Suicide Assessment and Treatment Pathway

The pathway assists staff with the assessment of people at risk of suicide and provide appropriate and timely treatment within appropriate timescales.

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The Scottish Government has set the target of reducing suicide in Scotland by 20% by 2022. To do this a national Suicide Prevention Action Plan (Every Life Matters) was launched in 2018. North & South Lanarkshire Multi Agency Suicide Prevention Groups have developed Action Plans focussing on the National key priorities. Local strategy focuses on a broad range of activities particularly awareness raising, promoting access to support such as Breathing Space and Samaritans and suicide intervention training. It has been highlighted nationally that more focus at a local level needs to be given to ensuring good suicide prevention initiatives are embedded in practice via protocol and procedures.

It has been estimated that internationally approximately one million die through suicide every year (WHO 2006). 

  • There were 784 suicides (deaths from intentional self-harm and events of undetermined intent) registered in Scotland in 2018, compared to 680 in 2017. These figures are based on the new coding rules introduced by the National Records of Scotland (NRS). The corresponding estimates based on the old coding rules (see note below) are 753 suicides in 2018 and 664 in 2017.
  • In 2018, the suicide rate for males was three times that for females. 
  • In 2014-18, the suicide rate was more than three times higher in the most deprived tenth of the population (decile) compared to the least deprived decile (21.7 deaths per 100,000 population compared to 7.0). 
  • While suicide rates are strongly related to deprivation level, this difference or inequality has decreased between 2004-08 and 2014-18. 
  • The suicide rate varies between different areas within Scotland and fluctuates over time. For 2014-2018, seven NHS Board areas had a higher European age standardised rate than the Scotland average. 
  • Scotland appears to have had a higher suicide rate than the UK overall since the early 1990s, though this comparison is affected by differences in data recording practices between countries.

The personal, family, community and economic impact of suicide are well documented. Many suicides can be prevented.

NHS Lanarkshire, North Lanarkshire Council, South Lanarkshire Council and partners have jointly developed a suicide assessment and treatment pathway. The pathway assists staff within these agencies in the assessment of people at risk of suicide and provide appropriate and timely treatment within appropriate timescales. It is envisaged that this pathway will ensure a more uniform, systematic and accessible response to this significant health issue, combined with training in the assessment and treatment of individuals at risk of suicide through initiatives such as safeTALK, ASIST and STORM.

This supporting guidance document is aimed at all health and social care staff who need to be vigilant of people who desire to kill themselves and has been designed to be read alongside the Suicide Assessment Treatment Pathway. All threats of suicide require to be taken seriously and thoroughly investigated.

Although suicide is a multi-faceted phenomenon three main factors require to be identified on assessment of risk: desire, intent and capability. ‘Buffers’ supports and factors, which mitigate and protect against suicide, also require assessment (Joiner et al 2006).

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