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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.
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.
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).
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.
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.
Suicide is one of the most serious adverse outcomes in mental health services. NCISH research is based on a comprehensive and internationally unique database (99,000 suicide deaths; 25,000 patient suicide deaths). NCISH impacts upon practice and policy by providing definitive figures on suicide to clinical services and government, producing data-driven safety recommendations and demonstrating that these recommendations reduce suicide. Based on NCISH research, overall patient suicide rates fell by 26% (2004-11), in-patient deaths fell by 58% (2001-2010), and individual recommendations may have prevented between 200-300 patient suicide deaths per year. A new vehicle for impact delivery is the social enterprise Safer Care Ltd (founded 2013), which has already reviewed 4 Trusts and, by reinvesting future income in the social enterprise, we will continue to meet the specific needs of mental health services.
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.