New toolkit aims to prevent suicides among NHS workforce

NHS England has published its latest strategy for suicide prevention among the nursing and wider health workforce.

The national suicide prevention toolkit for England, published last week, has been created to “embed” good practice in all parts of the health service.

It pulls together resources from more than two dozen support services; existing guides for suicide prevention; mental health charities; and ‘postvention’ toolkits to support staff who have experienced a colleague dying by suicide.

"The challenges facing the NHS now can also feel relentless at times. Our support for our colleagues is needed more than ever"

Ruth May and Navina Evans

As well as providing these resources for organisation leaders, the toolkit offers step-by-step guides for managers on how to respond to warning signs among their healthcare staff, and how to spot people who are at risk of suicide.

In a foreword to the toolkit, Dame Ruth May, chief nursing officer (CNO) for England, and Dr Navina Evans, chief workforce officer, said they hoped the resources could help mitigate the increasing pressures on nursing and other healthcare staff.

They said: “The pandemic created an environment with unprecedented challenges for staff, who were also dealing with the impact of lockdowns and grief in their personal lives.

“The challenges facing the NHS now can also feel relentless at times. Our support for our colleagues is needed more than ever.

“We are committed to building on our existing resources to support the mental health and wellbeing of NHS staff, and to creating environments where staff feel able to be honest about how they are feeling and comfortable in asking for help.”

According to the toolkit a “holistic workforce suicide prevention programme” should include:

• A workplace that values its employees and their families

• Education and training on mental health and suicide awareness

• Internal communications that tell staff what resources and support are available

• Clear policies and “practical" guidance on where and what help there is

• Having a clear plan to respond to a suicide attempt or death as per the postvention toolkit

They pointed to the fact that suicide prevention measures for NHS staff must take into account the heightened risk for specific workers.

The report references a 2017 Office for National Statistics (ONS) study which found that, while men were still the highest-risk members of society, suicide rates and risk among women were also on the rise.

In particular, the 2017 study found that female nurses had a 23% higher rate of suicide than other women.

The toolkit noted: “It has been suggested that nurses remain at particular risk of suicide due to a unique combination of attributing factors including mounting pressures to work extended/extra shifts, self-imposed psychological pressures due to patient dependence and lack of engagement of mental health support due to fears of job insecurity or perceived collegial failure.”

As well as this, NHS England’s publication referred to the 2022 NHS staff survey which showed staff were facing physical violence, harassment, bullying and abuse in record numbers.

It noted how these factors, as well as moral injury, stress and burnout, increased suicide risk.

Dame Ruth and Dr Evans said: “We know that some groups of staff are more at risk of suicide than the general population. 

“This toolkit has been designed to help NHS organisations reduce the risk of suicide in their workforce.

“It will assist organisations to embed suicide prevention strategies in the organisation’s health and wellbeing policies and guide the approach to supporting those at risk of suicide within the workforce.

“We hope this toolkit will help organisations to support the health and wellbeing of their staff and to understand and act on suicide risk factors.”

The toolkit also added that NHS England recognised that people with other protected characteristics may experience sterotyping and descrimination that negatively impacts their mental health wellbeing.

It pointed to the added potential stress on Black and minority ethnic staff due to higher rates of regulatory referrals.

It ended with examples of working suicide prevention campaigns at NHS organisations, and listed actionable recommendations for trusts.

Recommendations included more staff training on suicide awareness; “timely access” to clinical supervision and trauma support after a colleague dies by suicide; acknowledgement that healthcare staff are at risk of suicide and a pledge to reduce the stigma; a pledge to make staff aware of local and national support; training for line managers to better talk about suicide prevention and mental health; and cultural sensitivity when tackling the issue.