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Mental health service changes achieve reduced suicide rates

Effectiveness of measures to tackle suicide compromised when staff turnover is high

Organisational changes in NHS mental health services can reduce suicide rates, although not when staff turnover is high, according to a study published today in The Lancet Psychiatry journal.

It is the first study examining the effect of 16 recommendations for improvements and changes to mental health services on patient suicide rates in all NHS mental health services in England.

The analysis by the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness at the University of Manchester took in data for 19,248 individuals who died as a result of suicide between 1997 and 2012.

The five service changes linked to the biggest falls in suicide were:

  • Increased availability of specialist community services such as crisis resolution and home treatment
  • Better management of patients with dual diagnosis 
  • Reviews with families following suicide
  • Introduction of policies to help manage young people's transition to adult mental health services
  • Implementation of NICE guidance on depression

Each of the 16 recommendations and service changes were linked with 20-30% decrease in the suicide rate, from around 12 suicides per 10,000 contacts with mental health services to approximately nine.

However, researchers also found wider organisational factors, including staff turnover, and the level of patient safety incident reports also influenced suicide rates.

Lead author Nav Kapur said: 'Our study suggests many of these interventions may prevent suicide and save lives. The data also show that at least as important as these initiatives might be the organisational context in which they are introduced.'

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