Agenda item

Report ACH24-023

The Public Health Intelligence Analyst presented the Bromley Suicide Audit, A Trend Analysis 2024 to the Board.

The Bromley Suicide Prevention Steering Group met regularly and were responsible for developing a Suicide Prevention Plan with an accompanying action plan. A link to the current plan had been provided and progress had been made on the action plan in relation to pathways, training, raising awareness and sharing of good practice. The Bromley Suicide Prevention Plan 2019-2024 and the action plan were due for renewal and update, ready for publication in 2025 – in preparation, the Public Health Intelligence Team had conducted a review and audit of the Suicide and Self-Harm data for the borough. Conclusions drawn included:

-  suicide rates in Bromley fluctuated annually, averaging around 21 suicides per year, requiring continuous prevention efforts;

-  men were disproportionately affected by suicide, while intentional self-harm rates were higher among women and young people;

-  common suicide methods in Bromley included hanging, strangulation, or suffocation, emphasising the need for targeted interventions;

-  hospital admissions for intentional self-harm were highest among girls aged 0 to 18 years, necessitating early intervention;

-  there was an increase in intentional self-harm admissions among individuals from "Black" or "Other" ethnic backgrounds;

-  older residents (aged 65 and over) with fewer self-harm admissions were at higher risk of subsequent suicide, requiring tailored support; and,

-  deprivation was associated with hospital admissions for intentional self-harm, particularly in specific wards like Penge and Cator and Cray Valley East, highlighting the need for targeted interventions.

In response to questions, the Public Health Intelligence Analyst advised that other demographics could be considered, however there was currently only very limited data available on sexual identity and disability. With regards to statistics on the number of people who died by suicide being known to services, some had access to mental health services however the level of support received would need to be investigated further. The Member noted that this would be useful to monitor – a key area was prevention and if already known to services consideration should be given as to whether the support provided was adequate. A Board Member noted that acute mental health services would record each suicide within their service and therefore may be able to provide some data in relation to this. The Director of Public Health advised that the data received for the audit was anonymised – in the past there had been an agreement with the Coroner’s Office to look at each record in depth, however this had been stopped nationally. It was noted that the department had links to other partner organisations and social care colleagues – mental health was one of the risk factors of suicide and they would actively seek to widen the work undertaken to inform the Suicide Prevention Plan.

In response to questions regarding the connection between self-harm and suicide, the Public Health Intelligence Analyst advised that self-harm data was included to give an indication of the risk of suicide – the number of suicide rates in the borough were low and a breakdown of self-harm was included to provide a better understanding of the age groups at risk. The Director of Public Health said that people who self-harmed had a significantly higher risk of suicide, and was something that needed to be monitored. As the number in the borough were small they needed to be cautious about the conclusions drawn from the data as the variations could be significant. With regards to children and young people, the LBB Consultant in Public Health Medicine had undertaken a lot of work in relation to this as part of the Children’s Joint Strategic Needs Assessment and this was being reviewed by the Children’s Executive. It was noted that one of the priorities of the new Health and Wellbeing Strategy was children and young people’s mental health.

The Director of Nursing – PRUH and South Sites advised that, in relation to self-harm, they saw a number of young adults presenting at the Emergency Department. Following this, they were referred to mental health colleague – sometimes they were already known to services, but this was not always the case. From that point the mental health pathways were implemented, and the individuals were not discharges until the required checks were completed or plans were in place. In terms of older age groups, self-harm presentations and ED were seen less frequently. There would be patients admitted to hospital with a physical illness and a concurrent mental health illness – it was therefore key that they maintained a close relationship with Oxleas to ensure patients were in the right place at the right time for their presentations. In relation to the report provided, the Director of Nursing – PRUH and South Sites highlighted the work undertaken with schools and the importance of providing them with the right support for children and young adults.

The Director of Children’s Social Care said he was pleased to see the school-based programme included and suggested that the Youth Services also be included in any further engagement work. In terms of next steps, he was keen for any links between young people’s self-harm/suicide and gender identity and sexuality to be explored.

A Member noted the implementation of school-based prevention and suggested that the report also be presented to the Children Education and Families Policy Development and Scrutiny Committee.

A Board Member noted the rise in intentional self-harm admissions among individuals from "Black" or "Other" ethnic backgrounds and questioned if this was a trend being seen locally and nationally, and the drivers behind it. The Director of Public Health advised that further information could be provided by the Consultant in Public Health following the meeting. In response to a further question, the Director of Public Health said that there was an active suicide prevention working group, the membership of which included representatives from voluntary agencies. The next steps would be to refresh the Bromley Suicide Prevention Plan and Action Plan which would be presented at a future meeting.

A visiting Member enquired if any work had been undertaken in relation to anniversary suicide. The Director of Public Health confirmed that one case had been report and a lot of work had been undertaken by the Consultant in Public Health and colleagues in the other local authority. This was one of the risk factors identified and they had followed up with the families. In response to a further question, it was confirmed that the Consultant in Public Health wanted to widen the plan to also look at the correlation between suicide and social isolation and loneliness as this was another risk factor.

In response to questions, the Public Health Intelligence Analyst advised that a summary report on someone that died by suicide would sometimes provide information regarding any previous attempts – this was the most common risk factor.

The Chairman thanked the Public Health Intelligence Analyst for the presentation to the Board. It was noted that the Bromley Suicide Prevention Plan and Action Plan would be presented at a future meeting.

RESOLVED that:

i.)  the findings and recommendations from the Bromley Suicide Audit report be noted; and,

ii.)  the refresh of the Bromley Suicide Prevention Plan and Action Plan, taking regard to the findings and recommendations of the Bromley Suicide Audit 2024 and the National Suicide Prevention Strategy 2023, be agreed.