Whilst the number of children and young people taking their own lives is quite low, particularly in younger children, the impact on family, friends and the communities they live in is immense. The loss of a child or young person, whatever the circumstance is a dreadful event, but the loss of a young person through suicide eats at the heart of families and they are the very fabric of our communities.
There were 145 suicides in children and young people aged under 20 between Jan 2014 - April 2015. These are by and large preventable, so if the same number of young people died from a one-off preventable accident there would be a national outcry, and an enquiry followed by action. The fact these deaths are taking place over a year means that whilst it is news it isn't front page news.
The reasons why someone takes their own life can be difficult to understand and it is only when you unpick the story afterwards that you identify what the possible triggers were. As the new study from the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCISH) points out, it is the pattern of cumulative risk that may have led to the 'final straw' event'.
The study from NCISH confirms what we already know that suicide rates are low in younger children, but they increase quite rapidly during the teenage years; and the rates are higher in males. What is particularly interesting about this report is that it looks at the factors that were associated with the suicide. These include:
• Mental illness in the family
• Academic pressures, especially related to exams
• Physical health conditions
• Alcohol and drug use
• Previous self-harming
• Diagnosis of mental illness
These factors do not necessarily have a causal relationship with the death, but rather they may be the final straw for these very distressed young people. It does beg the question, if more was done to identify those at risk and provide support, would it have saved a life?
What is particularly worrying is that 43% of these children and young people were not in contact with any service. Whilst this may not be totally surprising, it is concerning that they hadn't come to anyone's attention. There needs to be a better mechanism by which children and young people, particularly those we know are facing stressful experiences, be that exams, bereavement etc. are given targeted support, or at least unobtrusively checking how they are.
At a policy level, there have been suicide prevention strategies around for many years. The latest suicide prevention strategy for England, highlighted groups at high risk of suicide, such as people with a history of self-harming. It also refers to the importance of improving the mental health of the whole population, with children and young people listed as a specific group that would benefit from this. Suicide prevention is included in the Mental Health Crisis Care Concordat. There is no doubt good work going on across the country around suicide prevention, but according to a recent Tweet from Prof Louis Appleby, a number of areas are not prioritising this, which is very concerning.
We advocate for a public health approach to improving mental health and wellbeing, especially in children and young people. Government's Future in Mind document, sets out the whole system change needed to improve children and young people's mental health. One thing it says loud and clear is a need for early intervention.
Promoting mental health and wellbeing in all children and young people is essential. We believe that they should be taught about mental health and how to manage their own stress, know how to help a friend, how to get help etc. Schools and colleges are an obviously place for this to take place, but we don't think that this is something that schools should do by themselves. This needs to be part of a whole schools approach, and sit within a wider system as highlighted in Future in Mind. As part of this, teachers, parents/carers, friends and so on need to be given support to help identify those who may be at risk of mental health problems, and suicide, and how they can help.
Children and young people's mental is currently a priority within Government. We have the policy framework and generally know what needs to be done. There is extra money in the system. We have a broad idea what children, young people and their families want. So why isn't children and young people's mental health and wellbeing being given the priority it deserves?
We shouldn't have to wait until there is a suicide before local areas wake up to the fact that they need to do something.