Hansard

I am pleased to open the debate on behalf of the Scottish Government.

As the motion says,

“significant progress ... has been made in recent years in suicide prevention”.

In 2012, there were 762 deaths by suicide in Scotland. We all want that number to be lower but the 2012 figure nevertheless represents a welcome decrease on the number of suicides in 2011. In 2012, as in each of the previous two years, we saw one of the lowest levels of suicide in Scotland since 1991. The three-year rolling average rate shows that, between 2000 and 2002, and 2010 and 2012, there has been an overall downward trend in suicide rates, with an overall decrease in Scotland of 18 per cent.

That progress reflects the priority that I believe the Scottish Government and the Scottish Parliament have given suicide prevention and mental health in the work that they have done since devolution. The Parliament has given attention to suicide prevention and to the wider mental health policy agenda for a significant number of years, and that has been widely recognised by many people outwith Scotland.

The motion also says that

“there is still work to be done to reduce suicides further”.

In December 2013, we published our new “Suicide Prevention Strategy 2013-16”. The intention is to build on previous work, while setting out commitments and actions for the next three years.

I will talk about what has been achieved already and the firm basis on which we have built our new commitments. I will also talk about how we developed our new suicide strategy and the importance of basing practical actions on established and emerging evidence to benefit people who are at risk of suicide and those who care for them.

As members are aware, “Choose Life”, a 10-year suicide prevention strategy and action plan, was published in 2002. At the end of 2012, we formed a working group to consider our future strategy and action on the prevention of suicide and self-harm. With the working group and a reference group, we developed an engagement paper to support progress on developing a new strategy for the prevention of suicide and self-harm. From February to May last year, several engagement events took place across the country at which stakeholders, including interested members of the public, had the opportunity to feed in their aspirations for a new phase of suicide prevention action in Scotland.

The engagement paper prompted discussion on a range of key issues at the engagement events and in the many written responses that were received. Those responses helped to inform the preparation of our new strategy on the prevention of suicide—I will say a little bit more about that later.

First, it is worth reflecting on some of the progress that has been made in suicide prevention over recent years by people working in a range of sectors across Scotland. As I said, in 2012, as in each of the previous two years, we saw one of the lowest levels of suicide in Scotland since 1991, and since 2000 to 2002 there has been an overall downward trend in suicides, with an overall decrease of 18 per cent. That means that we have achieved most of the planned reductions in suicide rates as set out in the choose life strategy.

Looking to the future, I mentioned that our engagement paper prompted discussion on a range of key issues, both at the engagement events and in the many written responses that we received. The comments received were considered by my officials, the working group and the reference group.

Through those deliberations, we have developed a robust new suicide prevention strategy for Scotland. I had the pleasure of launching the strategy last month when I addressed the annual stakeholders forum, which was organised by NHS Health Scotland’s choose life programme team. The strategy contains 11 commitments across five themed areas: responding to people in distress; talking about suicide; improving the national health service response to suicide; developing the evidence base; and supporting change and improvement.

Our purpose in the strategy is to focus on a number of key areas for future work that we believe will continue the downward trend in suicide in Scotland that we have seen over the past 10 years. We want the strategy to deliver better outcomes to people who are suicidal and who come to services; to their families and carers; and to those who are not in contact with services. We also want to ensure that we improve our knowledge of what works in this complex field.

We acknowledge that there is a broader focus on activities that are not directly related to suicide prevention but which, if taken forward effectively, will contribute to reducing the overall suicide rate. Such activities include building resilience and mental health and emotional wellbeing in schools and in the general population; working to reduce inequality, discrimination and stigma; and promoting good early years services.

All that work is undertaken in the context of being vigilant about improving mental health; supporting people who experience mental illness; and preventing suicide. The strategy continues the trend in previous strategies of focusing on where the evidence leads us. The strategy echoes key messages—learned from practice and research—that suicide is preventable; that it is everyone’s business; and that collaborative working is key to successful suicide prevention.

Members may recall that the engagement paper covered prevention of suicide and of self-harm. However, after taking into account the views that were received in the engagement process and the deliberations of the working group and the reference group, we have taken the approach that our strategy should focus on suicide prevention. Although it covers self-harm as a risk factor for suicide, it does not specifically deal with support for people who self-harm as a coping mechanism.

We will undertake separate work this year on supporting people at risk of self-harm, including those in distress. That will link with the commitment in the mental health strategy to develop an approach that focuses on improving the response to distress. As many members will know, we are working with NHS Tayside and other partners to develop a shared understanding of the challenge and the appropriate local responses that can engage and support people who are experiencing distress, and to provide support for practitioners.

I mentioned the importance of following the evidence. A growing evidence base has emerged in recent years that suggests that there are practical actions that we can take to reduce suicide. For example, improving the NHS response to suicide, which is one of our five themes, is based on evidence from a range of sources such as the Scottish suicide information database, or ScotSID, and the national confidential inquiry into suicide and homicide by people with mental illness.

As well as pointing to the actions that can be taken in the NHS setting to support people who might be at risk of suicide, ScotSID has thrown up challenges that we need to look at further. For example, those who died by suicide tend to have had fairly extensive contact with a range of healthcare services, including general practitioners, accident and emergency departments and acute hospitals. ScotSID also throws up the fact that, at the time of death, many people are receiving some form of medication that is used in the treatment of mental illness. We have therefore set out commitments on ways in which the NHS can focus on effective treatment that brings benefits to patients.

Analysis from the confidential inquiry has already informed safety improvements for patients, prioritised attention to follow-up for patients after discharge from hospital and supported a focus on actions to tackle problems around drinking and drug use. We have a strong, internationally recognised research community in Scotland, which stands us in good stead as we move forward with the aim of continually improving the evidence base on suicide and on how we can support people who are at risk.

Like the choose life strategy, the new strategy has a strong focus on services, but it is not intended to replace existing population-based health work that many people and agencies have been doing to help prevent suicide in Scotland. We expect many of the elements of the suicide prevention action plan that is set out in the strategy to continue alongside the work that is already taking place as part of the choose life legacy. Indeed, one commitment in the new strategy is that NHS Health Scotland will continue to host the choose life programme. The national programme will, among other responsibilities, continue to provide leadership and direction to local choose life co-ordinators. We are committed to working closely with NHS Health Scotland, the see me campaign and other agencies to develop an engagement strategy to influence public perception about suicide and the stigma surrounding it.

The way in which we talk about suicide is important. We know that talking openly about suicide in a responsible manner saves lives. We have adopted that approach through the choose life campaigns—“Suicide. Don’t hide it. Talk about it” and “Read between the lines”—and we will continue to campaign in that way during the period covered by the new strategy. It is also important to continue to challenge the media misconceptions that sometimes still arise about suicide and suicide numbers and rates in Scotland.

Suicide prevention remains a significant challenge, but progress over the past several years has been encouraging. We are proud of what we have achieved collectively so far in Scotland in improving the population’s mental health and services for people who experience mental illness, and in significantly reducing the suicide rate. Our new suicide prevention strategy reflects the high priority that we attach to that agenda. The strategy reflects a changing landscape, but we still need to ensure that we have the right commitment and energy to implement it and to continue to make progress. The strategy builds on existing successful suicide prevention work and sets out new commitments that are based on emerging evidence on the risk factors that are associated with suicide.

I look forward to seeing further progress being made in the coming years. I know that practitioners and others across numerous services and agencies will continue to approach the work with the dedication and commitment that they have shown in recent years. I am confident that we in the Parliament have a shared objective of continued improvement in suicide prevention in Scotland, and I have no doubt that all members will want to support our aim of achieving that objective.

I move,

That the Parliament recognises the pain experienced by families and friends who have lost loved ones through the tragedy of suicide; notes the significant progress that has been made in recent years in suicide prevention, with an overall decrease of 18% in the suicide rate in the last decade, and in supporting people who have been bereaved through suicide; agrees that there is still work to be done to reduce suicides further, and therefore welcomes the publication of the new Suicide Prevention Strategy 2013-2016, which builds on previous and continuing work and establishes the priorities and actions for suicide prevention over the next three years in support of a healthier and fairer Scotland.