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Our work on suicide prevention, led by Christabel Owens of the University of Exeter in conjunction with Devon Partnership NHS Trust, has led to environmental changes to improve safety at public locations worldwide. The work has been recognised by ministries of health and cited in national suicide prevention strategies and guidance documents worldwide, and is associated with demonstrable benefits at specific high-risk sites. Ground-breaking research into the role of family members and friends in suicide prevention has led to a strategic partnership with all the major suicide prevention charities that are leading the way in public education in England.
In 2011 there were 6,045 suicides in people aged 15 and over in the UK. Training health and social care professionals is an essential component of suicide prevention strategies across the world. The University of Manchester (UoM) has developed and evaluated a method of training health and other frontline professionals in suicide risk assessment and management skills (STORM). The STORM project, now incorporated as a social enterprise with 2 permanent members of staff, has provided training to 670 training facilitators who have subsequently trained around 230,000 workers in the UK and overseas. In the first year of trading as a social enterprise, the majority of customers of Storm CIC were NHS Trusts with an annual turnover of £250k in 2012-13.
University of Bristol research has played an important role in shaping local, national and global suicide prevention initiatives. The consequent reductions in suicide rates have been substantial and many hundreds of lives have been saved thanks to this research.
The scope and scale of the impact has ranged from shaping World Health Organisation (WHO) strategy on preventing suicides by pesticide poisoning, informing national legislation on limiting access to the means of suicide in several countries (e.g. analgesics in the UK — 1000 fewer suicides between 2008 and 2013), informing guidelines on the responsible reporting of suicide for the UK media, and developing highly successful prevention measures at the Clifton Suspension Bridge, a suicide site in Bristol (30 fewer suicides between 2008 and 2013).
Our research has made an outstanding contribution to the policy and practice of Health bodies acting to prevent suicide and self-harm. Research conducted within the Suicidal Behaviour Research Laboratory (SBRL) has systematically examined the causal antecedents of self-harm and risk of suicide, leading to the creation of a new theoretical model of suicide that: (1) has substantially informed new public policy, including the National Institute for Health and Care Excellence's (NICE) and Royal College of Psychiatrists' (RCP) Clinical Guidelines on the management of self-harm and suicide risk, and; (2) has demonstrably altered practice, both Nationally and Internationally, via the development of assessment tools specifically designed to identify those who are at greatest risk of psychological distress, self-harm and suicide.
Epidemiological and evaluation research conducted at the UoE has enhanced understanding of risk and protective factors for suicide and self-harm, the relative importance of compositional and contextual effects in explaining suicide inequalities, the unequal distribution of suicide risk in the population and the effectiveness of the national suicide prevention strategies in Scotland and elsewhere. Research findings have been effectively disseminated and have informed the development, implementation and sustaining of evidence-informed suicide prevention programmes and activities in Scotland, resulting in a fall of 18% (from 17.5 to 14.8 per 100,000 population 15+ years) in the suicide rate in Scotland during 2000-2012.
Research by Bhui 1996-2013 showed striking differences by ethnic group in diagnosis and management of mental health disorders due to a complex interplay of socio-cultural factors and different perspectives of patients and professionals. Impacts included: [a] the development and implementation of a UK-wide mental health policy 'Delivering Race Equality'; [b] a national training and workforce development programme that shifted the conceptual paradigm from the cultural competencies of individuals to system-wide intervention (called `cultural consultation'); [c] service development research `Enhancing Pathways into Care' (EPIC) to implement findings and draw lessons across four NHS Trusts; [d] incorporation of research findings into national and international guidelines, and influence on mental health legislation and policy; and [e] a new phase of research on implementing findings.
Research on the scale and nature of suicide in Northern Ireland has changed awareness of suicide as a problem and has informed the development of suicide prevention strategies. The findings have received widespread coverage in local, national and international media with impact on a range of audiences. These include policy makers, suicide prevention practitioners, mental health professionals and the wider public. Elected representatives have used the research in debates in the House of Commons and Northern Ireland Assembly. Psychiatrists, counsellors, suicide prevention workers, volunteers for the Samaritans and the Commission on Victims and Survivors have actively engaged with the research.
Impact: Health and welfare; public health studies in Sri Lanka and clinical trials in a cohort of 35,000 pesticide self-poisoning patients have led to the withdrawal of high-dose pralidoxime as a WHO-recommended treatment and bans of three toxic pesticides in Sri Lanka.
Significance: Resultant changes in clinical practice and pesticide regulation have saved 3000 lives in the last four years in Sri Lanka alone; in the rest of Asia many times this as local guidelines and practice have changed.
Beneficiaries: Patients and communities, healthcare providers, policy-makers.
Attribution: Studies designed and led, with international collaborators, by Michael Eddleston, UoE.
Reach: International, particularly Asia, changes in WHO and international guidelines on pesticide use.
The Galatean Risk and Safety Tool (GRiST) is a clinical decision support system (CDSS) conceived and developed by computer scientists at Aston University from 2000 onwards, where it is being delivered as a cloud-computing service. It is used every day by mental-health practitioners in the NHS, charities, and private hospitals to assess and manage risks associated with mental-health problems. Between 1/1/2011 and 31/7/2013, clinicians provided 285,426 completed patient risk assessments using GRiST. It has changed organisational and clinical processes by its systematic collection of risk information, explicitly linking data to clinical risk judgements, and showing how those judgments are derived. Increasing international awareness has come through presentations to mental-health practitioners in Europe, America, and Australia.
Staff are concerned as public intellectuals in debating policies that closely affect personal life and happiness, taking part in current social policy debates on adoption policy and on assisted suicide. Their participation is shaped by their historical research at the University of Sunderland within a framework of engagement with modern political debates on social issues which have become of acute concern to the general public.
Impact is demonstrated with reference to the way that the terms of debates have been shaped and re-drawn by this participation, in the media (particularly radio), in Parliament, and amongst healthcare professionals in the UK, and in the parallel controversies of the USA, Japan and South Korea.