Wednesday, April 15, 2009

How many people need to die each day for it to be an indictment of mental health services?

The Observer, the Liberal Democrats and Rethink argue that four people dying each day in contact with mental health services (Front page news story) shows that psychiatric help is inadequate. The data comes from incidents reported to the National Reporting and Learning Service (Quarterly data summary Feb 2009) resulting in death in mental health settings (most of which will have been suicides).

Actually this data isn't new. The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness found 1367 cases of suicide (including open verdicts) of people in 2005 who had been in touch with mental health services within the last year, which is more than the number of NPSA incidents leading to death.

About 27% of people in England and Wales who commit suicide have been in touch with mental health services in the last year before their death. Suicide rates vary by country (see WHO data). Suicide is quite common, certainly in terms defined by the politics of mental health that it reaches the front page of a Sunday newspaper. What suicide rate is it reasonable for a country to have without blaming its mental health services?