SSRU: Suicide, Risk and Safety
SSRU provides crucial evidence to support service and training improvements and ultimately contribute to a reduction in suicide and self-harm rates and to improve the safety of our service users.
About SSRU
The Suicide, Risk and Safety Research Unit (SSRU) is a collaboration between Greater Manchester Mental Health NHS Foundation Trust (GMMH) and the University of Manchester led by Professor Gillian Haddock, Professor Daniel Pratt with Dr Paula Duxbury.
Established in 2017, the SSRU aims to provide crucial evidence to support service and training improvements, and, ultimately, to contribute to a reduction in suicide and self-harm rates and to improve the safety of patients.
Suicide and self-harm prevention
To meet the ultimate aim of reducing suicide and self-harm rates, the SSRU works to identify and provide comprehensive data on suicide and suicidal behaviour in mental health patients and the wider community; making recommendations on patient safety and the quality of care; and advising services on quality improvement measures based on these recommendations.
The SSRU has also pioneered improvements in the prevention of suicide and self-harm across the criminal justice system (CJS) with the introduction of some of the first clinical trials on self-harm in prisons and improving access to targeted psychological treatments for suicidal prisoners.
Our current strategic goals are:
- continued provision of high quality data on people who self-harm;
- continued provision of national data on suicide in mental health patients, including UK-wide support for local areas to strengthen and adapt their suicide prevention plans and self-harm care in the community;
- improving patient outcomes through the application of high quality translational research;
- enhancing support for the development of suicide prevention strategies and community based self-harm care in the NHS and the CJS;
- development of interventions for the prevention of and treatment of self-harm in the community and in prisons; and
- developing our international work on self-harm and suicide across settings.
We have three major areas of work. These are not mutually exclusive, and many leading academics and clinicians contribute to more than one.
- Suicide
- Self harm
- Psychological treatments to prevent suicide and self harm
Suicide
The National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) database is unique internationally, providing in-depth data and analysis on over 25 years of research on patient safety across the UK. Based on their evidence from studies of mental health services, primary care, and accident and emergency departments, NCISH has developed a list of "10 key elements for safer care for patients". NCISH evidence is cited in national policies and clinical guidance and regulation in all UK countries. Their recommendations on suicide prevention provide health professionals, policy makers and service managers with the evidence to effectively manage change and reduce risk of suicide by service users. These recommendations have also been shown to reduce suicide rates (Kapur et al., 2016).
NCISH continue to examine the circumstances surrounding suicide in mental health patients and changes in trends over time in their UK-wide annual state of the nation reports, as well as undertaking biannual spotlight studies, the most recent study being on suicide by people in contact with drug and alcohol services.
Psychological treatments to prevent suicide & self-harm
We have pioneered the development and evaluation of novel psychological treatments specifically targeting the prevention of suicide and self-harm. We have evaluated predominantly cognitive behaviour therapy (CBT) interventions across a range of clinical groups identified to be at exceptionally high risk of suicide or self-harm.
Our completed NIHR-funded studies have involved community dwelling individuals experiencing psychosis, inpatients of mental health services, and prisoners. These pilot and feasibility studies have demonstrated the potential of the new interventions to offer significant clinical benefits to vulnerable individuals, thus demonstrating the need for larger scale, pragmatic evaluations of clinical and cost effectiveness.
Most recently, our MRC-EME funded multi-site study CARMS (Cognitive Approaches to Combatting Suicidality) has sought to evaluate the clinical and cost effectiveness of a suicide prevention therapy for individuals experiencing psychosis and suicidality.
We are also delivering an NIHR programme grant PROSPECT (Prevention of suicide behaviour in prison: enhancing access to therapy), evaluating a psychological intervention for suicidal prisoners. This theme includes colleagues from both the University of Manchester and the NHS whose research is shaping clinical practice across the UK and internationally.
Self-harm
The Manchester Self-Harm project (MaSH) has been collecting, monitoring and analysing local self-harm data for over 20 years. As part of the Multicentre Study of Self-harm in England they are funded directly by the Department of Health and Social Care to help provide evidence and support towards aims of the National Suicide Prevention Strategy. The results of their work feed in to recommendations and clinical guidelines on the care for people who self-harm with the aim of reducing risk of self-harm and contributing to suicide prevention.
The Manchester Self-Harm Project continues in its core work of monitoring self-harm rates and investigating trends and subgroups of people who self-harm. Current/recent work has looked at self-harm by people experiencing homelessness, by young people from ethnic minority groups, and by people in midlife. MaSH has also developed an online learning resource on the management of self-harm in the emergency department, designed to help clinicians understand why people self-harm, common risk factors, and guidance on self-harm management.
In collaboration with National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) and the Greater Manchester Patient Safety Research Collaboration (GM PSTRC), MaSH are supporting local areas to improve self-harm care in the community. MaSH feeds its data into the larger Multicentre Study of Self-harm in England which has produced important academic outputs on non-fatal self-harm. The Patient Safety Translational Research mental health work stream are conducting several studies focussed on the translation of research evidence into practice.
Unit Director: Prof Daniel Pratt
Honorary Consultant Clinical Psychologist, GMMH
Professor of Clinical Psychology, University of Manchester
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