Calls to improve crisis care as number of suicides by mental health patients increases

Mental health experts and charities have called for improvements to crisis care after new figures revealed that the number of suicides by mental health patients in England increased significantly in 2011.

Figures from by the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCI), produced by The University of Manchester, found that the number of suicides among mental health patients in England climbed to 1,333 in 2011, an increase of 158 year-on-year.

The increase in suicides is being largely attributed to the current economic climate and experts and charities have called for more to be done to support people with mental illness with debts, housing and employment issues.

The research team say safety efforts need to focus on patients receiving home treatment where there has been a rise in suicide deaths in recent years. Combined with a fall in the number of inpatient suicides, there are now twice as many suicides under home treatment as in inpatient care.

In addition, the NCI revealed that the number of homicides committed by mental health patients fell to 33 in 2010, a 10-year low. This fall is attributed to safer patient care and the possible effect of better treatment of drug and alcohol problems as well as new legal powers in the community.

Louis Appleby, director of the NCI and professor of psychiatry in the Institute of Brain, Behaviour and Mental Health at the University of Manchester, said:  “It is welcome news that patient homicides are falling and reflects well on the safety measures taken by mental health staff. These are early trends and the precise causes are unknown but they may reflect better care for “dual diagnosis” patients - those with both mental illness and alcohol or drug misuse. The introduction of new Community Treatment Orders may also have played a part.

“The increase in suicide among mental health patients is in line with an increase in the general population and is mostly likely due to the current economic circumstances. Although these are only early indicators, it would suggest services should try to address the economic difficulties of patients who might be at risk of suicide. Ensuring patients receive advice on debts, housing and employment could make a difference, while improvements in home treatment should now become a priority for suicide prevention. Particular caution is needed with home treatment for patients who live alone or are reluctant to accept treatment.”

Getting help to those in crisis

Paul Farmer, chief executive of mental health charity Mind, added: “Every life lost is a tragedy that affects families, friends and whole communities. These figures show clearly that, when in crisis, people with mental health problems are far more likely to harm themselves than they are to harm someone else and, while it is good news that homicides have dropped so dramatically, the increase in suicides is deeply concerning. 

“The current economic climate, unemployment and benefits cuts are likely to be having an impact but we know too that people in a mental health crisis aren’t always getting the help and support they need from the services there to support them. Mind’s own research has shown that, in many parts of the country, crisis care teams are under-resourced, understaffed and overstretched.

“Good services can make a huge difference to whether someone recovers from a mental health crisis, yet we often hear from people who have been turned away because they ‘aren’t suicidal enough’ or who have been made to wait for hours to be assessed and offered help. When people in crisis don’t get the help they need, the consequences can be catastrophic.

“This is important research shining a light on the number of vulnerable people that are taking their own life but further assessment of the data is needed so that we can see if this is an early warning sign of a long term trend.  Budgets for mental health services have been cut for the second year running and this could be a worrying indication that cuts are now having a serious impact. The government needs to be investing in mental health now more than ever, particularly if they are to achieve true parity of esteem between physical and mental health.”