As part of NatCen’s 50th anniversary celebrations and with sponsorship from the National Institute of Health Research, the Royal Statistical Society hosted a day-long event, 'Using data to inform suicide and self-harm prevention' on 25 February 2019. The question of the day was: How do we ensure the right data are available, analysed and communicated to address the major questions in suicide and self-harm reduction policy and practice? The presentations covered a variety of research areas, datasets and methods of analysis and included speakers from a range of different sectors.
The day started with a welcome from the chair Professor Louise Arseneault (King's College) and an overview from Professor Louis Appleby (University of Manchester) on the use of data in the National Suicide Prevention Strategies. He highlighted that groups identified in the strategies as high risk had to be identifiable and countable. He gave an important reminder that ‘behind the data there is tragedy to individuals and loved ones’. Liz Scowcroft (Samaritans) also put the need for accessible data on suicide into context; she described how delays in coroners’ verdicts has led to variability between UK countries.
Following this were three presentations on general population and cohort surveys. Sally McManus from NatCen outlined the various surveys that have asked adults about suicidal thoughts, suicide attempts and self-harm, in particular England’s national mental health survey the Adult Psychiatric Morbidity Survey (APMS). Patience is key as accessing the latest survey in the APMS series now requires data users to apply for approval from NHS Digital. The process is bureaucratic and has been taking up to one year. Professor Tamsin Ford (University of Exeter) described using the Mental Health of Children and Young People survey to investigate self-harm in children with emotional, behavioural, and neurodevelopmental disorders and Dr Becky Mars (University of Bristol) presented findings from the longitudinal ALSPAC cohort on which adolescents with suicidal thoughts were most likely to go on to make a suicide attempt.
Dr Ben Windsor-Shellard from ONS explained the process involved in registering suicide deaths and promoted the use of data linkage to deal with the data missing from this, such as ethnicity or student status. Professor David Gunnell (University of Bristol) detailed the advantages and challenges of using national suicide mortality statistics, then Professor Appleby presented data from the National Confidential Inquiry including setting out the key ways to improve patient safety. Next, we heard from Dr Sarah Cassidy (University of Nottingham) who described a psychological autopsy approach to examining suicidality among people with autism and autistic traits.
After lunch, two presentations set out research carried out in health care settings. Professor Nav Kapur (University of Manchester) emphasised the importance of using hospital self-harm data as it can help researchers and clinicians determine when people present to health care, what works in supporting them, and when to intervene in this population. Next up was Dr Karyn Ayre (King's College) who covered her research in the area of self-harm in the perinatal period. Dr Ayre’s work has been submitted for publication and we hope to hear more about this soon.
Two presentations focused on broader socioeconomic and cultural risk factors for suicide and self-harm. Dr Chris Fitch (University of Bristol) explained his work collaborating with financial services to investigate experiences of debt collections agencies with clients who express suicidal thoughts or behaviours and how best to intervene with these individuals. His message was to ‘step outside of health and think about engaging with other sectors’. Caroline Turley, head of qualitative research at NatCen, presented her NIHR-funded research on the experiences of mid-life men who had experienced suicidal distress. This research led to recommendations for what men would like from services: 'ask don’t assume', 'recovery takes time' and 'be mindful of language and imagery in the media'.
The final three sessions focused on data platforms and hubs. Professor Ann John (Swansea University) described the benefits and limitations of a range of data sources, including ‘big data’ and data linkage. She also provided an overview of exciting developments including artificial intelligence, specifically artificial neural networks, with routine health data to aid identification of those at risk of suicide and self-harm. Following this, Dan Collinson from NHS Digital provided an overview of the datasets available in relation to mental health, suicide and self-harm, how to access these and the possibilities for data linkage. Finally, Helen Garnham and Cam Lugton from Public Health England described the Fingertips tool which collates and presents a range of publically available data including facets of suicide prevalence, associated risk factors and service contact among groups at increased risk. This provides planners, providers and stakeholders with a means to profile their area and benchmark against similar populations.
The take home messages from Professor Arseneault, summarised by The Mental Elf (@Mental_Elf):
- A refreshing meeting
- Let's make self-harm and suicide data accessible
Keywords from the day: GDPR, need, voice, trends, big, profile, harmonisation, story, gap, challenges and love: ‘we love data!’
Now let’s start analysing! (After we receive the data that is.)
The Twitter hashtag for the meeting was #SelfHarmData.