Suicide prevention: does it work?

Professor Keith Hawton FMed Sci, Professor of Psychiatry and Director of the Centre for Suicide Research, University of Oxford, and Consultant Psychiatrist, Oxford Health NHS Foundation Trust

When I was invited to speak at an Academy Discussion Dinner I have to admit that initially I was somewhat daunted by the prospect.  Having recently been elected as a Fellow I experienced the all too common thought when joining an elite group “Am I going to be shown up as an undeserving interloper?!”  As things turned out I  found the experience thoroughly enjoyable and personally rewarding.

I chose for my title ‘Suicide Prevention: Does it Work’.  Perhaps shamelessly, I focused a large part of my presentation on initiatives with which I have been closely linked.  One example was the introduction and evaluation of smaller packs of paracetamol.  Another was the evidence that resulted in the withdrawal of the analgesic co-proxamol and the demonstrative that it appears to have presented a large number of overdose deaths – with spread of this initiative to the whole of the EU, North America and other parts of the world, where the particularly dangerous component of co-proxamol, dextropropoxyphene, has now been banned.  A third topic was the Wellcome Trust – funded large-scale cluster-randomised trial, led by Michael Eddleston in Edinburgh, of introducing safer storage of pesticides in farming communities in Sri Lanka to try to counter their extensive use for fatal self-poisoning.  Overall however, I had to admit that much evidence in this field is weak, often based on naturalistic before-and-after studies, rather than randomised trials.  The thankfully relative infrequent occurrence of suicide being one reason for this.

The social atmosphere of the evening was excellent, beginning with a calming drink and chat prior to my presentation with other Fellows and guests. While addressing challenging questions over dinner after my presentation at the same time as attempting to make the most of the excellent meal was quite a task, I also found it the most rewarding part of the evening.  The questions were very diverse and resulted in a lively discussion.  Although most of the participants were from psychiatry or related fields the discussion ranged from legal to philosophical aspects of suicide prevention.

At the end of the evening as I left the delightful ambience of the Academy building and walked in the cool London night to the hotel that the Academy staff had kindly booked for me I found myself smiling at the thought of my initial anxieties.  While preparing for the meeting had been a challenge I greatly enjoyed the experience and was left with a sense that the guests were persuaded that suicide prevention, while hugely challenging, was certainly worthwhile and could be effective.  For other Fellows invited to give an Academy Discussion Dinner Presentation, or thinking about doing so, I can thoroughly recommend it.

Click here to view information on the Academy’s upcoming Fellows discussion dinners.



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