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Projects

Implementing a personalised approach to risk

An illustration of a woman sitting on a picnic bench next to some trees. Illustration by Leanne Walker.

View full illustration and accessible text version on NHS England.

We are working with the National Collaborating Centre for Mental Health (NCCMH) to deliver one of four key interventions that aims to improve the culture of care on in-patient, learning disability and autism wards for patients and staff.

We are working alongside experts in neurodiversity, learning disability, equality, trauma, and quality improvement to support these wards to provide safe, equitable, trauma- and autism-informed care.

Our work will support mental health organisations to implement a personalised approach to suicide risk assessment. Initially, we will be working closely with ten organisations providing expert advice to support them to change their approach to assessing risk. This support will then be extended nationally.

We will bring together online resources related to a personalised approach to suicide risk assessment and management. These resources are available here.

This work is funded by NHS England and forms part of their Mental Health, Learning Disability and Autism Inpatient Quality Transformation Programme.

National real-time data collection of suspected suicide deaths under mental health care

A patient in a therapy session.We have established a national real-time data collection of suspected suicide deaths by people under the recent care of mental health services in England.

Our initial focus is on patients in closest contact with mental health services, specifically in-patients and post-discharge patients who died within 14 days of discharge.

Our overarching aim is to collect information that we need to know early to support suicide prevention efforts. This includes emerging novel methods, suicide related internet use, possible clusters, problems in care which may be systemic and particular problems that patients face.

We are taking a staged approach to establishing this real-time data collection:

  1. Firstly, we piloted this RTS data collection in eight NHS Trusts in South East England.
  2. In April 2024, we expanded this RTS data collection nationally to all mental health trusts across England that provide in-patient care.

We are asking clinicians for early notification of any suspected suicide death of an in-patient or a patient recently (within 14 days) discharged from in-patient care, where the death occurred from 1 January 2024, without waiting for the inquest or for a request from us. This is via our anonymous online questionnaire.

Further information can be found in our information sheet and FAQs. We have also produced an infographic for onward sharing. We will report findings in our 2025 Annual Report.

Suicide in NHS staff: a national data collection to inform prevention

A person holding a mug of coffee, looking out over a hilly landscape.We have been commissioned by NHS England to establish a prospective data collection about suicide by NHS staff, with the aim of preventing future deaths.

Some health service staff may be at an increased risk of suicide, and staff wellbeing is a priority in the context of sustained and growing pressures.

We are taking a stepped approach to establishing this data collection:

  1. Firstly, we are working with Greater Manchester NHS Integrated Care Board to engage with stakeholders and HR representatives across Greater Manchester as our trailblazer site to explore data availability for clinical staff;
  2. We will expand our engagement to the North-West region. NHS Trusts in Greater Manchester, Lancashire and South Cumbria, and Cheshire and Merseyside will provide data on suicide deaths by NHS staff in clinical patient-facing roles over a 5-year period (January 2019 to December 2023). This data is being collected via our anonymous online questionnaire;
  3. We will expand this data collection nationally, and further develop the data collection to collect information about non-clinical members of NHS staff who die by suicide. By learning from these tragic deaths, our aim is to improve safety and wellbeing for people working within the NHS. This work will run from May 2023 to April 2026.

Further information could be found in our information sheet and FAQs.

Clinician bereavement study

A bench outside a hospital.Mental health professionals can expect to experience the death of a patient by suicide at least once but as many as four times in their professional career.

Each death can have a profound effect. In this study, conducted in collaboration with the Centre for Suicide Research at Oxford University and the Royal College of Psychiatrists, we will:

  • examine the impact of patient suicide on the emotional well-being and clinical practice of clinicians
  • map wanted and available resources for clinicians before and after the suicide of a patient
  • make recommendations on how to develop support services locally and nationally for clinicians.

We will undertake this by using our existing NCISH methodology to identify clinicians who have experienced the death of a patient by suicide. We will invite them to complete a questionnaire focusing specifically on the impact the patient’s death had on them. To find out more please see the clinician bereavement study’s participant information sheet or watch a short video of Dr Cathy Rodway discussing why the study is important and what its impact could be.

The study has been funded by the Medical Protection Society (MPS) Foundation.

National review of higher education student suicides

Blurred background of a university campus on an autumn day.We have been funded by the Department for Education to conduct an independent national review of suspected suicides (and non-fatal incidents of serious self-harm) in higher education (HE) students in England. This will enable broader lessons around mental ill-health and suicide in HE students, with the aim of preventing future deaths.

We will undertake this by examining serious incident (SI) reviews of suspected suicide by HE students, conducted by HE providers in line with guidance published by Universities UK. The focus of the study is reviews conducted during the 2023/24 academic year but we will also consider some earlier reviews.

We are acutely aware of the sensitivity of this study and the interest in it from families bereaved by suicide. We have always worked closely with families and will be asking for their input throughout.

Further information about the study can be found in our information sheet and FAQs. The study will report around spring 2025.

Completed projects

Suicide in former service personnel

*NEW* findings from the first phase of the study published in PLOS Medicine.

We found the overall suicide rate was not greater than in the general population, but risk was 2-3 times higher in male and female veterans aged under 25 than in the same age groups in the general population. Male veterans aged 35 years and older were at reduced risk of suicide. Male sex, Army service, discharge under the age of 35 years, being untrained on discharge, and length of service under 10 years were associated with increased suicide risk. Factors associated with reduced risk included being married, a higher rank and deployment on combat operations. 

Read our paper “Suicide after leaving the UK Armed Forces 1996-2018: a cohort study” (PLOS Medicine)

 

Download our key messages sheet (PDF)

 

Watch our Professor Nav Kapur talk about the key findings and recommendations

This study, with the Ministry of Defence, aims to investigate suicide amongst those who have left the UK Armed Forces, and to make comparisons with serving personnel and the general population. The study will update our previous work from 2009, which showed although the overall rate of suicide was not greater than that in the general population, the risk of suicide in young men who had left the Armed Forces was 2-3 times higher than in the same age groups in the general population. Since this study was carried out there has been no systematic investigation of suicide in UK veterans.

The purpose of the study is to understand the rate, timing and risk factors for suicide for those who have left the UK Armed Forces between 1996 and 2018. The study will include the linkage of data from the Ministry of Defence on all suicide deaths in serving personnel and all personnel discharged from Armed Forces with NCISH data on general population and mental health patient suicides. It will also include a review of coroner’s records and inquest hearings for a sample of veteran suicide deaths. This study will provide more detail of the factors related to suicide (particularly early and recent vulnerabilities, in-service exposures, difficulties after discharge, living circumstances, and contact with a variety of health and third sector providers) in this population.

The study is funded jointly by the Ministry of Defence and NHS England. Further information on the study design and purpose can be found in our study summary and information sheet, and is also available on the GOV.UK website. 

Reducing suicides: Quality improvement and patient safety

We worked with experts in Quality Improvement at the National Collaborating Centre for Mental Health (NCCMH) to support Sustainability and Transformation Partnerships (STPs) to strengthen their local suicide prevention quality improvement plans. This was part of a nationally recognised suicide reduction priority across Department of Health, NHS England, and an overall Mental Health Five Year Forward View recommendation to reduce the suicide rate by 10% by 2020/21.

Together with NCCMH, we worked with Quality Improvement teams in each STP to:

  • review their services against established guidelines and recommendations, and improve the quality of care they offer, using bespoke data provided from the NCISH database, benchmarked against the national average;
  • provide expert knowledge of suicide prevention in three priority areas – mental health secondary care, services for self-harm, and middle-aged men;
  • identify and help STPs adopt and embed national evidence including NCISH “10 ways to improve patient safety” into local quality improvement plans;
  • advise on local data collection and suicide prevention plans.

Read more about this collaboration on NCCMH’s Suicide Prevention National Transformation Programme webpage. The study was commissioned by the Healthcare Quality Improvement Partnership (HQIP).

In May 2019, NCISH were winners of a 2019 Making a Difference award for social responsibility.

Video iconClick here for a video explaining our work on suicide prevention.

Blog iconRead our March 2020 update on the national suicide prevention programme in this blog, by NCISH researchers Nicola Richards and Cathryn Rodway.

Blog iconRead a blog on our work with NCCMH to help local areas improve suicide prevention plans, by the NCISH project manager, Dr Pauline Turnbull.

Download iconDownload a summary of how we help local areas improve suicide prevention plans.

A diverse range of multifaceted, novel projects have been established throughout this programme. See some examples of innovative work being carried out by local areas in the programme.

Support for improving community-based care for self-harm

We were commissioned by NHS England and NHS Improvement to support areas in England to improve community-based services and care for people who self-harm. Together with experts from the Manchester Self-Harm Project (MaSH) and NIHR Greater Manchester Patient Safety Translational Research Centre (PSTRC), we supported participating areas by providing:

  • Expert knowledge of current self-harm data and research;
  • Guidance on national guidelines and recommendations for the care of people who self-harm;
  • Advise on methods of data collection to monitor and evaluate the impact of service changes for people who self-harm;
  • An online resource to gather useful information in an easily accessible format.

This was part of a national programme funded by NHS England and NHS Improvement linked to establishing new and integrated models of primary and community mental health care across England. Read more about this collaboration here. This work was commissioned by the Healthcare Quality Improvement Partnership (HQIP) and funded by NHS England and NHS Improvement.

Suicide Information Database Cymru (SID-Cymru) and NCISH database linkage study
This collaboration between the NCISH and SID-Cymru (hosted with the Secure Anonymised Information Linkage (SAIL) Database) will link routinely collected data about all individuals in Wales who died by suicide between 2001 and 2015 with clinical data collected by the NCISH on patients in contact with mental health services within 12 months of their death.
National academic response to COVID-19 related suicide prevention

We extended our national suicide prevention support role to include responding to local area’s concerns specific to the pandemic. Read more about our work here.

Blog iconRead a blog on NCISH’s contribution to suicide prevention during COVID-19.

Evaluation of the Mersey Care NHS Foundation Trust Zero Suicide initiative
A two-year project working with Mersey Care NHS Foundation Trust to evaluate their Zero Suicide initiative.

Video iconWatch a video of Professor Louis Appleby talking about the Zero Suicide initiative

Safety in marginalised groups
One of four research themes being undertaken by the NIHR Greater Manchester Patient Safety Translational Research Centre in collaboration with NCISH, to further explore suicide and self-harm by primary care patients.
The impact of suicide in the UK

A survey-based study conducted in collaboration with the Support after Suicide Partnership (SASP) to better understand the impact of suicide on people’s lives, including the support received.

All our projects

More information on our projects can be found within the University’s Research Explorer.