1. Suicide Prevention in
Mersey Care NHS Trust
Steve Morgan
Director of Patient Safety

2. Suicide Trends in Mersey Care 2005-2011
(Suicide rate and Suicide Numbers)
1-2005 ,2 -2006 ,3 - 2007 ,4 -2008 ,5-2009 ,6 - 2010 , 7 -2011
Series 1 - Rate per 100,000 , Series 2 - Actual Numbers.

3. Age Distribution - Suicides 2011
Age Distribution –Males

4. Age Distribution - Suicides 2011
Age Distribution –Females

5. Marital Status
Diagnosis, Method Used and Month of Suicide

6. Suicide – Primary Diagnosis

7. Method of Suicide against Gender
Series 1-Males , Series 2 - Females , X axis - Numbers

8. Overdose – Source of Medication
1 - Prescribed medications , 2 - Prescribed Medications and Alcohol.

9. Month of Suicide

10. Past history of Self Harm
1-h/o previous self harm , 2- No h/o previous self harm.

11. Past history of Mental Health problems
1 - Past h/o mental health problem, 2 – No Past h/o mental health problem

12. Suicides in patients recently discharged from hospital/CRHT/under
CRHT (<3 months) care
1 - Recent Discharges from inpatient unit (<3months)(n=3)
2- With CRHT at the time of suicide (n=3)
3- Recent Discharge from CRHT (<3months)

13. Patients last seen by services before death

14. Number of professionals seen in the last year preceding death
Series 1 - CMHT , Series 2 - CRHT

15. Number of missed contacts in the last year preceding death

16. Re: Henry Ford, Suicide Prevention System
‘Depression Care Initiative’ commenced in 2001
The Henry Ford Health Systems Behavioural
Services provides a full continuum of mental health
and substance misuse services through a range of
integrated delivery systems: -
Two hospitals
10 clinics
500 employees
The organisation provides care for South East
Michigan and adjacent states.

17. Results
• During the first four years of the programme deaths
within the department dropped by 75% - to 22 per
100,000 from 89 per 100,000.
• They implemented very rapid suicide investigations
(2 weeks) - probably combining investigation and
debriefing with a clear focus on implementation of
outcomes.
For a similar population the expected figures would be
230 /100.000 population. During the period 2008 –
2010, no deaths from suicide were undertaken by
patients in their care.

18. Dr Ed Coffey the lead clinician believes that the success
of the programme lies in a shift in thinking and culture.
The key components of the new ideology are: -
None acceptance that people would kill themselves.
Pursuing perfection.
Need to know what perfect care for depression would
look like.
Care process is made up of two distinct parts.
Assessing service user’s risk for suicide, the assessment
identifies if individuals are an Acute / Moderate / Low risk.
Implementing measures to reduce that risk.
Ideology of Service provision

19.  Staff identify if service users have weapons at home 
Service users encouraged to remove these.
 Staffs have to undertake a course on suicide prevention
and have to achieve a 100% pass rate or receive
additional education.
 Checking along the pathway that practices have been
carried out is a consistent process.
 Each level of risk identified has a clear set of interventions
attached to it.
 Provision of Cognitive Behaviour Therapy for all patients
on the pathway .
Key focus for Care

20. AIM
Reducing incidents of suicide by service users who
are registered as Mersey care Trust service user
(will include those service users who are assessed)
by 100% over 4 years: -
25%: 2014 ~ 2015
25%: 2015 ~ 2016
25%: 2016 ~ 2017
25%: 2017 ~ 2018
Improvement in Suicide Prevention

21. Improvement in Suicide Prevention
Key Primary Drivers / Work Schemes
 Understand evidence internally and externally
 Treatment of Depression
o Pathways of Care for Depression
o Effective pathways for high risk groups
 Pathway Re: Suicide Prevention (Patient Safety
Pathway)
o Improve identification of suicidal patients

22. Improvement in Suicide Prevention
Key Primary Drivers / Work Schemes
 Enhance knowledge and skills of all clinical staff
 Transitions of Care / Co-ordination
 Engagement with carers
 Staffing / Resources
 Primary Care Interface