The Public Health Agency (PHA) is currently holding a number of stakeholder engagement events on the Protect Life 2 Strategy, with events happening in all five Health and Social Care Trust areas. The stated purpose of these events is to 'inform the procurement of services to implement the pending 'Protect Life 2' suicide prevention strategy. 

One element of the health services which is critical in any prevention of suicide strategy is primary care.  We know that the GP is usually the most recent point of health service contact prior to the death of a person by suicide. 

The evaluation of the Protect Life 1 strategy highlighted the need for suicide prevention training for GPs as a key gap that needed to be addressed in Protect Life 2.  Evidence obtained by PPR under Freedom of Information legislation underscores the urgent need for this gap to be addressed in Protect Life 2. As it stands, GPs are not required to undertake training in any accredited suicide prevention training programme such as ASIST.  Most of the training taken up under Protect Life 1 was limited to depression awareness training, not suicide prevention training.  Since 2015 no specific training on mental health at all has been delivered to GPs due to the poor uptake. Information has been provided via an online facility only. 

A study carried out by the Health Services Executive ( HSE) and the Irish College of GPs found that three quarters of GPs have lost a patient to suicide, something which Yvonne Williams GP, Vice-President of the Irish College GPs described as 'one of the hardest things' a GP will be faced with. Dr. Williams pointed to the lack of resources, in the form of suicide prevention training, time allocated to patients and accessibility of timely, counselling services as some of the key barriers they are faced with. 

A report on Suicide Prevention published by the Westminster Health Select Committee last year recommended that the General Medical Council ensure that all undergraduate medical students reecive training in the assessment of suicide risk as well as depression. It also recommended that the Royal College of GPs and Health Education England should include the assessment of depresssion and suicide risk in the training and exmaination for GPs. It emphasised the need for strong and co-ordinated leadership to ensure that GPs as well as primary care nurses receive adequate ongoing training in detecting suicide risk. 

All of this underscores the need for Protect Life 2 to include real commitments, targets and timeframes for training for all GPs in suicide prevention.

The #123GP campaign is calling for mandatory training for both trainee and qualified GPs.  Trainee GPs do not receive suicide prevention training. There is no mandatory requirement for GPs to undertake training in suicide prevention as part of their CPD.

One of the 14 objectives underpinning the Protect Life 2 Strategy is 'Deliver a multi-sectoral training programme in suicide awareness and intervention'. However, the outline of the 4 staged approach to training proposed by the PHA, and set out in the online questionnaire, fails to mention the word 'suicide' and focuses only on mental health. This is deeply concerning. While mental illness, especially severe depression, is a recognised suicide risk factor, it is also recognised that a wide range of risk factors exist, including what are termed 'situational crises'. It is difficult to understand why therefore the proposed training framework focuses only on mental health problems and crises. 

The Department of Health has indicated that it plans to introduce a target of 50% of health sector staff, including GPs, to be trained in suicide prevention. The #123GP campaign disagrees with this target and calls for a target of 100% of GPs to be trained in suicide prevention (and in mental health, recognising that these are different types of training but both absolutely necessary).  A target of anything less than 100% is not a defensible target - aside from anything else it would discriminate against patients potentially receiving the vital care they need and against GPs in turn being equipped to provide that care.

The #123GP campaign, which is supported by the Royal College GPs, is calling on the Department for Health and the Public Health Agency (PHA) to ensure that the new Protect Life 2 Strategy includes a target of 100%  of GPs, both trainee and qualified, being trained in suicide prevention training. 

You can support the #123GP campaign by signing the petition http://bit.ly/onetwothreeGP  

To find out more about the #123GP campaign check out our Twitter, Facebook or updates on www.pprproject/right-to-health