Key points

Key points

  • The NHS Five year forward view for mental health set targets to reduce the number of suicides by 10% by the year April 2020 to March 2021.

  • Self-poisoning is the second most common means of suicide, and opiates and opioids (including opioid-containing compounds, as well as prescribed and illicit drugs) are still the main type of drug taken in fatal overdoses in the UK.

  • In a large UK observational study in people aged 65 years and over, the risk of suicide was markedly increased in people who had a previous self-harm episode compared with those who did not. Self-poisoning through ingestion of drugs was the most common means of self-harm.

  • Evidence suggests that we can prevent suicide by optimising medicines, and multi-agency suicide prevention plans should be developed.

  • Reducing access to means of suicide may include:

    • restricting availability of medicines for purchase, prescription and in the home

    • reducing stockpiling

    • carrying out medication reviews in line with the NICE guideline on medicines optimisation.

  • Suicide prevention features in the NHS Long Term Plan published in January 2019.

  • Options for local implementation:

    • When making decisions about prescribing controlled drugs, the risks of prescribing, including dependency, overdose and diversion should be taken into account. Enough of a controlled drug to meet the person's clinical needs for no more than 30¬†days should be prescribed.

    • Ensure local compliance with national guidance to reduce access to methods of suicide. For example, in the community restrict access to painkillers.

    • If a person with a common mental health disorder, in particular depression, is assessed to be at risk of suicide, take into account toxicity in overdose when choosing a medicine as well as potential interactions with other prescribed medicines. If necessary, limit the amount of medicine(s) available.

    • Monitor people who are prescribed antidepressants for an increased risk of suicide.

    • Educate and support health professionals to ensure that people with mental health conditions are treated adequately, in line with national guidance.