp construction workers Skilled builders, esp plasterers, painters, decorators culture, media and sport occupations (esp those working in artistic, literary & media occupations) carer workers and home carers

8 Occupational groups at risk: women (ONS, 2017) elementary trades occupations culture, media and sport occupations (esp those working in artistic, literary & media occupations) health professionals, especially nurses primary & nursery school teachers carer workers and home carers

9 LGBT YOUTH

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11 Summary of paper at The Mental Elf Pitman & Rowe (2017) Sexual orientation and suicidal behaviour: what are the specific risk factors for suicidality in young LGB people?

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13 Risk factors risk of suicide attempt & suicide lot of attention on bullying as RF but evidence suggests: being open with families about sexual orientation being called a cissy or tomboy by parents parental psychological abuse family history of depression & suicidality childhood gender atypicality

14 PEOPLE WITH ACCESS TO LETHAL MEANS

15 At risk groups People with chronic illness People with cancer People with chronic pain Opioid users Carers for people with chronic illness All have access to potentially lethal medications

16 PEOPLE BEREAVED BY SUICIDE

17 Risk of suicide & suicide attempt risk of suicide & suicide attempt in people bereaved by suicide relatives & non-relatives stigma scores (Pitman et al, 2014; Pitman et al, 2016a; Pitman et al, 2016b)

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19 Spouses (Erlangsen et al, 2017)

20 Parents - especially mothers (Qin & Mortensen, 2003)

21 Possible explanations genetic factors (even in peers) shared social adversity loneliness / loss of a confidant(e) psychiatric illness (PTSD, mood disorders) family breakdown substance use stigma stigma stress stigma help-seeking stigma offers of help suicide suggestion (social modelling, contagion)

22 All three groups described stigmatising social awkwardness. The death taboo in relation to sudden deaths is particularly marked after suicide.

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24 Screening for psychiatric illness

25 Help is at Hand, 2018

26 UCL Maxine Roper Support After Suicide Partnership Judi Meadows Memorial Fund Co-produced resource Free download Hard copies available