Suicide rates – a Public Health issue

On the 18^th February, the Office for National Statistics (ONS) published a report on suicide rates in the UK for 2012. The report highlighted that although the overall rates for people committing suicide had dropped since 1981, they had actually risen over the last five years. The report also identified the growing concern of high suicide rates for men compared with women for the same period.

The ONS Key Findings

• In 2012, there were 5,981 suicides in people aged 15 and over in the UK – of which 4,590 were males and 1,391 were females 
• In 1981 there 6,595 recorded suicide rates of which 4,129 were male and 2,466 were female
• The highest suicide rate was among men aged between 40 and 44 (25.0 deaths per 100,000 population) and the lowest rate was among men aged 15 to 19 at 6.4 deaths per 100,000 population
• In 2012 in England, the suicide rate was highest in the North West at 12.4 deaths per 100,000 population and lowest in London at 8.7 per 100,000 population

In 2012, the male suicide rate was more than three times the rate for females

The difference between men and women, socio-economic affects

The high suicide rate is undoubtedly a huge cause for concern despite the fact they have fallen over the past thirty years. However, it is the disparity between the rates of men and women that needs to be considered. With males three times more likely to commit suicide than their female counterparts, one needs to question why?

A recent report published by the Samaritans “Men, Suicide and Society” suggested that social and cultural changes, (rising female employment, increases in solo living), could be having significant impacts on the lives of men who are now in mid-life. In addition, the report made clear that men from low socio-economic backgrounds are also particularly at risk of committing suicide. This may be attributed to the arguments that people who live in disadvantaged communities, may have fewer prospects, less support networks leading to feelings of isolation, are more likely to be unemployed – augmenting feelings of low self worth and feeling they have nothing to live for. As a result they are more likely to engage in high health risk behaviour (smoke, drink, take drugs) as a form of escapism/way to deal with their stress.  

Nonetheless, women and young people are not immune to these problems described above. The evidence clearly states that people who live is in poorer communities, are more likely to experience greater physical and mental health problems, are more likely to do less exercise and have poorer diets – both of which have been indentified as improving ones overall wellbeing.   

 As with men, suicide is the leading cause of death among women aged between 20 and 34 years of age

The ONS report states that that people with mental illness have a higher suicide risk than the general population. Therefore, we need to help improve, protect and support people who are at risk of developing mental problems, as  well as targeting the younger population to build mental resilience. 

What is to be done?

In September 2012 the Department of Health launched ‘Preventing Suicide in England’ which sought to reduce suicide rates and improve those affected by suicide. The new strategy outlines six areas for action including: reducing the risk of suicide in key high-risk groups (for example, people in the care of mental health services, people with a history of self-harm, people in contact with the criminal justice system, and men aged under 50) and reducing access to the means of suicide.

It is also essential that the government looks deeply at the root causes that can lead to poor mental health, such as, economic deprivation, isolation, community disengagement, as well as supporting individuals and communities to partake in activities that are recognised as improving mental wellbeing – this could help reduce suicide rates. 

The Royal Society for Public Health (RSPH) is passionate about supporting the public's health and advocates that increased health awareness, community engagement and training individuals can help eliminate many of the problems highlighted throughout this Blog. A clear example is our Well London Training Communities programme, information can be found here and here, which aims to equip volunteers living in hard to reach communities to increase wellbeing knowledge, confidence and skills to bring about positive lifestyle changes.

The RSPH has also developed a Level 2 Award in Mental Wellbeing qualification, which aims to provide evidence based, practical skills on how to improve and maintain good mental wellbeing. When we are positive and happier, we are more likely to feel we can tackle everyday issues and face what life throws at us.

For information on this training please contact Gina Mohajer gmohajer@rsph.org.uk.       

Suicide is the leading cause of death in England and Wales for men aged between 20 and 49 years

Support for people who have suicidal thoughts

The NHS Health Choices website provides helpful information for people who are considering taking their lives. If you have thoughts about taking your own life, it's important you ask someone for help.

·         speak to a friend, family member or someone you trust as they may be able to help you calm down and find some breathing space

·         call the Samaritans 24-hour support service on 08457 90 90 90

·         go to, or call, your nearest accident and emergency (A&E) department and tell the staff how you are feeling

·         contact NHS 111

·         make an urgent appointment to see your GP

Visit the NHS Health Choices website here

Cancer Rates on the Rise - says new report by WHO

The World Health Organisation’s (WHO’s) International Agency for Research on Cancer (IARC) has today published a new “World Cancer Report 2014” to coincide with World Cancer Day. The report highlights the growing rates of cancer around the world and advises that stronger efforts on prevention are needed to tackle this problem.

The IARC estimates that the global burden of cancer will rise from around 14 million new cases per year in 2012 to 22 million within the next 20 years

The report identifies that due to growing ageing populations, developing countries are disproportionally affected by growing rates of cancer. It is believed that over 60 percent of the global burden is in Africa, Asia and Central and South America, were 70 percent of cancer sufferers die. A lack of early detection and treatment are a particular concern.

The report argues that half of all cancers could be avoided, if measures to prevent the disease are put in place. 

There is now a wealth of information on cancer available as well as more effective and efficient ways to treat the disease. However, more is needed to ensure early detection and fair access to treatment.      

Dr. Christopher Wild, report co-editor and director of the IARC, says:

"Despite exciting advances, this Report shows that we cannot treat our way out of the cancer problem. More commitment to prevention and early detection is desperately needed in order to complement improved treatments and address the alarming rise in cancer burden globally."

Cancer continues to be the leading cause of death worldwide and therefore a huge global public health issue. Statistics reveal that in 2012 there were 8.2 million deaths to cancer, with lung cancer being the highest (1.59 million deaths), followed by liver (745,000 deaths), colorectal (bowel) (694,000 deaths) and breast (521,000) to name a few.

In addition, the costs associated with cancer can be very damaging to even the richest nations and very hard hitting for the poorer ones.

In 2010, the total global annual cost of cancer reached an estimated US$1.16 trillion

The report advocates that half of all cancers could be avoided, saving millions of lives a year, if detection is made early enough and if we implement the knowledge that we already know. This also includes individuals being aware of high risk behaviour and consequently taking steps to limit their chance of developing cancer.    

Currently, tobacco use has the single biggest impact, with 22 percent of global cancer deaths and over 70 percent of global lung cancer deaths

It is estimated that around 30 percent of cancer deaths could be prevented if certain health risk factors are avoided and or reduced. These namely include, stopping smoking, reducing alcohol consumption, preventing being overweight, eating healthily and increasing levels of physical activity.

For information on understanding the importance of health and how to help and support others to make healthier changes, visit http://www.rsph.org.uk/en/training-solutions/index.cfm to view a list of our training programmes.   

Understanding Behaviour Change: 

Happening at all levels

On the 29^th November 2012, the Royal Society for Public Health (RSPH) held a seminar on behaviour change. Led by Graham Rushbrook Development Advisor for RSPH, there was a chance to learn about the RSPH’s new Understanding Behaviour Change qualification, as well as to hear Kent Community NHS Health Trust’s experience of using the qualification. Participants then engaged in discussion about their experiences of obstacles to behaviour change for their clients.

The RSPH Understanding Behaviour Change qualification focuses on how best to support individuals in adopting positive behaviour change. At the heart of effective behaviour change is effective communication and relationship building. Within a one-to-one setting, the needs of the client are at the centre of all interactions, and the focus is on the holistic support of clients – not limiting support to narrow health requirements. As Graham highlighted, behaviour change “is done with, not to people”.

If individuals are to choose to change their lifestyles, any fear or ambivalence first needs to be addressed. It is also essential that an individual’s right not to change their behaviour is respected, and that the context and circumstances that may affect development of a plan to change lifestyle or health behaviour information is understood. The qualification also covers the importance of presenting information appropriately and accurately based on the needs of the individual, and teaches how to develop an effective lifestyle or behaviour change implementation plan and how to evaluate the impact of advice given.

Anne Ford, Head of Self Management and Prevention at Kent Community NHS Health Trust, spoke about her experience of using the RSPH’s behaviour change qualification to enable Health Trainers to support people with chronic health conditions. She highlighted that the effectiveness of behaviour change techniques lies in their client-centred nature and underlined the potentially valuable role of Health Trainers in supporting individuals in self management. The assessment of the Kent Community NHS Health Trust self-management and prevention plan has shown that through behaviour change training, Health Trainers have offered a wide range of support to clients, including referrals, signposting, accessing services from Age UK, organising respite care and supporting improvements in eating habits.

The RSPH qualification is set at Level 2, involves 16 hours guided learning time and is assessed through a multiple choice exam. Graham Rushbrook then led participants through a workshop session, asking participants to assess how the organisations, systems, disciplines and professions that they represent make it harder for clients to change.

Participants suggested that if behaviour change interventions are to be successful and sustainable:

-      There needs to be a holistic focus on the client, enabling underlying issues as well as health behaviours to be addressed. The client needs to be at the centre of the decision making process and interventions must be tailored to their needs.

-         Frontline staff need to buy into behaviour change techniques and training needs to be provided to enable them to work effectively with clear and consistent models. Communication between frontline services is vital if clients are to be treated holistically and effectively.

-    Behaviour change interventions need to be better understood by funders and management. This will involve recognition of the timescales involved (behaviour change interventions are not quick-fix) and also that quantifying results may not be possible in traditional ways.

Participants then looked at how these difficulties could be turned into opportunities for improving health. The focus in behaviour change theory on joined up services and holistic interventions, as well as developing partnerships was deemed an opportunity. In addition, moving the focus from assessing interventions based on quantity to assessment based on quality was seen as a huge opportunity for health improvement. It was also noted that behaviour change training can be achieved with little funding where training is offered in-house and that by sharing best practice between organisations and services, there is a great opportunity to ensure that behaviour change interventions meet their potential.

Next Steps

RSPH Training Solutions, will be running training sessions throughout 2013 to build understanding about behaviour change and to also build capacity to deliver the Behaviour Change qualification and training.  Our first date for this will be on the 26th February followed by a Train the Trainer programme on the 5th March.  For further information on opportunities to share best practice and offer in house training please contact Gina Mohajer, 0207 265 7327 or visit Training Solutions homepage. 

We will also be hosting further seminars around behaviour change to facilitate an engaged discussion with funders and commissioners about the case for supporting this type of intervention.  The next one will be in March, to register your interest, please contact Gina. 

Make A Difference Day – Sat 29^th October

Have you ever considered volunteering and making a difference to perhaps someone’s life or community, but just never got round to making it happen? Well this Saturday the 29^th October is Make a Difference Day, a campaign organised by CVS aimed at encouraging people to get involved in volunteering to help make a difference.

This year’s theme will be highlighting how volunteers can help to tackle loneliness and isolation.  The charity is calling for volunteers to register their activity, which can include anything from creating a bus stop garden to teaching IT skills, renovating a homeless shelter or knitting blankets for cats and dogs in shelters.

For further information or to register your interest click here

To support the work of volunteering and the great work that volunteers do, the Royal Society for Public Health (RSPH) is offering free* training in health improvement to people who are volunteering / or thinking of volunteering.  Under the East London Health Makers Scheme, participants will gain a Level 2 Award in Understanding Health Improvement, which will enable them to not only understand the importance of healthy living and physical activity, but also how to positively encourage others to make healthier lifestyle choices.  By being educated, proactive and reaching out to people of need, we can all help to diminish health inequalities and improve the quality of peoples lives.

For further information on training please contact Nelly Araujo by email: naraujo@rsph.org.uk or by phone: 020 7265 7322. 

*The funding has been made available through the Mayor's Legacy Fund and the Big Lottery.  To be eligible to receive free training, all applicants must be willing to commit to volunteering work in London and be able to provide information on the organisation they will be volunteering at. 

Do you know the most effective ways to improve community health? Or the proven techniques to encourage healthier life styles?

The Foundation Programme in Health Improvement

The Foundation Programme in Health Improvement is a new programme designed to give a firm grounding in Public Health to key individuals who work in Local Authorities and Voluntary Organisations.

This two day programme takes place on November 8^th and 9^th in our Head Office in London. It costs just £350 per delegate for two full days and includes lunch, refreshments and full course materials. Contact Nicolette Smith to make your booking, on 020 3177 1625 or email nsmith@rsph.org.uk.

There are only 3 days left to book at our Early Bird price of £315

What we will cover:

1. The three key lifestyle choices affecting personal health, and their impact on your community.
2. The practical implications of these choices for our public health.
3. First principles for promoting good health
4. Three ways to improve community health, and how to communicate them
5. The critical barriers to improving health in the community and how to overcome them
6. Proven techniques for encouraging changes in behaviour
7. How to handle confidential information securely
8. The most effective ways to evaluate your results

“The journey starts here. Educational, enjoyable, empowering.”

Dartmoor works towards better health

Over the past twenty years the number of older people entering the criminal justice system has trebled and these prisoners tend to have poorer health than the general population.  Those over the age of 50 are more likely to suffer from physical disabilities, long standing illnesses and have mental health issues.

As a result, NHS Devon’s health promotion team in partnership with Age Concern (now Age UK) created the Age Concern Older Offenders’ Project, with the primary aim of improving the health of older offenders within Devon Prisons. 

The joint project was developed to support the pilot of a Health Trainer programme in prisons.  The Introduction of the Health Trainer role for older offenders enables them to support their peers with first level health and social care advice, as well as ensuring appropriate steps are taken to improve their health. 

Stephanie Parker and Jean Harrison, Health Improvement Advisors for NHS Devon, delivered two Royal Society for Public Health (RSPH) courses on Understanding Health Improvement.  The accredited course provides an introduction to the basics of health and wellbeing and how to empower offenders to make healthier lifestyle choices.  26 volunteers, 18 of whom were offenders, successfully completed the interactive training. 

Since then, numerous health related activities have been introduced in the prison.  Offenders have noted that they are beginning to benefit from this more supportive and personalised approach to health, commenting:  “I feel more relaxed and am able to sleep without interruption” and “I have lost weight and I am aware of my improved physique”.

Stephanie Parker has since won an NHS Devon Staff Award for her contribution and due to the overall success of the pilot, work is now continuing in Dartmoor prison to help support and develop the offender Health Trainer role.