Preventing suicide during the cost of living crisis – how to adapt prevention services

Michelle Farr, Research Fellow at ARC West, was involved in our evaluation of Hope. Hope is a project to help men aged 30-64 who are at risk of suicide led by Second Step. The research team and Second Step have received additional policy funds to share research findings with policy makers, and they have just published a policy brief. Here she blogs on how suicide prevention services could be adapted to address the financial pressures of the cost of living crisis.

The cost of living crisis is having an adverse impact on some people’s mental health, with one charity seeing a 196% rise in clients with suicidal thoughts. The Samaritans, a suicide prevention charity, are receiving a record number of calls from people with money worries, including energy bills, household costs and eviction threats, as reported recently on Channel 4 news.

Economic hardship and suicide rates

People in debt are two to three times more likely to consider suicide than those not in financial difficulty. Men can be particularly affected by economic downturns, with recession-associated rises in suicide observed in men, particularly those who are middle-aged. Men account for over three-quarters of people who die by suicide in the UK, with the highest rates in middle age, particularly for men from disadvantaged backgrounds. When men contemplate suicide, research shows that a range of factors may be at play, including debt, housing, and employment issues. However, suicide prevention services often focus on psychiatric and emotional support without capacity or expertise to provide advice with the more practical issues that men might be facing.

How suicide services can be made more effective

Our recent research has shown that people at risk of suicide can be helped by combining emotional support with practical advice to tackle financial, housing and employment issues that may be contributing to suicidal thoughts and attempts. Whilst welfare advice services can effectively support people in debt, and many mental health services provide emotional support at times of crises, these different services are rarely integrated. We undertook an evaluation of the Hope service, run by mental health charity Second Step, which supports men at risk of suicide by providing a series of one-to-one support sessions, with access to specialist advice for financial, employment, housing or welfare benefit difficulties where needed.

Our research illustrated how integrated emotional support and practical advice can save men’s lives at times of suicidal crises by creating a space in which men can discuss all issues affecting them and be supported to manage and overcome life challenges. We spoke to different men who had used the Hope service who said:

“They sorted my life out… at the time, I had my money slashed to bits which I don’t know how I survived plus I felt myself sinking into depression… I wasn’t sleeping, I wasn’t eating, I was a bit of a mess. They certainly helped me.”

“I mean I was always brought up as a man don’t cry and you know a man gets on with it whatever’s thrown at him, so I never ever discussed with anybody up until not long back…. There’s no judgementalness at all and I found that very comforting… it’s the first time I’ve ever opened up in me life.”

We found people in suicidal crises can benefit from timely access to community-based, informal, integrated emotional and financial support. Another man contrasted his experience of the Hope service, with his experience of long waiting lists within traditional health services:

“I tried to hang myself. It was really, really bad… I was in A&E… they basically say to you “you’re not bad enough to be admitted to the psychiatric unit… We have to refer you back to your GP” … I had a GP ringing me the next day “oh we’ll refer you to (mental health support provider) they’ll speak to you within a week” and then they say to you “oh there is a seven to 10 month waiting list.”

The Hope service in its current form targets middle aged men because of the high rates of suicide in this group.

What needs to be done

A policy brief has been recently published, based on the findings of this research. Policy implications include that:

• Suicide prevention services need to focus on the multiple issues that people may face when feeling suicidal through an integrated approach. These could include debt, housing, welfare benefit, finance or employment problems, relationships, bereavement and alcohol or drug use problems alongside psychological and emotional issues. By connecting, directly supporting and advocating with people so they can access practical, expert financial and housing advice, this can help people feel more in control of their life circumstances, which can help to reduce suicidal feelings.

• Traditional funding streams tend to focus either on mental health (i.e. NHS psychiatric services), or practical and legal advice (i.e. local authority/Legal Aid) which have been subject to severe cuts. Whilst there have been developments to integrate services, there is a strong need to ensure such services are appropriately funded. For example, since our research, the Hope service has had some of its funding for specialist advice workers cut.

• The Hope service in its current form targets middle aged men because of the high rates of suicide in this group. The service could be developed and adapted to target other, at risk, population groups.

For more information about the Hope service, please watch Rescued from the rabbit hole on YouTube:

If you’re struggling with suicidal thoughts, Samaritans UK can provide you with support. Call 116 123.