The Commons Health Select Committee has launched an inquiry into the action needed to reduce the number of people who die by suicide. In doing so, I hope that they will consider the role of Suicide Crisis Centres.
I run a Suicide Crisis Centre in Gloucestershire where we have achieved zero suicide. We have been providing services for more than three years and have never had a suicide of a client under our care.
My reason for setting up the Centre was that I couldn't find the right kind of help when I experienced suicidal crisis in 2012. Neither mental health services nor existing charities were providing what I needed. I had a traumatic experience in that year, developed symptoms of post-traumatic stress disorder, and attempted suicide twice. I struggled to connect with the large number of people involved in the NHS crisis team, having experienced a profound loss of trust as a result of the traumatic event.
I wanted to set up services which would be very different from anything that was currently available. My experiences showed me so clearly what was missing, and what was needed.
Initially we set up a Suicide Crisis Centre where people could come every day when in crisis. This is still the place where we support most of our clients. However, one of our first clients showed us that we needed to include additional services. He was referred to us by a psychiatric nurse who told us: "He needs to talk to someone now."
I phoned him immediately and it was clear that he was highly distressed. He had experienced an extremely traumatic event five weeks previously and was afraid to leave the home. It was vital that he received help and so I went out to his house.
We quickly recognised that we would need to offer this service to some of our clients; for example some are alcohol dependent and their level of alcohol consumption means that they cannot leave the home.
We also make home visits to clients who are at imminent risk of suicide.
As well as providing these face to face services, we have an emergency line for our clients to phone when they are at imminent risk. When they phone, they get through to a team member who they know. This makes a difference. They are not calling a stranger at this point, but a person with whom they have already built a connection. There is a separate emergency night line for clients who are assessed as being at particularly high risk. Clients often tell us that they would not have phoned an anonymous service or the NHS at that point. They called us precisely because of the connection that they had with us. A client told us: "I couldn't have ended my life without talking to you first. You have done so much for me."
A high proportion of men access our services. They have cited a number of reasons why they contacted us. Some wouldn't have gone to their GP because they were concerned that it could affect their future job prospects if it was on their medical record. They also tell us they like the level of control that they have within our service. They can decide how often they come to see us and what kind of support will be best for them. They also decide how long the support lasts. We support clients for as long as they need us, including through their recovery.
We ensure that only a small team supports each client and indeed some of our male clients have only felt able to be supported by one person. They have told us that they simply couldn't have repeated the information to someone else. It was hard enough to reveal it to one person. Most services would be unable to provide this. We know that there are times when we have to, in order to ensure the survival of a high risk client.
The quality of the relationship between staff and clients is extremely important. We get to know our clients well and try very hard to understand their individual situation and needs.
We care about them and care about their survival. Clients tell us that they know this. We rarely need to tell them. When I was under mental health services, I found that the clinical detachment I encountered just left me equally detached. I recall phoning the crisis team once, and the nurse who answered was concerned that I might make a suicide attempt that night. "I'm not afraid to say that I care," she said. The phrase was interesting because it implied that there was a fear amongst mental health professionals of appearing to care. From my work with clients, I feel that it is vital that clients know this. I do not feel that caring for a client conflicts with a professional approach.
We are tenacious in helping clients to survive. Caring about our clients means that we want to do all we can to help them. The prospect of their death is painful to us and so we want to ensure that doesn't happen.
I have often been told by clients "You haven't given up on me". They felt that other services had. We know that it is a case of finding the right approach and the right type of support for each individual. If a client is not engaging with a service, it means they are not providing the right kind of help for them, not that there is something in the client which means they cannot be helped.
My hope is that the Select Committee will look in detail at the combination of factors which have contributed to the success of this Crisis Centre. There is a very great need for similar Centres in other counties and we are starting to work to make this happen. If we had a Suicide Crisis Centre in every county, it could play a major role in reducing the number of people who die by suicide.
Information about the Suicide Crisis Centre can be found at http://www.suicidecrisis.co.uk