As I struggle to download third Annual Report on Suicide Prevention in England & Wales and mull over the Prime Minister's remarks this morning, I feel like I'm balancing two very different verdicts. 'Smoke and mirrors' or a 'historic moment', which will it be?
When I launched CALM in 2006, dedicated to preventing male suicide in the UK, the idea that I would one day be invited to hear the Prime Minister mention the subject was inconceivable. As was the idea that the campaign might be supported by the royals. Or Lynx, for that matter. Those early years were filled with repeating male suicide statistics to incredulous journalists who, in the end, felt that if suicide was such a big killer, then there wouldn't just be some mad old bat in Hampstead going on about it. And fruitlessly scanning lists of grant categories to see if preventing male suicide could conceivably be twisted-to-fit within selective criteria - only if he had one leg/was black/aged under 21/had committed a crime/had served in the army/wasn't male seemed to be the answer.
So yes, great to see male suicide name-checked. But as I leave CALM at the end of January the idea that after 10 years the pinnacle achievement is Mrs May giving the issue a nod is disheartening.
I know. Bloody historic having the PM address mental health, and a tribute to a lot of work done by the whole mental health sector who have been collectively been hammering on bars over the last few decades. The smoke and mirrors thought comes up, unkindly, as what appears to be the case is that various pieces of work, ie the progress report on the cross-government outcomes strategy to save lives (prevent suicide), were tied together with a bow and launched as proof that the PM is serious about mental health. She may well be, and whilst there was much mention that this is the 'start of a journey', this is a journey many have been on for some time.
Delving into today's suicide prevention report, there is lots to welcome. It is great to see young and middle aged men top the list of those at high risk. And recognition of the need to support the bereaved, have better data, have local suicide prevention plans in place. Mr J Hunt's introduction sums up the plan succinctly:
"Throughout this annual report there are examples of what local areas can and should be doing to link national action to local delivery. That is the only way that we can achieve the ambition of reducing the national suicide rate by 10 per cent by 2020/21."
It's all down to local action. Money will be sprinkled around to local initiatives, and hopefully local plans and targeting will deliver the rest. So for young men/middle aged men (first on the 'high risk group', hurrah!), mention is made of some really good work, State of Mind Sport, Andy's Man Club, Men's Sheds etc which we should copy and adopt. I know, these are fantastic initiatives. But if that's the plan, then fuck me, we're doomed. We need more than the voluntary sector here.
These are GREAT initiatives, but this isn't a realistic national strategy. Men account for 75% of all suicides. We need to take this issue seriously. Yes, great to see Public Health England state that "sporting initiatives may be an effective way of targeting young men and local areas may want to engage local sporting figures, or gym/fitness professionals to become suicide prevention champions'."
Very often these great initiatives are created by men in despair of getting any kind of help. Take a long look at your dad - he's in the high risk group. How will he respond to your local sporting figure?
CALM dealt with just under 60,000 webchats and calls last year from men down and suicidal. Hopefully we'll run 24/7 soon - but even if we double, or indeed quadruple, our capacity, we aren't the answer. We need a fully functioning Mental Health Service. Drugs maybe involved. And counselling. We can't just outsource mental health services to the charity sector. It's bad enough that localisation means that responsibility lies within the local authorities, bad enough that there's no enforcement measures. But if the thought here is that the bun fight is extended to the voluntary sector to deliver on, then I fear we'll have gone backwards.
There's not much in the Department of Health's review that hasn't been mentioned in previous reports. We need to have a better idea around how many suicides there are in the UK, and have timely statistics and richer data about those suicides. Local areas ought to have plans, and think about who their audiences are. I mean no disrespect to the authors - suicide prevention has been an underfunded backwater for a long time, people are doing their best. What's lacking is money, commitment, and enforcement. Otherwise it's a wishlist.
I despair about the data, both the inaccuracy, the inadequacy and the delay in getting it. And I despair about the lack of questioning around gender. Why do more men take their lives than women? I feel like CALM has accomplished an own goal here. When I launched CALM the only part of the equation we could tackle were the social expectations upon men. Given the way the rates and numbers change, a huge part of why more men take their lives patently is social. But surely, with any health issue the normal procedure is to examine the causes of a problem before deciding upon a course of action. The Department of Health had £1.5million to put into research into suicide. None went into looking at why men. I don't believe 'men drink more, don't see their GP and are better risk takers' is a good enough answer. Why did the suicide rate for women all but half from 1980s?
We need to break out of the bake sale perspective around mental health, and if we are to tackle male suicide, then a real plan is needed. Being positive: it is marvellous to see men mentioned in relation to suicide. Yes, it is historic. The journey now needs to be about how we tackle the issue. The voluntary sector has a role. As does government - we need a national strategy, with teeth. Suicide is the single biggest killer of men aged under 45 in the UK, so let's move on from the name-check and look at a national plan.