Despite public campaigns to combat stigma around mental illness, people with mental health problems still face ongoing discrimination. And while some sections of the media focus on mental illness in cases of violence, a rise in the number of people who are more of a risk to themselves goes unnoticed.
We still find it difficult to discuss such issues. For example, people in hospital for mental health reasons rarely receive the “get well soon” messages other patients do. And in the some areas of the media, there’s still an obsession over the relatively rare cases when a person with a mental health problem commits a serious violent offence.
The annual National Confidential report from Manchester University into trends in suicide and murders committed by people with mental illness showed murders committed by people who are mentally ill are at their lowest since data collection began in 1997. In 2010, there were 33 such reported cases in England. In 1997 there were 54, and more than 70 in 2004.
The authors suggest this fall may be attributable to the better management of patients with dual diagnosis – those who have a major mental health illness and a substance misuse problem. The report also argues that the introduction of community treatment orders – which allows conditions such as what medication to take and where to live to be placed on people who are discharged from hospital – may be a factor in the more effective management of patients with the most complex needs.
The data also show that the victims are much more likely to be spouses or family members than strangers. This is not to diminish in any way the impact of these awful events, but it demonstrates how complex these cases are and how difficult they are to prevent.
The report says:
Comprehensive figures for homicide and mental illness show that in 2001-2010 an average of 74 patients per year were convicted of homicide in the UK. When people with symptoms of mental illness are added, the total rises to an average of 115 per year. These are perpetrators – the corresponding figure for victims, taking account of multiple homicides, is 122 per year. All these figures appear to be falling.
Mental health and suicide
The report highlights another, very worrying trend in the suicide rate among people with mental health problems. The bare facts are startling; provisional figures suggest about 1333 such deaths in England in 2011 – an average of three each day and up from 1175 recorded in 2010. Collecting this information is a complex process involving a number of agencies such as coroners’ courts and the final year covered in the report, 2011, has yet to be completed.
Suicide isn’t just an issue for people with mental illness. In the general population, the number of suicides went up from 4221 in 2006 (about 75% were men) to 4612 in 2008, but dropped to 4303 in 2010 and projected to fall again in 2011 to about 4100.
But the figures suggest that in people with mental illness the number is rising. And a disproportionate amount happens in this group – about a quarter of suicides are by people who have been in contact with mental health services, according to a previous study.
There also appears to be a clear link between suicide and substance misuse with some some issues particularly high in some areas; suicide involving alcohol misuse is highest in Northern Ireland and Scotland, while drug misuse is highest in Scotland.
Climate of austerity
A rise in suicides is a phenomena in periods of austerity or economic difficulties as we are going through now. However people with mental health problems can face a number of additional difficulties.
A 2004 report into social exclusion emphasised that people with mental health problems must overcome enormous barriers to accessing employment. Despite the fact that discrimination on the basis of mental health status is illegal, the report highlighted that such practices continue.
The changes to the benefit system, in particular the assessment of individual’s capability at work, is producing further pressures.
The “invisibility” and fluctuating nature of mental health problems can also make it very difficult for individuals and carers to document adequately – that is, to the satisfaction of the assessors – the impact mental illness has on their day-to-day lives. This produces a situation where an individual is assessed as “fit for work” but can’t find employment because of discrimination and stereotypical attitudes.
The whole process of reassessment and possible financial implications is, of course, inherently stressful for the individuals involved.
One of the key recommendations of the Manchester University report is that if the increase in the suicide rate is to be reversed, then community mental health services will need to ensure people with mental health problems receive appropriate support in areas such as housing, benefit payments and debts.
The stark reality is that the pressure on all public service agency budgets mean that such advice will be needed by more people but will be more difficult to access.
Ian Cummins does not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article, and has no relevant affiliations.
This article was originally published at The Conversation.
Read the original article.
If you need help
If you need help and support now and you live in the UK or the Republic of Ireland, please call the Samaritans on 116 123.
If you live elsewhere, we recommend finding a local Crisis Centre on the IASP website.
We also highly recommend that you visit the Connecting with People: Staying Safe resource.
The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. Annual report: England, Northern Ireland, Scotland and Wales (PDF). University of Manchester, July 2013.
Safety First: Five-Year Report of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (PDF). Department of Health, 2001.
Mental Health and Social Exclusion (PDF). Social Exclusion Unit, June 2004.
RT @Mental_Elf: We ignore the rise of #suicide in people with mental illness http://t.co/0ENzMWEaIb
We ignore the rise of suicide in people with mental illness: Despite public campaigns to combat stigma around … http://t.co/OdfmZqqLXl
@Mental_Elf we do not persoally we actully r all touched by thectradgied but this government &media retoric r killing people in services 4
@Mental_Elf medercation must b factored in 2 of tge sucides i know were caused pain by tge new meds they were put on ! Alarm
@Mental_Elf suicide rate in mentally ill rising as is rate in detention we need to ask why more often
Significant: RT @Mental_Elf: We ignore the rise of suicide in people with mental illness http://t.co/pD8qhBgrgm
Great debut blog from @IanCummins9 on mental health, homicide, suicide, employment and stigma http://t.co/TKN2fUvkX5 Welcome Ian!
Murders committed by people who are mentally ill are at their lowest since data began in 1997 http://t.co/TKN2fUvkX5 #stigma
@Mental_Elf @hullodave Does that include statistics for the number of psychopaths in govn?
@Nexusdog_UK @Mental_Elf Doubtful. The numbers might be too high. Ha ha etc. Also “psychopath” isn’t a clinical diagnosis.
@hullodave @Mental_Elf Damn your logic, Spock!
@Nexusdog_UK @Mental_Elf Live long and nitpick.
We ignore the rise of #suicide in #mentalillness http://t.co/XcxDj1iizg @Mental_Elf #consulting #MentalHealth #stigma http://t.co/Q1szDrM6xr
Murders committed by people who are mentally ill are at their lowest since data began in 1997 http://t.co/Tx5zCFzP1S #stigma #mentalhealth
Suicide involving alcohol misuse is highest in N. Ireland & Scotland, drug misuse is highest in Scotland http://t.co/TKN2fUvkX5
#Suicide involving #alcohol misuse highest in N Ireland& #Scotland, #drug misuse highest in Scotland http://t.co/DyjZm9FPrX via @Mental_Elf
@Mental_Elf @CraigEdwards01 42% of homeless people/rough sleepers attempt suicide compared to 1.3% in settled pop. Real health inequalities
@Mental_Elf @CraigEdwards01 Levels of anxiety, depression, PD and schizophrenia all significantly higher in homeless pop.
Ppl with mental illness may be assessed as “fit for work” but can’t find employment because of discrimination http://t.co/TKN2fUvkX5
Today’s hoodie #headclutcher http://t.co/0qs8WCkcak We ignore the rise of suicide in people with mental illness via @Mental_Elf
New @Mental_Elf #headclutcher http://t.co/BKJyIyLsA8 Preventing or reducing domestic violence against pregnant women: more studies needed
#Headclutcher bonanza! http://t.co/MnjXPY8lHf More evidence needed on reducing mortality in older people with depression @Mental_Elf
@Mental_Elf Disclosure of a mental health issue to a potential employer is difficult. It’s hard to know what to say to avoid discrimination.
@Mental_Elf Thatcher intro’d “Care in Community= No more mh inst’n farmwork, Remploy, pblic svce Green Card Scheme; just Atos & suicides :(
In case you missed it earlier: “We ignore the rise of suicide in people with mental illness” by @IanCummins9 http://t.co/TKN2fUvkX5
We ignore the rise of suicide in people with mental illness http://t.co/bZdLFCQyfN via @sharethis @Mental_Elf @IanCummins9
@OxfordMHF @ShareThis @Mental_Elf @IanCummins9
More and more lives are lost by failing mental health systems.
When will it ever stop…
We ignore the rise of suicide in people with mental illness – The Mental Elf http://t.co/L9tAhuPEKP
Mental Elf: We ignore the rise of suicide in people with mental illness http://t.co/zUpg8YUV4d
We ignore the rise of suicide in people with mental illness http://t.co/b4vDmn9dnh via @Mental_Elf
Murders committed by those with mental issues is at its lowest since 1997 – The Mental Elf http://t.co/fSDXOkSYDR
It’s been a busy week! @IanCummins9 had the most hits: We ignore the rise of suicide in people with mental illness http://t.co/TKN2fUvkX5
Runners up: @IanCummins9 http://t.co/TKN2fUvkX5 @field_matt http://t.co/BM7qt3Q6WB @dr_know http://t.co/zFQ2WwRdy0
[…] the fact that though the number of homicides by people with mental health problems had fallen, the number of suicides in this group has actually risen. A rise in suicides is associated with a period of economic austerity where people face increased […]