The Five Year Forward View for Mental Health, published to much acclaim earlier this year, has a bold vision for the future of mental health care in England, driven by a series of ambitious targets. None is more ambitious than the target to reduce the number of suicides by 10 per cent by 2020/21.
To do so would be an extraordinary achievement. Suicide rates have increased steadily in recent years, peaking at 4,882 in 2014. So the target set by Paul Farmer's independent taskforce requires us to prevent almost 500 deaths by suicide every year. That's 500 mums and dads, sons and daughters, friends and lovers; 500 lives that we have to save, protect, cherish and celebrate.
To achieve this target there must be systemic change across the NHS, the police and judiciary, and social care, as the Taskforce has acknowledged. There must be societal change to remove the stigma around mental health. But change will also be achieved through the determination and commitment of people like Joy Hibbins, who have resolved, through their own experience, to dedicate their lives to transforming mental health care.
Joy twice tried to end her own life in November 2012. Since then she has helped to save hundreds of lives and is bringing new thinking to suicide prevention in the UK.
From the depths of despair Joy went on to set up the charity Suicide Crisis, using her own difficult journey through the mental health system to bring profound change to the care of people in a mental health crisis. Against all odds, and assuaging doubts about her ability to overcome difficult personal circumstances as a former mental health patient, Joy has established the charity as the go-to place for people who feel they have nowhere else to turn. The Suicide Crisis Centre, based in Cheltenham, has an exceptional zero suicide record since it opened in 2013. Funded entirely through public donations, the charity supports about 25 people in a typical week.
"We are tenacious in helping people to survive," Joy tells me. "If we need to stay up all night with a client, we will. We know of no other crisis centre that works like we do. Clients can visit us, or we will make home visits, providing extended support over several hours if there is an imminent risk. There is also an emergency line to a member of the team who knows them.
"What helped me to survive was the total focus of setting up the charity. I was very much on my own, and had to find people who felt like me, that there had to be a better way to help people who were in crisis. Given my illness, many people must have thought this was never going to happen. But I could see the potential of what could be done."
"I wanted to set up the kind of suicide intervention services that would have helped me: small team, continuity of care, individualised support programme and team members who had empathy and kindness.
"The person that I was before the trauma could not have developed this charity. The difficulties and huge challenges would have defeated my previous self. The experience of trauma has given me a determination and tenacity that I didn't have before."
Joy had no previous history of mental illness. But in March 2012, following an extremely traumatic and terrifying experience, she developed symptoms of Post-Traumatic Stress Disorder, and suffered a psychotic episode. She received treatment at home for three months but her recovery was made more difficult by the constant turnover of healthcare professionals who treated her and by the long waiting list for therapy. In November that year, unable to cope with her mental illness, Joy attempted suicide twice. She would have died but for the unexpected intervention of a nurse who came to visit a day early. Joy was assessed under the Mental Health Act, sectioned and admitted to a psychiatric hospital.
It is this lived experience which has informed the design of the support provided by Suicide Crisis, and which is attracting the attention of national policymakers looking for answers. Helen Garnham, the National Lead for Suicide Prevention at Public Health England, asked Joy to address a recent suicide summit in London. The value of Joy's work has also been recognised by Luciana Berger, the Shadow Minister for Mental Health, and by the South West Zero Suicide Collaborative, one of three pilot schemes for the Government's zero suicide initiative.
The Mental Health Taskforce has set out the grand vision that is needed to create a mental health service that is fit for purpose. But, as Joy is showing, what saves lives is personal care and compassion, and a determination to make a difference.