louis appleby Profile picture
Nov 1 5 tweets 1 min read
How can students & families tell how well a university is doing on suicide safety?

Does it talk credibly about a mentally healthy campus?

Check student/staff surveys: does experience match rhetoric on bullying, disability, international students, management style?

Short 🧵 1/5
Are all staff - academic & admin - trained in mental health & #suicideprevention?

So that if a student doesn’t hand in an essay, will they be seen as under-performing or will someone check they’re ok?

Is the physical environment safe?

2/5
Is mental health promoted, on exam stress, drugs & alcohol, financial worries & loneliness?

Is it clear how to get help if anxious or distressed - starting with practical advice, then counselling & if needed, referral to NHS?

3/5
Does the university learn when a tragedy occurs, when someone takes their own life?

Not just the oblique “lessons learned” but actual change.

Is it supportive of families? Of students affected? Is it open with coroners & the media?

4/5
Universities are making progress on mental health.

Being a student is exciting but for some, disillusioning & lonely.

Suicide doesn’t have a single cause or solution.

But - and this is important - student suicide numbers have recently fallen. Prevention is possible.

5/5

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More from @ProfLAppleby

Oct 1
Plenty of justified outrage following #BBCPanorama’s film of staff abusing patients in a secure mental health unit.

It made headline news. Investigations are under way. Staff have been suspended.

But outrage alone will not prevent a repeat.

Short 🧵 & TW.
Many felt weary over a too-familiar story.

That was my reaction. 5y ago I wrote about how my mother was assaulted in a care home - the perpetrator was erased from their professional register thanks to evidence from other staff.

No action was taken against the care home itself.
Individual responsibility is important here. No-one should excuse the member of staff who treats a patient cruelly.

But abuse takes place in a wider system that can be complacent & culpable. And that is where prevention lies.
Read 21 tweets
Jun 22
Been asked for data sources re my #suicideprevention talk at #RCPsychIC. Mainly @ONS & my research unit @NCISH_UK - link to our website.

Short 🧵 on our research findings.

sites.manchester.ac.uk/ncish/
First, important reminder that graphs & data represent real lives lost, families devastated.
Our national study of suicide in CYP, almost 600 deaths over 3 yrs, based on data from inquests & other official sources.

Shows rapid rate rise in late teens & important stresses such as bullying, suicide bereavement & exams.

cambridge.org/core/journals/…
Read 10 tweets
May 4
Discussion on Twitter this week of suicide rate in doctors, after widely-reposted tweet claiming rate in this country to be several times higher than in general population.

This is untrue in England (UK data not available).

It’s worth looking at the figures.

Short 🧵 & TW.
First, a reminder that suicide statistics are real people, lives cut short, preventable deaths not prevented.

No figure, high or low, is acceptable.
Key source of data is @ONS. 5yrs ago they reported on suicide in occupations.

Jobs at high risk tended to be low pay, low skill.

Risk in medics was not high. In male doctors, it was low (SMR 63). In females, average for general population (SMR 101).

ons.gov.uk/peoplepopulati…
Read 13 tweets
Apr 8
Latest suicide figures for England are just published, giving us rates for the final 3 months of 2021, based on deaths registered post-inquest. Headline message: no change from previous years. But there’s something troubling there too.

Short 🧵 & TW.
First thing to say, always, is that these figures are not dry data. They are real lives tragically lost, preventable deaths, devastated families. We should never forget this.
Most important thing about figs for final quarter of 2021 is they complete the data for the whole year. They show 2021 suicide rate (10.5 per 100,000 people) was similar to pre-Covid years but higher than 2020 when the inquest system was disrupted. ons.gov.uk/peoplepopulati…
Read 9 tweets
Feb 26
Often asked for advice on managing a suicide cluster.

Clusters - where there is a link between deaths - are not unusual.

They cause understandable anxiety in those handling them who may be taking urgent actions on limited information.

Short🧵 & TW.
Links between deaths vary. They may be direct & causal, when one tragedy triggers another. Or indirect via shared circumstances or method.

Clusters occur more in young people & settings like schools & universities but also mental health units. The connections may also be online.
Faced with a series of deaths, it’s easy to waste time checking whether they meet the cluster definition. My rule is that by the time you’re asking, it’s a cluster.

In fact, part of handling a cluster is prevention, recognising that the first death has the potential to spread.
Read 10 tweets
Jul 11, 2021
It’s become common to see an academic dropping off Twitter to escape abuse.

It starts with a tweet or media appearance commenting on evidence from their field of study. Someone takes exception to their message, outrage spreads. Their timeline becomes a torrent of hostility.
This is hardly unique to researchers. Twitter is a bear pit.

Public engagement is part of the academic job. Funders expect it. A #publichealth crisis demands it. Yet we have calls for Covid scientists to #resign. One expert’s bio says simply: I block.
How did it come to this?
I should mention my own brush with the Twitter pile-on, though it was comparatively minor. In November my research group released the first pandemic suicide figs for England. Against expectations, we found no rise. The findings were later published here: thelancet.com/journals/lanep…
Read 21 tweets

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