Opinion piece: service-user safety

Helping to make ‘zero suicide’ a feasible goal

Director of award-winning design and manufacturing company Safehinge Primera, Philip Ross, discusses Health Secretary, Jeremy Hunt, and Mersey Care NHS Foundation Trust’s goals for a ‘zero suicide rate’ in mental health facilities, and ‘how the role of the built environment and staff training can be part of the solution’.

According to a report by the Samaritans, three times more people die by suicide than by road accident,1 and it is estimated to be the leading cause of death in men under the age of 50. As one of the leading causes of premature death within the UK, the whole issue of poor mental health is one that, rightly, has become increasingly high profile. Alarmingly, however, this rise has been met with significant budget cuts, as resources for the NHS have become more and more stretched. Indeed mental health Trusts in England have had their funds cut by £150m over the past four years,2 while nursing posts have shrunk by 12% – limiting the amount of care and time available for recovery.3 In a recent report by The Guardian, six in 10 NHS mental health workers said they were unable to provide proper care because they did not have enough time,4 while a recent account by a mental health service-user described staff as being ‘too tired, too overstretched, too budget-poor, or too undertrained, to provide adequate care’.5

Despite this, Mersey Care NHS Foundation

Trust chief executive, Joe Rafferty, is committed to eliminating suicides among people in his care. He has recently said: “If zero isn’t the right number, then what is? No death by suicide should ever be regarded as acceptable or inevitable.”6 Indeed, it is surely better to aim for zero and miss, than to set the goal too low.

AN ‘INCALCULABLE IMPACT’ As the first mental health Trust to publicly commit to the ambitious aspiration, Mersey Care’s policy sets out the standards of care that will be offered to all service-users who express suicidal ideas to ensure that they have the highest quality assessment, support, and treatment, until they have recovered and are safe. According to Joe Rafferty, ‘Every suicide is another person who either felt unable to ask for help or did not know how to access it. It’s a tragedy that has incalculable impact on those who knew the person’.6 Vicki Nash, head of Policy and Campaigns at

Mersey Care NHS Foundation Trust’s Broadoak Unit at the Broadgreen Hospital site in Liverpool.

mental health charity, Mind, also backs the goal of ‘zero suicides’, saying: ‘Suicides are not inevitable – they can be prevented with the right support in place. Nobody who is in touch with services, asking for help, should reach the point of taking their own life.’7

GOVERNMENT TARGETS Health Secretary, Jeremy Hunt, has also set out plans to reduce the number of mental health inpatients taking their own life on NHS premises from more than 80 to none, describing the suicide rate as a ‘litmus test’ for healthcare quality.8 Under proposed plans, he explained, the Government will require every mental healthcare facility in England to draw up detailed plans for preventing suicide – with measures including improved patient observation, better collection of data, and safer psychiatric wards. Yet with underfunding of mental health services meaning that some of society’s most vulnerable find access to inpatient care is limited – as one service user put it, ‘I was sectioned and spent 22 hours in a mental health suite waiting for a bed on an inpatient psychiatric ward’ – achieving zero suicides is not just about safer spaces, but equally about more spaces.5 This, of course, is the critical question for the Government – ‘What additional funding will be made available to deliver on this ambition?’

Vibrant colours for wayfinding, and plenty of natural light, show how the Sussex Partnership NHS Foundation Trust’s Brunswick Ward, at the Mill View Hospital in Hove, uses modern design methods to improve recovery.

SUPPORTING ESTATES AND CLINICAL TEAMS I was inspired by reading Joe Rafferty’s comments, and felt that, as product designers, we have to recognise our role in helping to reduce risks and work towards the ambitious goal of zero suicides. We established our ‘Target Zero’ campaign to capture our ambition to


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