Recipient organisationAvon and Wiltshire Mental Health Partnership NHS TrustSource-published name: Avon and Wiltshire Mental Health Partnership NHS Trust
Funding£1.8M
PeriodApr 2012 — Mar 2018
In plain English
AI plain-English summary
Around 4,500 people die by suicide and 200,000 attend hospital for self-harm in England each year. This programme aims to cut those numbers by giving the National Suicide Prevention Strategy better evidence on three pressing issues: how economic hardship drives suicide risk, how to improve care for people who self-harm, and how to reduce access to lethal methods. The researchers will analyse national data and interview people whose self-harm followed job loss, compare different risk assessment tools across hospitals, study coroners’ records for new gassing methods such as charcoal burning, and calculate which medicines are most dangerous in overdose. If successful, the work will produce practical guidance for NHS services—for example, which risk assessments work best, how to manage patients with advance decisions, and what support parents of young people who self-harm need. It will also identify which groups are most vulnerable during recessions and which suicide methods are rising, so that prevention efforts can target them directly. The findings are intended to be taken up immediately by policymakers and clinicians, not left on a shelf.
View original technical description
Aims & objectives: Our overall aim is to reduce suicide rates in England by informing the National Suicide Prevention Strategy. We will investigate three issues of importance in the care of people who are at risk of suicide: how best to reduce the impact of the economic crisis on suicide, the care of people who self-harm and reducing the lethality of available suicide methods. Background: Suicide is a major cause of premature mortality, with around 4,500 suicides and 200,000 hospital attendances for self-harm every year in England. Previous self-harm is one of the strongest risk factors for suicide; unemployment and easy access to high lethality suicide methods are the most potent influences on suicide rates. Research plans: The complex antecedents to suicide and challenges to intervening appropriately require a programme of linked, mixed methods research studies:a) The recession and suicide risk: we will i) analyse national & local data on suicide and self-harm to determine who is at greatest risk during the recession and ii) carry out qualitative interviews with 30-40 people whose self-harm was precipitated by job loss or economic difficulties to understand how recession can influence self-harm. b) Improving self-harm services: we will i) investigate the effectiveness and cost effectiveness of different forms of risk assessment in preventing repeat self-harm by comparing outcomes using cross sectional and cohort analyses across hospital services; ii) systematically review the literature on the management of self-harm patients presenting with advance decisions and, using focus group and expert panels, develop clinical guidance for their management; iii) use qualitative methods to investigate the impact of self-harm by young people on parents to determine their needs and develop helping resources. c) Identifying and reducing access to lethal suicide methods: we will i) study the records of 12 coroners to identify whether the use of new and high lethality methods of suicide by gassing (e.g. charcoal burning, hydrogen sulphide) is increasing; ii) calculate drug-specific fatal toxicity indices using available databases to identify medicines associated with high fatality in overdose. Research team: The co-PIs are leading researchers in suicidal behaviour and members of the National Suicide Prevention Strategy Advisory Group. Three of the team are NIHR Senior Investigators. Co-investigators are managers, clinicians, service users and researchers from the NHS Trusts local to the Universities in Bristol, Oxford and Manchester. Our team has a range of complementary disciplinary backgrounds (psychiatry, public health, nursing, social science) and research expertise (health economics, qualitative methods, biostatistics and epidemiology). Programme Management: The three PIs will have collective responsibility for the programme; each component will be lead by a named centre. The research group will meet annually to present findings and review progress and the PIs and core researchers will meet four times per year to monitor project milestones. Each component will have weekly operational meetings. Research environment: The host and collaborating NHS organizations each currently run over 100 research projects, including several programme grants. The collaborating University Departments were all highly ranked in RAE 2008. Two of the centres are hubs in the Mental Health Research Network. Resources available to the applicants include: data from the National Confidential Inquiry into Suicides and Homicides; the self-harm registers of Oxford (1976-present) and Manchester (1997-present) and an extract of the Hospital Episode Statistics Database.Anticipated outputs, outcomes and impact on the health of patients, public, & the NHS: We will: characterise the people most at risk of recession-related suicide and develop interventions for them; develop guidance on self-harm risk assessment tools and the management of people presenting with advance de
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