Talking can help tackle mental health problems

First Step is an NHS service that provides talking therapies for people across Cumbria with common mental health problems, such as depression and anxiety disorders (including Obsessive Compulsive Disorder, Panic Disorder or Health Anxiety).

We receive around 14,000 referrals each year – mainly from people referring themselves.

Although the service is designed to see people with mild to moderate levels of these problems, we know things can change rapidly in people’s lives and risk is something that is always on our minds as practitioners. The vast majority of patients receive help and recover without them ever thinking of suicide and most of these people will have no wish to take their own lives.

For a very small number of these patients, where the suicide risk becomes greater, we ensure that they are able to seek help from the appropriate services (eg Crisis Resolution and Home Treatment Teams) who can provide more intensive support to individuals at home in order to reduce the risks to themselves.

From our own personal experiences, our work with patients who have been bereaved by suicide and our close links with the Cumbrian branch of SOBS (Survivors of Bereavement by Suicide) we are very aware of the impact of suicide on friends and families.

Following a suicide those close to the person can often blame themselves or feel responsible when they actually couldn’t have predicted or prevented what happened.

Such tragedies can also leave staff devastated. Practitioners spend their days trying to help people, building up strong working relationships with patients and often have the same self-blaming thoughts following a suicide.

Staff are trained to understand the latest research around what factors suggest someone might be at higher risk of taking their own life.

Having a range of risk factors does not mean people are definitely going to take their own life and an absence of these factors does not mean the person is safe.

If only it were that simple. Suicide is complex and risk can change from moment-to-moment. Also, we cannot see into people’s minds and there are times when people can successfully hide their intent to take their own life from those around them.

But while mental health staff need to think about suicide every day in their work, we can sometimes forget that most suicides in Cumbria occur in people that are not receiving help from specialist services.

More than ever, the people of Cumbria need to think about how we can all support each other. Many organisations in Cumbria are now working together to try to reduce suicide under the umbrella of the Cumbrian Suicide Prevention Group.

Each person that is prevented from taking their own life can then have the opportunity to recover from their problems.

When patients receive effective help, they can often look back at those dark times when suicidal thoughts came into their minds with horror and disbelief – amazed that things got so bad.

Each suicide prevented will also save friends and families from lifetimes of questioning and potentially self-blaming.

However, 58 suicides per year out of a population of almost 500,000 means it is still a relatively rare event. Yet nearer 100,000 people each year will experience a common mental health problem, such as depression or panic.

I believe we need to continue to work together to create an atmosphere where it is acceptable to discuss such problems in an empathic and supportive way.

here has been significant improvement since I started in Cumbria 20 years ago yet we still have further to go until people are as comfortable talking about depression as they are about physical health problems.

Only then will we be able to ensure that everyone gets the help that they need as early as possible.

Please visit http://www.cumbriapartnership.nhs.uk/first-step for more information on First Step, including how to access help.