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Suicide prevention toolkit for healthcare staff launched

by Julie Griffiths
11 September 2023

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A toolkit has been published by NHS England to help health employers reduce the risk of suicide among staff.

Working Together to Prevent Suicide in the NHS Workforce: A National Suicide Prevention Toolkit for England sets out how to identify healthcare staff at risk of suicide and what to do about it (see box).

The toolkit follows NHS England’s guidance published in July on supporting NHS staff who have been affected by a colleague’s suicide.

The document provides information and resources so practice managers can signpost staff to support. And it provides examples of good organisational practices in preventing suicide among staff working in healthcare, as well as recommendations on developing suicide prevention strategies.

The toolkit said that, ‘given that one in five adults experience suicidal thoughts and feelings during their life, it was likely that there would be many healthcare staff struggling to cope in the workplace’.

And it pointed to evidence that some healthcare professionals – doctors, nurses and dentists – are at a higher risk of suicide than other professional groups.  

For example, female healthcare workers have a risk of suicide 24% higher than the female national average, which is largely explained by the high suicide risk among female nurses (who have a 23% higher rate of suicide than other women).

Female doctors are also considered to be at a higher risk of suicide than the general population.

Meanwhile, the guidance said that men remain the most at-risk group within the general population and are three times more likely to die by suicide than women. The highest rate of suicide in men is among those aged between 50 to 54 years.

The NHS staff survey 2022 revealed that ‘high levels of physical violence, harassment, bullying and abuse experiences in the last twelve months’ are contributing to workplace stress, the toolkit also explained.

‘Association between burnout, moral injury and suicide also means it is likely that healthcare staff are at an increased risk of suicidal ideation,’ it added, while explaining that the pandemic and cost of living crisis have also negatively affected mental health among the NHS workforce, adding to the risk of suicide.

The guidance recommended that NHS organisations develop suicide prevention strategies that ensure staff are aware of the support options available to them and consider cultural sensitivity, being mindful that not all colleagues will talk about and experience mental ill-health in the same way.

Meanwhile, the Government has also launched a strategy to prevent suicide in the general population, which will include a focus on safe prescribing in general practice and perinatal mental health.

It has pledged to reduce England’s suicide rate within two and a half years, with a focus on ‘specific groups at risk of suicide’, including children and young people, middle-aged men, autistic people, pregnant women and new mothers.

The strategy said that the RCGP is in the process of revising its curriculum and will assess where guidance on safe prescribing may be strengthened to reduce risks associated with the prescribing of certain medicines.

Identifying a member of staff at risk of suicide

The following signs do not necessarily mean the person is thinking of suicide but may indicate that they are struggling, the newly launched toolkit says. Look out for:

Changes in productivity 

  1. Deterioration in performance at work
  2. Lethargy in a previously energetic person
  3. New pattern of unexplained lateness or absence
  4. Recent inability to concentrate at work
  5. Recent inability to complete work

Changes in social functioning

  1. Deterioration in social functioning
  2. Withdrawal from colleagues/isolation

Changes in personality or behaviour 

  1. Extreme mood swings
  2. Acting anxious or agitated
  3. Showing rage, uncontrolled anger
  4. Behaving recklessly
  5. Increased alcohol or drug use – including prescription medicines
  6. Changes in eating and sleeping patterns
  7. Signs of self-inflicted physical harm

The toolkit also sets out how to respond in a crisis:

  1. If self-harm is imminent make sure the person is not alone and call for help.
  2. Stay with the person until professional help arrives.
  3. Encourage the person to talk but do not promise confidentiality.
  4. Ask the person if there is anyone they would like to speak to.
  5. Follow the policy (if there is one) to let someone know what is happening and who will follow up.
  6. Seek support for yourself such as accessing restorative clinical supervision.