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The Wales Suicide and Self-Harm Prevention Action Plan

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The Wales Suicide and Self-Harm Prevention Action Plan Midpoint review of the implementation of Talk to me 2: the Wales suicide and self-harm prevention action plan Authors: Professor Ann John, Professor of Public Health and Psychiatry, Swansea University, Hon. Consultant Public Health Wales; Dr Chukwudi Okolie, Research Officer, Swansea University and Public Health Wales; Sian Price, Head of the Evidence Service, Public Health Wales Date: 15th March 2018 Version: Final Publication/ Distribution: Welsh Government Review Date: Not applicable Purpose and Summary of Document: Welsh Government asked Public Health Wales and Swansea University to undertake a review of the implementation of Talk to me 2 - the Wales suicide and self-harm prevention action plan, 2015-2020. This document provides a report of this review. It includes an update on the epidemiology of suicide and self-harm in Wales, a report on progress against the actions set out in Talk to me 2, a content analysis of currently available local plans and makes recommendations on the way forward with regard to suicide and self-harm prevention in Wales. Public Health Wales Midpoint review of Talk to me 2 Table of contents Acknowledgements ........................................................................... 4 1. Executive summary ................................................................... 5 1.1 Background and purpose ......................................................... 5 1.2 Methodology .......................................................................... 5 1.3 Implementation of the action plan ............................................ 6 1.4 Current epidemiology in Wales ................................................. 6 1.5 Progress against actions in Talk to Me 2 .................................... 7 1.6 Conclusions ........................................................................... 7 1.7 Recommendations .................................................................. 8 2. Background and purpose ........................................................... 9 2.1 Methodology .......................................................................... 9 2.2 Scope of the strategy and action plan ..................................... 10 3. Implementation of the action plan ............................................. 11 3.1 Role of Welsh Government .................................................... 11 3.2 Role of Public Health Wales .................................................... 11 3.3 Role of the National Advisory Group for Suicide and self-harm prevention .................................................................................. 12 3.4 Local implementation ............................................................ 12 4. Current epidemiology in Wales ................................................. 13 4.1 Wales ................................................................................. 17 4.2 Wales in comparison with other UK nations .............................. 17 4.3 Trends in suicides in Wales .................................................... 18 4.4 Suicide in Wales by age and sex ............................................. 20 4.5 Trends in suicide in Wales according to areas of deprivation ...... 22 4.6 Suicide by area within Wales ................................................. 23 4.7 SID-Cymru .......................................................................... 24 4.8 Admissions for self-harm in Wales .......................................... 25 5. Progress against objectives in Talk to Me 2 ................................ 28 5.1 Objective 1 - Further improve awareness, knowledge and understanding of suicide and self-harm amongst the public, individuals Date: 15/03/18 Version: Final Page: 2 of 64 Public Health Wales Midpoint review of Talk to me 2 who frequently come in to contact with people at risk of suicide and self-harm and professionals in Wales .............................................. 28 5.2 Objective 2 - To deliver appropriate responses to personal crises, early intervention and management of suicide and self-harm ............ 29 5.3 Objective 3 - Information and support for those bereaved or affected by suicide and self-harm ................................................... 31 5.4 Objective 4 - Support the media in responsible reporting and portrayal of suicide and suicidal behaviour ...................................... 32 5.5 Objective 5 - Reduce access to the means of suicide ................. 33 5.6 Objective 6 - Continue to promote and support learning, information and monitoring systems and research to improve our understanding of suicide and self-harm in Wales and guide action ...... 35 6. Assessment of current situation ................................................ 37 6.1 The scope of the action plan .................................................. 37 6.2 Implementation ................................................................... 37 6.3 Epidemiology ....................................................................... 38 6.4 Progress .............................................................................. 38 6.5 Progress since last mid-point review ....................................... 39 7. Conclusion ............................................................................. 39 8. Recommendations to Welsh Government ................................... 40 8.1 Immediate........................................................................... 40 8.2 Longer term ........................................................................ 41 Appendix I Terms of reference National Advisory Group ...................... 43 Appendix II Current membership National Advisory Group ................... 44 Appendix III Inclusion of action to prevent suicide and self-harm in local action plans and strategies in Wales ................................................. 45 Appendix IV Contents of local prevention strategies mapped against National Advisory Group Guidance on suicide prevention planning ........ 46 Appendix V Progress against the actions in Talk to me 2 ...................... 50 References .................................................................................... 64 Date: 15/03/18 Version: Final Page: 3 of 64 Public Health Wales Midpoint review of Talk to me 2 Acknowledgements This document has been compiled following a request from Welsh Government that Public Health Wales and Swansea University undertake a review of the implementation of Talk to Me 2, the Wales suicide and self- harm prevention action plan, 2015-2020. Public Health Wales Observatory, with particular thanks to Rhian Hughes, Holly Walsh, Victoria Middleton, Miriam Moules, Beth Patterson and Zoe Strawbridge, and Marcos Del Pozo Banos at Swansea University Data conducted the data analysis. Thanks also to the members of the National Advisory Group on Suicide and Self-harm who commented on the draft. Professor Ann John Chair of Wales National Advisory Group on Suicide and Self-harm Prevention Date: 15/03/18 Version: Final Page: 4 of 64 Public Health Wales Midpoint review of Talk to me 2 1. Executive summary 1.1 Background and purpose In 2009 Welsh Government published Talk to Me a five year national action plan to reduce suicide and self-harm in Wales [1]. A review of progress undertaken in 2012 by Public Health Wales [2] found that, although there had been good progress in some of the commitments, the inclusion of a large number of supporting actions in the plan was felt to have reduced focus on delivering actions specific to suicide and self-harm prevention. The report of the review contained a series of recommendations. One was that action should be taken to enhance the involvement of health boards, local authorities and a broad range of other organisations named in Talk to Me. Following the review, the Minister for Health and Social Services asked The National Advisory Group to Welsh Government on suicide and self-harm prevention to redraft the plan. The finalised strategy and action plan Talk to Me 2, was launched in July 2015 and addresses the period of 2015 to 2020. Public Health Wales and Swansea University were asked to undertake a review of the implementation of Talk to Me 2 and provide a report to Welsh Government by the end of February 2018. This document sets out the report of this review. 1.2 Methodology This review has four elements: • An update on the epidemiology of suicide and self-harm in Wales. • A report of progress on the actions set out in Talk to me 2 including progress since the last review. • A content analysis of currently available local suicide prevention action plans. • Recommendations on taking forward action to prevent suicide and self-harm within Wales developed by Public Health Wales through discussion with its National Advisory Group on suicide and self-harm prevention. Date: 15/03/18 Version: Final Page: 5 of 64 Public Health Wales Midpoint review of Talk to me 2 1.3 Implementation of the action plan Implementation of Talk to Me 2 follows a ‘3Cs’ approach, one that is cross-governmental, cross-sectoral and collaborative, with shared responsibility at all levels of the community. Talk to Me 2 stated that: • Welsh Government would provide national leadership and oversight of the implementation and evaluation of Talk to Me 2. • High-level engagement would be facilitated at health board and local authority level through the Welsh Government. • Where actions involve matters that are not devolved, the Welsh Government would engage with the relevant UK Government Departments to ensure a collaborative
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