PACTS conference: Reducing suicides on UK roads, 19th October 2017

PACTS conference: Reducing suicides on UK roads, 19th October 2017

Speaker presentations

Suicide prevention – a multi sectoral challengeRuth Sutherland, Chief Executive, Samaritans

Suicides on UK roads – lifting the lid. PACTS’ research findingsKaty Harrison, Policy Officer, PACTS (Full report here)

Suicide classification in road traffic accident records – an important part for intervention in Sweden  – Dr Anna-Lena Andersson, Special Adviser – Traffic Safety, Swedish Transport Administration

What do we know about suicide? – Prof Ann John, Swansea University

Reducing suicide on the Strategic Road Network – Tim Holland, Suicide Prevention Policy Lead, Highways England

Images and sound bites from the ‘Reducing suicides on UK roads’ conference, organised by PACTS, which took place on 19 October.

  • Session One: Preventing suicides in the UK – Overview of policy and research
  • Session Two: Reducing suicides on the road
  • Session Three: Perspectives from other sectors
  • Session Four: The Way ahead

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Session four


15.20 – The way forward
  • Improved data collection
  • Information awareness/learning
  • Round table to surface themes
  • Take it up with Government as an important issue
  • ‘Time to change’ campaign – destigmatising mental health – individuals and organisations can sign a pledge to become a champion in the workplace
  • ‘Mental Health First Aid’ scheme
  • Access to road network very different to rail and air – need to think outside the box to address this issue.

Session three


13.40 – Perspectives from other sectors – panel discussion

Featuring:

  • Richard Burnett, Road Haulage Association
  • Dr Rob Hunter, BALPA
  • Ian Stevens, National Rail
  • Mark Smith, British Transport Police

Richard Burnett, Road Haulage Association
“You are shining a light on a problem none of us were aware of in terms of its scale”
“I’m staggered by how much information there isn’t”
“HGV drivers are in the front line of this issue”
“The more we can ‘normalise’ this issue, the better”

Dr Rob Hunter, BALPA
“The suicide patterns for pilots outside the cockpit are similar to the wider population”
“The number of people on the flight deck is reducing (now typically two) and there is talk of having just one – what are the safety implications of that?”

Ian Stevens, National Rail
“Suicide is a really big issue for our customers”
“Some drivers involved in suicides never come back to work”
“We need to look at this issue upstream and away from the railway”
“We look to protect our assets and support the communities we work within”

Mark Smith, British Transport Police
“Police perspective is public protection and protection of life”
“Having information and data is key to addressing this issue”
“2,233 people attempted suicide on the rail network in 2016”
“People who survive a suicide attempt are put on a suicide prevention plan – just 0.6% of those people go on to take their own life in a second attempt”
“Data exists about people at risk but it sits in silos – wherever possible we should exchange information (we need to get better at this)”

Questions

What were your first steps on this topic, where do we (in road safety) start?

Mark Smith – need to understand the problem – start to record in advance of the coroner – and share that data

Ian Stevens – make people realise suicides can be stopped – empower people to do something

Richard Burnett – there is a shift in people’s attitudes towards mental health – the time is right now to try and do something about this

Rob Hunter – peer support programmes to support colleagues with problems

What information is given to passengers on the rail network, and what advice would you give to HE about how they should communicate with their customers (about suicide on their network)?

Ian Stevens – we don’t talk about suicide in public announcements but are struggling with this – somehow we’ve got to be able to talk about suicide on the railway without the risk of contagion – we are developing a new campaign to get our customers to work with us – as a customer on the motorway I’d like to know (personal view)

Is this the right time for a campaign to educate people about the steps they can take to help prevent suicide?

Ian Stevens – putting together a ‘Bystander’ campaign to bring our customers together to support us – talks about giving the public permission to go and talk to potential suicides – and what to look out for – not just on the railway but also within their communities.

Rob Hunter – I think there is mileage in this idea

Mark Smith – we are keen on the Bystanders campaign but are reluctant to ask people to intervene (physically) for fear of putting themselves in danger


Session Two


12.00 – Dr Anna-Lena Andersson, special adviser – traffic safety, Swedish Transport Administration

Dr Anna-Lena Andersson is a Bachelor of Science in Social Work and trained in psychotherapy.

She is also a Doctor of Philosophy – the title of the thesis 2003 was “Psychosocial Factors and Traffic Injuries with special emphasis on consequences, risk factors for complications, influence of alcohol and benefits of intervention.”

Between 1983 and 2010, Dr Andersson worked with patients at hospitals as an almoner/advisor/ counsellor and as head of the almoner’s department. The work with the patients was mostly in trauma care.

Since 2010, Dr Andersson has worked at the Swedish Road Administration, becoming a Special Advisor in Traffic safety in 2015. Areas of speciality include suicides in the transport system and trauma related events.

Presentation: Suicide classification in road traffic accident records – an important part for intervention in Sweden

“Many organisations still see suicide as a taboo subject and do not want to be associated with it”

“In Sweden suicide (1,478 in 2016) causes five times more deaths than road traffic collisions”

“84% (four out of five persons) who died on Swedish railway were suicides”

“We want to reduce the number of uclear causes of death on roads”

Classification scale for road traffic fatalities (five levels – levels one and two reported as suicides)

  • Was suicide
  • Strongly supports suicide
  • Cannot determine manner of death was suicide
  • Strongly supports manner of death was an accident
  • Shows manner of death was accident
  • 2012 – 2016 – approximately 10% of roads fatalities classified as suicides
  • Majority diagnosed with mental illness
  • Psychosocial factors trigger risks (alcohol, drug abuse etc)
  • Suicide prevention – in vehicle technology could help prevent some suicides (but not all)

11.40 – Tim Holland, suicide prevention policy lead, Highways England

Since August 2016, Tim has led the development of Highways England’s suicide prevention policy.

After graduating from the University of Liverpool with an Electrical Engineering degree he joined the rail industry as a graduate engineer.

Following this Tim joined Highways England where he was responsible for the installation of traffic management technology on England’s strategic road network. Subsequently he managed a number of large infrastructure projects before being involved in the development of policy and standards for the road network.

Tim now leads a team with responsibility for preventing suicide on Highways England’s roads while ensuring the strategic road network remains accessible to all users.

Presentation: Reducing suicides on the Strategic Road Network

The numbers

  • There are three times as many suicides as there are deaths on the roads
  • HE identified 392 suicides on the roads between 2001- 2015
  • North West England (massively) over represented – not sure why
  • Around one third of suicides on the roads happen on the strategic road network

Circumstance of suicide on roads

  • Half jumped into road
  • Quarter stepped in front of vehicle
  • 10% drove into another vehicle

What is Highways England doing?

  • Developed suicide prevention strategy to be published next month and a suicide prevention toolkit (and will report on progress annually)
  • Frequently used/high risk locations being identified and prioritised
  • Making funding available for suicide prevention
  • Training staff to approach a potentially suicidal person
  • Reviewing procedures to better support those affected by traumatic events
  • Working to de-stigmatise mental health issues
  • Identifying new ways of working with partners
  • Establishing an expert panel
  • Implementing data sharing processes

11.20 – Katy Harrison, policy officer, PACTS

Originally from North Wales, Katy completed a degree in Politics at York University in 2009. After University, she worked for a brief time in the office of Lesley Griffiths, Member of the Welsh Assembly for Wrexham. Following the 2010 election, Katy began working as a Senior Caseworker for Susan Elan Jones MP, Member of Parliament for Clwyd South.

In March 2016, Katy became Policy Officer at PACTS and for the past year has been conducting research into the issue of road-related suicide in the UK. The resulting report ‘Suicide on UK roads: Providing a Baseline’ is scheduled for publication in November 2017.

Presentation: Reducing suicides on the road – Providing a baseline. PACTS’ research findings

Cost of suicide estimated at £1.6m per suicide

Road network 

  • No official number of suicides
  • No central database
  • Not identified as an issue
  • Limited collaboration & policy
  • Little research

PACTS report

  • Put out FOIs to police, coroners & LAs
  • Held expert workshop and created advisory panel

Police forces do not record information relating to roads suicides (this is a matter for the coroner…)

PACTS estimates around 50 deaths by suicide on roads each year in the UK (similar to the amount killed by drug driving) & 100s of attempts each year (800 on strategic network)

Recommendations

  • National guidance is needed (from Government – Department for Health & DfT)
  • Review of databases – reworking of what is going on & classifications
  • Knowledge gathering – aviation, RNLI, rail sector etc
Lots of interest and enthusiasm among stakeholders to address the issue

Session one


10.20 – Prof Ann John, professor of public health and psychiatry, Swansea University

Ann John, a public health trained former GP, is a Professor in Public Health and Psychiatry at Swansea University Medical School.

She chairs the National Advisory Group to Welsh Government on suicide and self-harm prevention and is the national lead for suicide prevention for Public Health Wales. She works across sectors aiming to translate research into evidence based practice to prevent self-harm, suicide and children and adolescent mental disorders.

Ann is a Farr Investigator and leads on the MQ funded Adolescent Mental Health Data Platform.

Presentation: What do we know about suicide?

Key facts

  • 800,000 people die globally by suicide each year, and for every one of these a further 20 attempt suicide
  • Suicide is the second leading cause of death among 15-29 year olds
  • Only 25% of suicides are known to mental health services in the year before they die
  • Men from lower socio-economic backgrounds are 10 times more likely to kill themselves than those from affluent backgrounds.
  • “Suicide is potentially preventable – I have no doubt about that”

Quality of suicide data

  • Only 60 of 172 WHO member states have good quality data
  • A lot of under reporting (probable & possible suicides)
  • Women more likely to die through poisoning, men through hanging

Suicide on roads

  • 2% of single vehicle accidents are suicidal behaviours
  • 2.8% of fatal RTAs are suicides (Scottish study)
  • Mainly men aged 25-34 years
  • Risk factors – previous attempts, mental disorder, alcohol
  • Why choose roads – financial benefits (insurance), less stigma (than other methods)
  • Overall 1/3rd of suicides leave note – on roads hardly anyone does

Interventions on roads

  • Install physical barriers
  • Boundary markings or lighting
  • Alcohol interlocks

10.00 –  Ruth Sutherland, chief executive, Samaritans

Ruth was appointed CEO of Samaritans in August 2015. She initially trained as a registered general nurse but has spent the majority of her career in public health roles, following a degree in Social Policy from University of Warwick and a Master’s degree in Health Promotion from the University of Ulster.

Ruth was the founding director of the Community Development and Health Network, a charitable membership network committed to addressing inequalities in health and wellbeing in Northern Ireland. Prior to joining Samaritans, Ruth was CEO of Relate and previously held senior executive leadership roles at Rethink, Alzheimer’s Society and Scope.

Ruth is also co-chair of the National Suicide Prevention Alliance, and a volunteer at the Bexley and Dartford branch of Samaritans. She has been a trustee of the Royal Society of Wildlife Trusts since November 2015.

Presentation: Suicide prevention: a multi-sectoral challenge

Suicide in GB – 2016

  • Three times as many men die from suicide as women
  • Most at risk group – middle aged men
  • Middle aged men on low income 10 times more likely to die from suicide

Crisis point

  • Relationship breakdown
  • Mental illness
  • Suicide a response to unbearable pain
  • Suicidal thinking is quite common (1 in 5 of population)

Network Rail & Samaritans

  • Around 300 suicides per annum on rail network
  • Coordinated national approach is crucial
  • Education & training – more than 16,000 rail staff trained to know what to do – simple techniques to ‘interrupt the thinking’
  • 2015 – more than 1,500 life saving interventions by rail staff (mainly middle aged men)
  • Prevention – for example roadshows at high risk locations (stations)
  • Postvention – bereavement support for relatives and others affected
  • Suicide rates on the rail network have fallen by 18% in the last two years (but almost no change in the first year – it takes time)
  • In identified high risk areas (certain stations) a 30% reduction in suicide rates

Areas for improvement for road-related suicides

  • No official record of the number of road-related suicides
  • Lack of awareness, and no priority given to it
  • Not clear where responsibility lies for tackling road-related suicide
  • Most local authorities have a suicide prevention plan but there is no reference to road-related suicides
  • Some local initiatives, but collaboration is poor

Policy recommendations

  • Creation of a database for suicide on UK roads
  • Research evidence required to enable industry, Government and third sector to develop plans
  • Burden of proof should be lowered so that deaths which are overwhelmingly likely to be suicide are recorded as such by coroners
  • Focus on the issue in national suicide prevention strategies

Practical actions

  • Adapt the model from the rail industry across the transport industry
  • Training for staff
  • Prevention through reducing access and promotion of support services
  • Good occupational health programmes that include mental health
  • Use expertise and influence of the transport sector to help:
  • Improve data collection and evidence
  • Ensure local action plans are in place
  • Increase places of safety

9.40 – Keynote address from Baroness Finlay of Llandaff

Baroness Finlay of Llandaff is a professor of palliative medicine and an Independent Crossbench member of the House of Lords. She is a past president of the Royal Society of Medicine, a professor of palliative medicine at Cardiff University School of Medicine, and consultant at the Velindre cancer centre in Cardiff. In June 2001 she was made a life peer as Baroness Finlay of Llandaff.

Baroness Finlay is a co-chair of the All-Party Parliamentary Carbon Monoxide Group and also chairs the All-Party Parliamentary Group on Dying Well, which promotes palliative care. In 2015 she was awarded the Grassroot Diplomat Initiative Honouree for her vigorous campaigning to improving the care of dying patients.

Soundbites:

All Party Parliamentary Group on suicide & self harm:

  • Concerned about impact of online world and links between socio-economic deprivation & suicide

Early life experience and the brain:

  • First two years of life baby’s brain grows from 25% to 80% of adult size
  • Adverse childhood experiences (ACEs) – higher incidences in Wales (and probably GB) than across Eastern Europe
  • 41% of adults suffer low mental wellbeing if they’ve suffered 4 or more ACEs
  • 30% of adults with 4 or more ACEs had self-harmed or considered suicide

Building blocks of resilience:

  • One or more stable, caring child-adult relationship (key point)

Suicide contagion:

  • Marilyn Monroe’s suicide resulted in a 12% increase in suicides
  • Focus on mental health and pain to the bereaved family can result in a fall in suicides and increase in calls for help

Coroners:

  • Would like better data
  • Need ‘beyond reasonable doubt’ or ‘balance of probabilities’

09.00 – Introduction

Some 6,000 people take their lives every year in the UK, often involving transport. The railway industry, working with Samaritans, has developed interventions that are having positive results. The roads sector lags behind.

This conference will be the first in the world exclusively about suicides on roads. It will lift the lid on a problem that is much bigger than recognised, and which has significant consequences for the highways sector and others. It will also shine a light on suicide recording and prevention strategies in general.

Senior figures from highways, transport, police, judiciary, mental health and voluntary sectors will share their expert knowledge and insights. They will explain the implications of this important but little-talked about issue for those involved in highways, health and other sectors.

Delegates will be the first to hear the results of pioneering research into the scale of suicides and suicide attempts on UK roads. There will be opportunities to discuss future cross-sector collaboration and effective interventions.


19 October 2017
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