The Jordan Legacy’s Response to the Government’s National Suicide Prevention Strategy 2023-2028
We welcome the Government's new National Suicide Prevention Strategy (NSPS) because it's a long overdue opportunity to bring more focus to the unacceptably high number of suicides in this country. However, we are also very disappointed with the new NSPS because we feel it lacks ambition.
We welcome the Government’s new National Suicide Prevention Strategy (NSPS) because it’s a long overdue opportunity to bring more focus to the unacceptably high number of suicides in this country, more than 5,000 deaths by suicide each year in England (the scope of this NSPS), a number that has not reduced for the past 15 years.
Link to the National Suicide Prevention Strategy
And we welcome the new NSPS for England for 2023-2028, because it has some good proposals, indeed many that are aligned with The Jordan Legacy’s action research based proposals outlined in our report published on 11 July ‘Moving Towards a Zero Suicide Society’, which we believe can help us reduce the numbers of suicides ‘towards zero’.
However, we are very disappointed with the new NSPS because we feel it lacks ambition; it lacks a suitable stretch target for significantly reducing the number of deaths by suicide (and suicide attempts); it lacks the resources needed to deliver reductions in suicides (no additional resources probably means another 5 years of no change in the numbers); and, as a result of these shortcomings, it makes us feel it lacks hope which is what we all need plenty of, especially those with lived experience.
It certainly falls well short of the shared ambition to ‘move towards zero’ of all those in The Jordan Legacy’s extensive network of people with lived experience and those working in suicide prevention – our ‘Zero Suicide Society community’ – and all those who contributed to our action research project and action learning initiatives, helping us to map out the practical actions that will get the suicide numbers on a downward trend ‘towards zero’.
We were also very disappointed with the process for generating the NSPS.
Having watched Scotland conduct a very inclusive, collaborative process for its Suicide Prevention Strategy ‘Creating Hope Together’ –
- a joint approach with national government and local government (via COSLA);
- a transparent, accountable leadership group and lived experience advisory group;
- commitment to a 10-year Strategy and annual action plans with clear targets and progress monitoring;
- an initial open public engagement process where anyone could input to help shape the Strategy;
- a public consultation where anyone could comment on the draft Strategy before it was finalised;
- the establishment of Suicide Prevention Scotland to monitor delivery and hold governments, institutions and all delivery partners to account;
- and, as it happens, a commitment to doubling the suicide prevention budget
– we were obviously disappointed with the lack of public engagement or consultation around the new NSPS for England. And arguing there was an opportunity to input ideas via the Mental Health Plan consultation last year is disingenuous – there was no dedicated consultation around suicide prevention, which is not just a mental health issue!
Also, the lack of widespread lived experience involvement is a major concern. It’s clear there was far more lived experience involvement for this 2023-2028 NSPS than any previous NSPS, but it still falls way short of what is needed in our view, and the view of most of those we’ve engaged with.
Will Scotland get a ‘return on investment’ with its approach and achieve significantly greater reductions in suicides over the next 5-10 years? We will watch with great interest.
As set out in our ‘Moving Towards a Zero Suicide Society’ Report in July, we certainly know that transformational change needs to consider ‘The 3 Key Dynamics of Change’ – one of which is wide & deep engagement because those involved in the process of creating strategies & plans are most likely to be committed to agreed goals, and delivery of those goals.
A second key dynamic of change is a clear, compelling vision of a better future that ‘pulls’ everyone to that positive, hopeful future.
And the third key dynamic of change is a high level of deep dissatisfaction with the status quo, in this case the numbers of suicide deaths (and attempts), that effectively pushes us all away from this unacceptable current state (5000+ deaths per year in England for the past 15 years) and helps propel us towards the compelling future vision at an even faster rate.
At The Jordan Legacy, both our hearts and our heads tell us that the new NSPS lacks ambition – as well as lacking stretch targets and the resources needed to deliver significant reductions in the numbers of deaths by suicide (and suicide attempts) – and therefore, sadly, lacks the hope we so desperately need.
Our calm, considered analysis of the NSPS also demonstrates, again sadly, that not only does the NSPS fall short on the Engagement & Involvement dynamic for change, it also falls short in terms of the key ‘Pull’ effect – where’s the clear, compelling vision of our low suicide future? – and also in terms of the necessary ‘Push’ effect.
Indeed, whereas The Jordan Legacy and our ‘Zero Suicide Society community’ strongly believe that the numbers of deaths by suicide in England over the past 15 years have been “unacceptably high” and “needlessly high“, as everyone agrees that most suicides are preventable, as well as the numbers not going down, and therefore we must aim much, much higher and do much, much more, and take different approaches to ‘do something different to get a different outcome’ – which would provide the huge Push that collective dissatisfaction brings – the new NSPS and the narratives put out around it, such as Minister Maria Caulfield on BBC Breakfast, paint a picture of suicide rates being ‘historically low’ or ‘at their lowest level for 20 years’ and there being ‘progress since 2012’.
We believe that such framing of the problem we’re trying to solve is counterproductive, unhelpful, dangerous, harmful, possibly even costing lives that could be saved.
The old adage says ‘the first step to solving a problem is accepting you have a problem’. If we don’t all work together, pull together, and push together – including all saying loud and clear that the current number of deaths by suicide (and the level it’s been at for the past 15 years) is “unacceptably high” (Push) and “needlessly high” (Pull) because we can reduce those numbers as most suicides are preventable – the numbers won’t come down.
All those fundamentally important points made, what are the positives in the new NSPS?
Well, there are those we listed in our ‘Moving Towards a Zero Suicide Society’ Report in July, so some alignment (if major differences in ambition), in terms of targeted support for:
- those bereaved by suicide, although we want to see better support for all forms of bereavement, as many different loss experiences can heighten suicide risk;
- people with “physical Illness” or, as we highlight in our Zero Suicide Society vision, providing wrap-around care and support for those people with disabilities, chronic illness, chronic pain, or long-term health conditions that make them a heightened suicide risk;
- those facing financial difficulty and economic adversity, although we want to go much further in having mandatory counselling for people who have lost jobs or businesses, and measures to tackle poverty-related suicides, eg a Universal Basic Income or Guaranteed Minimum Income;
- those with alcohol and drug misuse issues – yes, and we believe we need much greater support for people with all forms of addiction;
- people consumed by gambling – yes, and we want to go further and faster, eg immediate bans on all advertising by gambling companies that can be seen by children, and actively encouraging people with a clearly out-of-control gambling addiction to continue gambling being a criminal offence;
- people experiencing social isolation and loneliness, although the NSPS is thin on detail on this;
- people experiencing domestic abuse – definitely good to see this in the NSPS, it’s long overdue as we need much better support for women and men experiencing domestic abuse, and we also believe there should be greater support for a range of relationship issues;
- those needing effective crisis support – yes, and we want to see much more community-based crisis support with community-centred support and services to stop people needlessly and often harmfully having to access ‘the mental health system’ which then struggles with approaches like ‘social prescribing’ because the ‘health/clinical model’ has already taken hold by then (eg assessments being ‘in the health system’ not outside).
And there are some positives we didn’t explicitly highlight in our report, so we need to clarify and confirm we agree – again just wanting to go further and faster, eg:
- targeted support for autistic people, which we have acknowledged within the broader ‘missing piece of the puzzle’ in support for people who are ‘neurodivergent’;
- targeted support for pregnant women and new mothers – we agree and also think there should be targeted support for parents experiencing or having experienced child-related trauma, including those experiencing miscarriage;
- reducing access to lethal means, which we covered within our much broader category of ‘designing out suicide’.
The Jordan Legacy supports proposals advocated by people like the 3 Dads Walking to have suicide education within the school curriculum – indeed this is included in our petition to Parliament with our package of proposals to minimise suicides. We note that the NSPS falls short of a commitment to implement this, saying DfE is still considering whether to implement, despite the almost universal support in The Jordan Legacy action research and broader engagement, and the 3 Dads Walking getting 170,000 signatures in support.
We welcome the commitment to greater training but, again, we want to go much further with universal mandatory suicide prevention training not identifying priority groups or organisations for training.
We welcome all support for personalised, tailored safety plans and not using group-based or cohort-based risk assessment systems, especially as the evidence has existed for more than 10 years that such risk assessment systems in clinical settings not only do not help but actually cause harm – by those assessed as low risk not getting support and then having a higher rate of death by suicide than those assessed as high risk of suicide, because the latter have got the support they need, ie the system itself was killing people!
We also want to avoid exactly the same syndrome being built into national suicide prevention strategies, ie a fundamental core focus on ‘priority groups’ means that those prioritised get lots of support and those not prioritised don’t, leading to the non-priority groups becoming a higher suicide risk, with the overall number of suicide deaths remaining static as this just ‘pushes the air round in the balloon’
We also broadly agree with the concept, or some might say sentiment, in the NSPS, that “suicide is everybody’s business” except our research suggests this is poor framing for public engagement and effective public communications.
It’s better than “suicide is everyone’s responsibility” which comes across as lecturing and finger-wagging and pushes people away when we really need to pull people in to the conversation.
But it’s still not an engaging message. Better to have a non-judgemental call-for-support that draws people in such as “everyone can help prevent suicides” or “everyone can help reduce the number of suicides” which are especially effective messages when prefaced with “anyone can be affected by suicide”.
And it’s crucial that we say “anyone can be affected by suicide”, which is unquestionably true and not disputed so no pushback from that message, and not the oft-used campaigning message “suicide doesn’t discriminate” as suicide clearly does discriminate (eg higher suicide rates among a number of groups, and the suicide rate in the North East twice that in London). This statement divides rather than unifies, with considerable pushback.
And, we would add, suicide prevention strategies and plans often discriminate by having priority groups – winners and losers! – whereas in The Jordan Legacy Zero Suicide Society vision & transformation model ‘Everyone is a Priority for Someone’.
We know from our analysis of past national strategies in the UK and around the world – studying the process (including degree and extent of stakeholder engagement and public consultation – or lack of it); the emerging and agreed content; the way the new strategy is communicated including the ‘media narratives’ put out (from clear communication of good messages to the political spin that often accompanies the release of any new Government Strategy); to the detailed action plans behind the overall strategy; to the way the Strategy and plans are implemented, monitored, reviewed, and evaluated; to the transparency and accountability (or lack of it) surrounding the Strategy and its action plans; to its final reflective review and assessment…
…that national strategies, like the new NSPS for England, can certainly help in reducing the number of deaths by suicide (and suicide attempts), although they often appear to make little or no difference in reducing the suicide numbers (just a contested claim that they’ve stopped the numbers rising even further)…
…and, as previously explained, they also have the potential to cause harm, e.g. a small number of priorities creating ‘winners and losers’ and those groups not identified as priorities experiencing higher suicide rates.
As The Jordan Legacy has collaboration in its DNA, we will continue to work collaboratively with everyone who shares our ambition to create a ‘Zero Suicide Society’ and get the numbers of deaths by suicide on a long-term downward trend ‘towards zero’. This includes with working with the Government (we meet with DHSC and others in government regularly) and collaborating around the new NSPS – if we’re invited, we’ll get involved!
As well as promoting our positive, hopeful visions and practical action plans, and giving active support to all those sharing our ambitions, and also trying to ‘create hope through action’, we will, however, continue to call out low ambition and highlight what we see as barriers to reducing the number of suicides, which includes ‘systemic low ambition’. ‘
Even the highest aspiration in the new NSPS ‘to aim for the lowest suicide rate ever’, i.e. to ‘get back’ to the suicide rate we had in 2007, allowing for the change in burden of proof for Inquests, is, in our view, low ambition so we must aim higher.
If this NSPS did help us get the suicide rate back down to the 2007 level, i.e. to the rate we had prior to the first published NSPS, by 2028 or sooner, we would welcome that but not ‘celebrate’ it because no level of preventable deaths, with the pain and suffering for those losing loved ones, is something to ‘celebrate’ and because we know we can achieve much greater reductions in the numbers of suicides (and suicide attempts) if we have the ‘will’ and with the right ‘way’ – a way which we have outlined in our Zero Suicide Society Transformation Programme and petition to Parliament for a Suicide Prevention Act.
Btw, have you signed our petition yet to help get those systemic changes we need to get the suicide numbers moving towards zero? And have you urged others to sign? https://petition.parliament.uk/petitions/640961
This formal public response to the Government’s National Suicide Prevention Strategy 2023-2028 is a joint statement from Paul Vittles and Steve Phillip on behalf of The Jordan Legacy.
Paul & Steve are co-authors of the action research based report ‘Moving Towards a Zero Suicide Society’ mapping out what a ‘Zero Suicide Society’ looks like and the practical actions that will deliver that vision and get the suicide numbers on a downward trend ‘towards zero’. The 2nd Edition of this Report was published on 28 September:
The Jordan Legacy CIC was established by Steve Phillip in memory of his son, Jordan Phillip who lost his life to suicide in 2019. Its mission is to help us move toward a ‘Zero Suicide Society’ which, in our eyes, is a society that is willing and able to do all it can to prevent all preventable suicides; and to move us away from the unacceptably high number of (what are largely preventable) deaths by suicide (more than 5,000 per year for the past 15 years in England) towards zero.