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Overview

Overview. Overview. The Problem: Suicidal Behaviour in Ireland The Response: Reach Out Strategy Development & Outline. National Office for Suicide Prevention - NOSP. Pattern of Suicidal Behaviour: Suicide. EU Total Population Suicide Rates per 100,000 Source: WHO site, Sept 9 th 2005.

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Overview

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  1. Overview Overview • The Problem: • Suicidal Behaviour in Ireland • The Response: • Reach Out Strategy Development & Outline National Office for Suicide Prevention - NOSP

  2. Pattern of Suicidal Behaviour:Suicide

  3. EU Total Population Suicide Rates per 100,000 Source: WHO site, Sept 9th 2005 National Office for Suicide Prevention - NOSP

  4. EU Youth Suicide Rates per 100,000 population Source: WHO site, Sept 9th 2005 National Office for Suicide Prevention - NOSP

  5. Suicide – Estimating the Cost… Annual Estimated Yearly Costs of Suicide (2002) • Direct € 1.6m • Non-market € 45.7m • Market € 193.8m • ‘Human’ € 595.5m • TOTAL € 836.6M National Office for Suicide Prevention - NOSP

  6. The Response

  7. Response / Policy Context 1993 - Criminal Law (Suicide) Act 1995 - National Task Force on Suicide 1998 - Task Force Final Report, NSRG, Health Board Suicide Resource Officers National Office for Suicide Prevention - NOSP

  8. Response / Policy Context 2001 – Quality and Fairness, National Health Strategy - Health (Miscellaneous Provisions) Act 2005 – Reach Out Strategy 2006 – Vision for Change, New Mental Health Policy National Office for Suicide Prevention - NOSP

  9. Developing Reach Out National Office for Suicide Prevention - NOSP

  10. Development Contd • Feb 2003 Decision by Health Boards Executive to develop a national strategy • Writing Group developed the strategy in partnership with the National Suicide Review Group and the Mental Health Directorate of the Department of Health & Children • Steering Group provided guidance • Reference Group provided quality assurance

  11. ReachOut – The Document • Broad-based, straightforward • In accordance with approach advocated by World Health Organisation (WHO) & International Association for Suicide Prevention (IASP) • Quality & Fairness – National Health Strategy

  12. ReachOut - Framework • Begins with a Vision • Employs 10 Guiding Principles • Proposes Action at 4 Levels • Lists 26 Actions involving multiple settings • Identifies Lead Agencies • 96 Deliverables • 3 Phases Short-term priorities for immediate start-up Start-up pending partnership commitment Follow-on Actions linked to Phases 1 & 2

  13. Reach Out – 4 Level Approach • General Population Approach • Targeted Approach • Responding following Suicide • Information and Research National Office for Suicide Prevention -NOSP

  14. Level A - General Population • Area 1 The Family • Area 2 Schools • Area 3 Youth Organisations and Services • Area 4 Third Level Education Settings • Area 5 Workplaces • Area 6 Sports Clubs and Organisations • Area 7 Voluntary & Community Organisations • Area 8 Church and Religious Groups • Area 9 Media • Area 10 Stigma & Promoting Mental Health • Area 11 Primary Care and General Practice National Office for Suicide Prevention - NOSP

  15. Level B - Targeted Approach • Area 12 Deliberate Self-Harm • Area 13 Mental Health Services • Area 14 Alcohol and Substance Abuse • Area 15 Marginalised Groups • Area 16 Prisons • Area 17 Police • Area 18 Unemployed People • Area 19 People Experiencing Abuse • Area 20 Young Men • Area 21 Older People • Area 22 Restricting Access to Means National Office for Suicide Prevention - NOSP

  16. Level C - Responding • Support following Suicide • Coroner Service National Office for Suicide Prevention - NOSP

  17. Level D - Information & Research • Information • Research National Office for Suicide Prevention - NOSP

  18. ACTION PLAN SAMPLE PAGE

  19. CORE IMPLEMENTATION STRUCTURES HSE Population Health Dept of Health HSE and Voluntary Services National Office for Suicide Prevention National Advisory Group National Research Network National Forum HSE Resource Officers NOSP National Office for Suicide Prevention -NOSP

  20. 2006 Development Plan (12-point plan) • Establish a National Forum (Making it Happen) Level A • Training and Awareness Programmes (e.g. 17.1) • Media Coverage of Suicide and DSH (9.1 & 9.5) • National Anti-Stigma Campaign (10.1) National Office for Suicide Prevention -NOSP

  21. 2006 Development Plan (12-point plan) Level B • Primary Care and Suicidal Crises Service (11.5) • A&E Response to DSH (12.1-12.3) • Traveller Project – Social Inclusion (15.1-15.2) • Institutional Abuse and Suicide Risk (19.1) National Office for Suicide Prevention -NOSP

  22. 2006 Development Plan (12-point plan) Level C • Bereavement Services (23.1) Level D • Data Collection and Management (25.1-25.2) • National Research Programme (26.1) • Reaching Young People (25.4) National Office for Suicide Prevention -NOSP

  23. PopulationHealthPerspective • ‘Population Health’ – made in Canada term • Long tradition of Public Health & Health Promotion • Lalonde Report ‘A New Perspective on the Health of Canadians’ 1974 – suggested that changes in lifestyles or social & physical environments could have an impact on health

  24. Contd. • Ottawa Charter for Health Promotion 1986 (WHO Document) introduced the notion of Key Determinants of Health

  25. Departure from the concept of health as an absence of illness to a notion of health as “The capacity of people to adapt to, respond to, or control like’s challenges and changes” (Frankish 1996) • Second Report on the Health of Canadians Towards a Healthier Future (1999) proposes that a population health approach focuses on the interrelated conditions or determinants that most influence health and applies the evidence to suggest broad priority areas

  26. Population Health Template: Key Elements and Actions that define a Population Health Approach • Focus on the Health of Populations • Address the Determinants of Health and their Interactions • Base Decisions on Evidence • Increase Upstream Investments

  27. Contd. • Apply Multiple Strategies • Collaborate across Sectors and Levels • Employ Mechanisms for Public Involvement • Demonstrate Accountability for Health Outcomes

  28. Focus on the Health of Populations A population health approach assess health status and health status inequities over the lifespan at the aggregate or population level

  29. Address the Determinants of Health and their Interactions A population health approach measures and analyses the full spectrum of factors, and their interactions, known to influence and contribute to health. Commonly referred to as the determinants of health, these factors include: social, economic and physical environments, early childhood development, personal health practices, individual capacity and coping skills, human biology an health services

  30. Base Decisions on Evidence A population health approach uses “evidence-based decision making”. Evidence on health status, the determinants of health and effectiveness of interventions is used to assess health, identify priorities and develop strategies to improve health

  31. Increase Upstream Investments The potential for improved population health is maximised by directing increased efforts and investments “upstream” to maintain health and to address root causes of health and illness. This will help to create a more balanced and sustainable health system

  32. Apply Multiple Strategies A population health approach integrates activities across the wide range of interventions that make up the health continuum; from health care to prevention, protection, health promotion and action on the broader determinants of health

  33. Collaborate across Sectors and Levels A population health approach calls for shared responsibility and accountability for health outcomes and multiple sectors and levels whose activities directly or indirectly impact health or the factors known to influence it

  34. Employ Mechanisms for Public Involvement A population health approach promotes citizen participation in health improvement. Citizens are provided opportunities to contribute meaningfully to the development of health priorities and strategies and the review of health-related outcomes

  35. Demonstrate Accountability for Health Outcomes Population health focuses on health outcomes and on determining the degree of change that can actually be attributed to interventions

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