Suicidal thoughts do not mean death is inevitable

With the news that Anthony Bourdain, celebrity chef has died today, just three days after the death of designer, Kate Spade, death by suicide has understandably been thrust into news headlines on both sides of the Atlantic, and beyond.

My condolences to their families, friends, colleagues and acquaintances, on their tragic deaths, especially as they navigate mourning in the glare of the media.

Both Antony Bourdain and Kate Space leave extraordinary legacies in their respective professional fields. For them, as with all the 45,000 people who have died by suicide over the last 12 months in the USA, and the 6,000 in the UK, we must all help to ensure that they are defined by the life that they have lived, and are not reduced to the manner of their death.

And yet, it would be irresponsible to not recognise, and take steps to mitigate the fact, that deaths by well-known figures present a very real public health risk as there is documented evidence of contagion effect. After the death of Robin Williams suicides in the USA rose by 10%. We therefore urge the media, health professionals and each and every one of us to make it clear that suicide is not inevitable for anyone.

When high profile suicides happen let’s seize the moment, to open up our minds to each of us having more conversations in our homes, our workplaces and communities about mental health. Talking is the way in which we can help break down taboos which do stop people in need from seeking help when they need it. Speak to everyone and anyone you meet about mental health – you need only watch Lady Gaga and Prince William’s tête-à-tête to realise that you can talk about mental health with the most unlikely of friends:

Share with each other the fact that mental health problems are incredibly common – one in four of us will experience mental ill health at some point in our lives. And mental health does not discriminate – it affects men, women, young, old, rich and poor. You are not weak, a failure, or pathetic if you have a mental health problem.

Talk also about the fact that suicidal ideation is much more common than we think, and dare to admit. It is estimated that for every one death by suicide there are 300 people thinking of suicide. Yes, it is a difficult fact to accept, but if we lock talk of suicidal thoughts away, and shroud it in shame and secrecy, then people become too fearful to share their darkest thoughts, and that’s when suicidal ideation can turn to death by suicide. Talking openly about suicide is NOT more likely to make it happen. On the contrary, all the evidence shows that when we are prepared and brave enough to ‘call out’ suicide and give a name to what people may be thinking, that it reduces their risk of death. The word suicide should not be avoided in favour of one of many unhelpful euphemisms (remember Lord Voldemort, and the sinister power he was given by being called ‘He who must not be named’).

We need to recognise as a society that suicidal thoughts can be a part of people’s lives, and a mechanism to navigate difficult painful times. By doing so people who are thinking of suicide will feel less shame, and feel better able to talk openly about how they are feeling, and turn to family and friends and health professionals for help and support.

Let’s make sure that Anthony Bourdain and Kate Spade’s deaths don’t drive up the number of suicides, but that instead compel each and every one of us to help lives that are threatened by suicidal thoughts.

Finding the words to support someone bereaved by suicide

Few people like to talk about death, and many of us feel awkward around someone who has been bereaved. Alongside our uncertainty over how we should react to a bereavement, is the fact that people bereaved by suicide have significantly less chance of receiving support from friends and family, and there are limited suicide bereavement support services across the country. To help to address this we have recently completed the editing, design and production of ‘Finding the words’, a booklet to support anyone bereaved or affected by suicide. The advice is based on the research of Dr Alexandra Pitman from UCL and it was written by Maxine Roper.

Diversity amongst students’ non-academic experience of university

The landscape of universities is changing rapidly as the sector faces the challenge of annually attracting and retaining more than 500,000 students, many (if not all) of whom are rightly demanding a high quality, impactful, value-for-money education that will provide them with the skills and knowledge to compete in the job market. Currently students report diverse experiences at university, and the scrutiny under which universities will find themselves is set to increase with the introduction of the Teaching Excellent Framework and the new Office for Students. Research commissioned by Unite Students, providers of student accommodation to over 50,000 people, also shows that whilst most students (74%) find university a satisfying experience, for some particular groups it can be more challenging. Not only is there an attainment gap between white and BAME students, but  there is a greater likelihood of dissatisfaction, difficulties and even dropping out amongst these, and other students such as those who identify as LGBTQ+, those with disabilities, who live at home, and/or who are the first in their families to attend university. These findings were brought together in Everyone In, a report highlighting the diversity of non-academic student experiences. We were commissioned to do the writing, designing and production of the report.

New guidance on bereavement by suicide support services

As part of yesterday Prime Minister’s speech on mental health and suicide prevention, PHE and NSPA have launched new resources developed by us here at Meadows Communications to encourage the development of services for people bereaved by suicide. It is a key ambition of the Government to see that everyone affected by suicide should receive timely and appropriate support and it has been recognised as a key area of action in the national strategy since 2012 but to date support services are very patchy across England and too many people receive no help in the wake of a suicide. To help commissioners provide appropriate local services a Guide to providing local services is now available from Public Health England. We hope that as part of local authority and health services’ wider suicide prevention work that they will provide more and better postvention services.  In addition, NSPA, have launched Developing and delivering local suicide postvention support and Evaluating local suicide postvention support. These resources outline a suggested pathway of support for people affected by suicide and a step-by-step framework for delivery. All three resources were produced by Meadows Communications during 2016 with input from a wide range of valued practitioners.

Theresa May landmark speech on mental health

Meadows Communications have been working on mental health for over 15 years. In that time we have been delighted by the way in which mental health has moved out of the shadows. Few of us would have imagined that in less than a generation we would go from having ‘Bonkers Bruno’ headlines in the Sun and very little acknowledgement or investment from Government for the issue, to having the Prime Minister announce she wants to see a ‘new approach’ to mental heath with ‘transformed’ attitudes towards people with mental health problems by reducing the stigma that surrounds mental illness. Hence we celebrate hearing this statement of intent from Government. We hope that the profile now being given to the scale of the problem is backed up with significant and ring-fenced resources and local leadership and accountability for action in order to deliver real change to the lives of people with mental health problems.

More on BBC News

New Year’s Honours recognises mental health champions

We are really delighted that the Queen’s New Year Honours has recognised the important work in the field of mental health of a number of brilliant and committed people who we have worked with over the years to raise the profile of, and improve services for, people with mental health problems. Heartfelt congratulations to Hamish Elvidge of the Matthew Elvidge Trust, Sue Baker of Time to Change, Alison Baum of Best Beginnings and Sarah Brennan of Young Minds.

Health Select Committee report on suicide prevention

We have spent much of 2016 working on producing suicide prevention resources for Public Health England and the NSPA. So it was with interest that we read the House of Commons Health Select Committee interim report on suicide prevention. They have provided a strongly worded conclusion and clear recommendations that more needs to be done. In particular they believe that the forthcoming refreshed suicide prevention strategy must be underpinned by a clear implementation strategy, with strong national leadership, clear accountability, and regular and transparent external scrutiny. We agree that this will provide much needed additional impetus for genuine and comprehensive action.
Interim report on suicide prevention (PDF)

2015/16 Alzheimer’s Society Annual Report

For the second year running Meadows Communications have produced the Alzheimer’s Society Annual Report. ‘Here every step of the way’ outlines the charity’s excellent year and record-breaking achievements. These include supporting over 110,000 people affected by dementia with our one-to-one and group based services, helping over 40,000 people through their Helpline and now reaching a total of 1.5 million signed-up Dementia Friends. We devised a graphic ‘journey’ through a community to help illustrate the four key areas through which Alzheimer’s Society work, alongside the compelling personal story of Brian. We provided original photography and a suite of infographics for digital and social media platforms.

2015/16 Alzheimer’s Society Annual Report

New suicide prevention guidance for local authorities

Today sees the publication of the Public Health England local suicide prevention planning guidance to support local authorities develop and deliver effective suicide prevention interventions. Amy and her team are proud to have led the development of this important guidance over the last six months. The project has involved a comprehensive review of the evidence and extensive consultation with practitioners. It has been shaped with regular input from Public Health England, Department of Health, NSPA, academics and our specially formed Expert Reference Group. A letter from the Secretary of State, Jeremy Hunt is being sent out to every local authority encouraging them to use the guidance. We are grateful to everyone who has contributed to the guidance and we hope that with this support that there will be more local action across England in 2017 and beyond.

Local suicide prevention planning guidance (PDF)

Our Chance, a new campaign launches

Today sees the launch of Our Chance, a behaviour change campaign to gives information and advice to reduce pregnancy risks and raises awareness of things that can go wrong in order to help mothers and their babies be healthy and safe. Meadows Communications were appointed by Best Beginnings, Sands and the Department of Health the summer to undertake the brand development for the campaign. Working at speed and with a limited budget, we provided three different creative propositions that were put to audience testing. Following feedback we refined the chosen route Our Chance. The campaign has been developed to help meet the Government’s aim to halve the number of babies and mums-to-be who died by 2030.

Suicide Bereavement Conference

We were delighted to have been invited to speak in Manchester for the fifth annual national suicide bereavement conference. Speaking with Hamish Elvidge of the Matthew Elvidge Trust, Amy gave the final plenary session of the event, outlining an ambitious vision for a national pathway and framework for bereavement support services. We are currently developing forthcoming Public Health England and NSPA bereavement resources to help people with an interest in developing, delivering and evaluation postvention support services for people affected by suicide.

Time to Change messaging

Our relationship with Time to Change, the national movement to end stigma and discrimination around mental health, stretches back 10 years to when we were involved in developing the original name and brand identity. Since then we have worked together in a number of ways, including shaping the young people’s strategy and conducting insights research and we are keen supporters of the campaign. That’s why this summer we were delighted to be win a competitive pitch to work with them again to review and refine their messaging in advance of their next strategic phase of work. In close collaboration with teams from across the campaign, including their community champions, Amy and Amanda have developed a clearer and simpler set of key messages to challenge people’s attitudes and behaviour that will be rolled out across Time to Change’s print, online and verbal communications throughout the autumn.

Highlights of the year for the Alzheimer’s Society

Today sees the launch of Alzheimer’s Society Trustees’ and Annual Report that have been delighted to have produced. After winning a competitive tender, we created a concept to explain the day to day impact of living with dementia, and therefore why there is a need for Alzheimer’s Society, with a strong demonstration of how the organisation helps people to maintain their identity and stay connected to their communities. The consequences of dementia were shown through the image of a familiar everyday object, alongside impactful portrait photography of people with dementia, with a simple message for people to look beyond the diagnosis and see dementia. The original photography was complemented by simple infographics to present the achievements. Both elements were also used across digital and social media platforms.

Help is at Hand

It has been a privilege for Meadows Communications to work closely with Public Health England and National Suicide Prevention Alliance on producing a revised guide for people bereaved by suicide. Amy led a group of people who have been bereaved by suicide in deciding how the guide should offer practical information and emotional support to others affected. We think Public Health England should be commended for handing over control and hope that other government departments will give beneficiaries the same responsibilities when producing future products. Amy launched the guide today at the Manchester Suicide Bereavement Conference and spoke about the issue on BBC Breakfast.

Get Help is at Hand

New Help is at Hand launches today at the Manchester Suicide Bereavement Conference

We’re delighted that Amy has led producing Help is at Hand, a guide offering practical and emotional support for bereaved by suicide. Amy has spent the last six months working with others who been bereaved by suicide, along with experts from Public Health England and the National Suicide Prevention Alliance, to produce a guide with stories, advice and sources of help. The guide launches today at the Manchester Suicide Bereavement Conference and Amy will be giving a speech about the project and bereavement by suicide.

Get Help is at Hand

Further information is available at

Inside Out

Huge congratulations to If You Care Share for their successful Inside Out campaign. Launched just last year they have really captured the public’ imagination this year with simple but brilliant call to action to wear your clothes inside. By turning your clothes inside out the campaign encourages people to bring what’s on the inside out into the open. Having conversations with people is a fundamental key to survival when you are experiencing suicidal thoughts.

E-cigarettes – courage or caution?

It’s been announced today that e-cigarettes are 95% less harmful than tobacco. Public Health England’s report even suggests that they could become such a significant tool in the arsenal to help people stop smoking that they could even be prescribed on the NHS.

Whilst the evidence now clearly shows that it much more preferable for people to use e-cigarettes than smoke tobacco, am I being too much of a purist in being feeling uncomfortable about seemingly endorsing the use of e-cigarettes? Am I being too cautious in not recognising the significant public health value that could be gained by using e-cigarettes to further support smokers and to drive down incidences of smoking from the stubborn rate of around 20% of all adults?

I ordinarily embrace being courageous and I welcome change. But on this occasion I think there’s good reason to be tentative. Yes, e-cigarettes may represent a safer option than cigarettes, but as the public health experts acknowledge, they are not entirely risk-free. They have been in widespread use for less than five years, which means there’s not yet been time to conduct longitudinal studies to ensure that they don’t cause any long-term health consequence. It is also known that some problems come from the fact that the quality of the e-cigarettes being marketed varies significantly.

So before we rush for the prescription pad can we please ensure that there’s stronger regulation as well as tighter marketing controls so we don’t find our young people being deliberately targeted and the renormalising of addictions to nicotine. Otherwise I fear we could well come to regret our current enthusiasm.

Becoming a dementia friend

Today I took a 96 year old cousin of my long deceased grandmother to a memory assessment. I’m her only living family, albeit a distant member. It was a challenging morning for both of us. Not only does she now have very limited mobility which makes it a huge effort getting her in and out of the car and in and out of a community hospital building, but given her increasingly poor mental health it’s distressing for her to be moved about, to meet new people and be asked questions when she doesn’t understand what is expected of her. And I too find it difficult because I feel very ill-prepared to be able to support her effectively as I know little about the condition and what best to say or do to help her. That’s why I have now signed up to become a Dementia Friend. I’ve watched the video, sent off for my pack and requested a date to attend an information session. I’ve joined over 1 million people in volunteering to become more aware and more supportive of the rapidly growing number of people in the UK with dementia. This seems to me to be a necessity for all people to ensure we can each demonstrate empathy and understanding to affected people in our communities that we could encounter any time any day. By each of us thinking and acting differently we can each help to value each individual and tackle the exclusion that dementia too often brings.

Ambitious plans for Dorset’s healthcare

Earlier this week the new Conservative government renewed their election pledge to provide an additional £8 billion of funding to the NHS and to deliver seven day a week access to GP services. Echoing the national direction of travel embodied within this pledge and also Sir Bruce Keogh’s review of urgent and emergency services are the ambitious new proposals from NHS Dorset CCG. The CCG’s Governing Body have today approved ambitious new proposals to improve the quality, safety and sustainability of health care services across Dorset. The plans include a bold vision for how to deliver greater access to GP and community services and a shift to having more care delivered closer to home and outside of acute hospitals. Acute hospital provision will change with the establishment of centres of excellence delivering the very best in emergency and planned services. Amy has been working with the CCG since October 2014 to help shape their engagement and communications work at this exciting time. She will continue to providing strategic advice up to the planned public consultation that will take place later this summer.

Great news for women’s equality

We’re delighted to hear that Sam Smethers has been appointed to be the new Chief Executive of the Fawcett Society. Sam has a long track record of working on women’s equality issues and will be an inspirational leader to champion women’s equality issues. Amy worked with Sam six years ago, whilst at Forster, to deliver a new brand model, logo and strapline for Grandparents Plus, the charity that promotes the rights of kinship carers. Under Sam’s expert direction Grandparents Plus has grown considerably, punching way above their weight in terms of their influence, profile and impact. She leaves the organisation in a much stronger position as she moves onto this exciting new venture for which we wish her the very best.

Let’s not take eye off the teenage pregnancy ball

It’s positive news that statistics published today by the Office for National Statistics show the under-18 concept rate is the lowest for for over 45 years including a drop of 10% on the previous year. It’s over 10 years since we first worked with the Department of Health and local public health teams to devise and deliver effective interventions to encourage young women to delay starting a family. The government then identified a reduction in teenage pregnancy as a priority in order to tackle women’s self-esteem, aspirations and attainment and ensure babies had the best start in life (given that young motherhood is associated with poorer outcomes in terms of birth weight, breastfeeding and other health indicators). It encouraging therefore to see this fall in rates. However, there is no room for complacency or the temptation to consider ‘job done’. Our rates continue to remain higher than other Western countries. So in actual fact we must ensure we sustain and build on this news with continued investment and interest across public health and education. We’re going to be looking closely for public health and education initiatives to ensure an ongoing focus and rolling programme of sex and relationship education and inspiration about aspirations and positive life choices.

Male suicide highest for 10 years

Bleak news today that more men are taking their own lives that at any time in last decade. There’s been a 4% rise to 6,233 suicides a year – equating to 19 deaths by suicide for every 100,000 men in 2013 (compared to 15.6 deaths per 100,000 in 1981 to 10.6 per 100,000 in 2007). 78% of all suicides are amongst men and the most vulnerable age group are men aged between 45 and 59, however, the rates have been increasing in all age groups except in the under thirties. It’s critical that more is done to encourage men to seek help early. The full ONS report can be read here.

Zero suicide ambition for NHS

Deputy Prime Minister Nick Clegg has today set out a new ambition for ‘zero suicides’ in the NHS in order to dramatically reduce the number of suicides happening in the health service. Recognising the significant stigma and taboo that surrounds suicide Nick Clegg’s spotlight on the issue is most welcome and we hope that it will bring new interest and commitment in the NHS to tackling this preventable cause of death. We hope other public services, schools, universities and employers will also rise to the challenge so the future quickly brings zero suicide communities across the UK.

This Girl Can

Congratulations to Sports England on the launch of the ground-breaking This Girl Can, a new national campaign that celebrates the women who are doing exercise and participating in sport no matter how they do it, how they look or even how sweaty they get.  We think this is a campaign with a great brand (and an eyebrow raising, head turning sassy video with music by Missy Elliott) that we hope will succeed in inspiring women up and down the country to wiggle and jiggle. It’s vital for us to motivate more women to participate in physical activity to help improve physical and mental health as well as connecting people with others in their community and their surrounding environment. We’re proud that our work with Ottaway Strategic Management throughout 2013 for Bury Council’s I Will If You Will has provided the valuable monitoring and evaluation means by which lessons from this pilot campaign have gone on to quickly and effectively influence the shape of the national This Girl Can. So come on girls, let’s see you get on, get in and show just how you can.

Marathon mission accomplished

Amy has accomplished her marathon on a very cold and windy day in New York City. Amy drew her energy from the wonderful crowds – their excellent live music and prolific name chanting. She didn’t stop running and she didn’t stop smiling and waving. Amy took on this challenge in memory of all the lives she knows that have been lost to suicide (as marked on the back of her bib). To date she has raised over £3,500. We intend to report back soon on how this money will be allocated to help progress our work.

We need to talk about it suicide. But we also need to research it.

Robin Williams’ death is a tragedy. He was undoubtedly a comic genius who has brought so much laughter and joy to millions of people around the world in his memorable (and at times immortal) roles. So many of his films and prophetic musings have been powerful way markers for my childhood and early adulthood.

Many health professionals and mental health charities have taken to the airwaves and social media to encourage people who are experiencing depression and have had suicidal thoughts to talk about how they are feeling and seek help.  This is really important advice that I hope people in distress will heed.

Yet, sadly, we have to recognise that sometimes it’s not enough. As it is being widely reported, Robin Williams was talking about how he felt, and he had sought help over many years. It also seems he was surrounded by a loving supportive family, another critical safety net. But he still made the fateful decision to end his own life.

My mum also died by suicide. She talked about how she felt before she died. She went, repeatedly, to see her GP, and just two days before she killed herself she sat talking to her psychiatrist. She had a doting husband, adoring children and a wide circle of caring friends who she shared how she was feeling with. But still she died.

In fact, almost 50% of people who take their own lives in the UK have seen their GP in the preceding month, and many in the fortnight before they die.

That’s why it’s not always easy for me to have confidence that the advice to share your worries and get professional help will be enough.

I don’t believe that suicide is inevitable. It doesn’t have to happen. But to really protect people who are thinking about suicide we have to do more than put the onus on them to talk and seek help. We have a duty to also ensure that those to whom they turn in times of distress are much better at recognising risk and spotting and acting on the danger signs. Every week thousands of people with mental distress go and see their GP, and prescriptions for drugs to effect mood and feelings are rising all the time. It’s understandably therefore a real challenge to spot those 6,000 people who each year take their own life.

For years, stigma and shame have prevented people from talking about deaths by suicide. And that’s stopped us from learning from their deaths – the factors that contributed to the risk, the build up to the day the tormenting demons got their own way, and how those bereaved by suicide think their loved one could have been saved.

Now, fortunately times are changing, thanks to the sterling work of organisations like Time to Change and occasions like the sad death of public figures like Robin Williams, are a chance to debate the issues. So please now let’s galvanise support and interest in suicide prevention.

And for me, that has to include recognition that suicide is a legitimate topic for medical and academic investigation. We have to invest in research that helps to equip us with the knowledge and tools to spot risk, to interpret warning signs, to train professionals and to educate the public. We need research that talks to families about their loss, to the professionals who have held conversations with them, and also to people battling their own suicidal thoughts. Then we need to organise this information and share it. And then use it to help to shape the delivery of effective services and to motivate and educate everyone in society to ensure that we’re all equipped to make a difference when someone does ask for help. From every suicide, each of which is a tragedy, we should be looking for the information that can help us to prevent another death. That’s what I, and every other bereaved family I know, feel is the least we can do for our loved ones.

And that’s why I commit my own time and energy to the Judi Meadows Memorial Fund to raise funds and awareness of the importance of suicide research. To date we have supported the University of Oxford Centre for Suicide Research and the GRiST safety and risk management tool. But we need many more people, clinicians, academics and policy makers to have an interest in, and willingness to, understand suicide to truly stand a chance to help save threatened lives.

We have to take every suicide, each of which is a tragedy, and use it to derive knowledge to help prevent another one.

Where you live can make, and keep, you ill

The economic and financial think tank Centre Forum have produced a hugely compelling but frankly shocking atlas of mental health variation to demonstrate the differences in the mental well-being of people across England. It exposes how people’s mental health problems are likely to be both caused by, and exacerbated by social, cultural and environmental factors outside of individual control. So with research showing that factors such as poverty, poor educational attainment, unemployment and early parenthood can significantly affect the risk of developing a mental health problem it is imperative that society has to recognise, and take action to tackle the huge social inequalities that have such a bearing on people’s well-being. It isn’t right that just because someone grows up in South Tyneside that you are three times more likely to be unhappy compared to someone living in Cheshire East. Particularly, as where you live can also impact so significantly on your chances of gaining access to accessible, timely and quality services. Such that people in Brighton and Hove are five times more likely to access NHS adult or elderly mental health services that people in Shropshire. So not only might you be more likely to get ill, you might also have to stay ill for longer because of where you live. With an election fast looming is it too unrealistic to hope that there will be a true demonstration of political will to tackle the massive health inequalities our country faces.

Employee Ownership Day

With today being employee ownership day I’d like to offer my congratulations to my old employers, Forster, who last year had a management buy-out which saw the company become owned by their staff. It is now 18 years since Jilly Forster founded this ground-breaking social change communications company and I was so excited to see that staff who have helped to build and drive the company now have ownership too. I’m sure employee ownership will foster ever greater energy and commitment and help continue to take the company to bigger and better social and environmental achievements. I hope too that their positive example, alongside that of long-standing employee owned companies like John Lewis, will help to inspire other companies to devolve ownership. 

To tackle disparities don’t blame GPs

Jeremy Hunt has proposed that GPs who fail to diagnose cancer should be named and shamed. This seems to be an utterly nonsensical idea. Surely, the different rates of detection of cancer, which show UK lagging behind other countries in the early detection of cancer cannot be attributed to GPs failing to spot the symptoms?

GPs are highly trained professionals who get presented with a multitude of health problems from their patients every single day. Of those people who present approximately 330,000 people (source: Cancer UK 2014)  are diagnosed annually with cancer.  Of these cases 50% are accounted for by the four most common cancers of bowel, lung, breast and prostate, the remainder can be from a large and very diverse range of cancers. People who present with cancer frequently have symptoms that could denote any number of complaints, and it must be important to consider common explanations as well as more severe and rare causes. In addition, some people with cancer can present with atypical symptoms. Therefore it seems to me that it must be expected, and acceptable, that even with the best performing GP that they may need to see someone several times before they can determine the cause of the problem, or refer on for specialist opinions.

GPs in most cases perform a brilliant job, but as with all jobs requiring human interpretation they may occasionally get it wrong. My worry with this proposal is that GPs will be completely deskilled. To mitigate against the risk they will simply refer on everyone. This will place an enormous strain on specialist services, and also mean that GPs, over time, will become little more that secretariats. The resulting pressure on secondary care will mean that those people will potentially have to wait much longer to be diagnosed, threatening their chances of long-term survival.

This seems therefore to be entirely the wrong solution. Instead, should we not look much more closely at the discrepancies in areas, and work more intensely to tackle the higher propensity for cancer that people from deprived areas have to develop cancer. We must ensure that health promotion is targeted, with motivating messages to ensure that people are equipped to reduce their chances of developing cancers (stop smoking, healthy eating etc.), but also that when invited to participate in screening that they chose to attend, and if they do develop worrisome symptoms that they understand the importance of seeking medical advice. Part of the encouragement in getting help is to ensure that they trust and respect GPs. Something Jeremy Hunt seems to be threatening in a most unwelcome manner.

Tackling mental health

I’ve just read my annual school magazine and it has compelled me to want to publically give three cheers to a woman called Emma who shared details of the mental health problems she has experienced since her teenage years, and the impact stigma has on her ability to lead her life as she would like. I admire Emma’s bravery in talking out about her experience because sadly the reality is that the majority of people with mental health problems do continue to experience serious, and frequent discrimination, whether that be during their search for work, accessing services or buying travel insurance.

We need the courage of people like Emma to talk about their problems because it’s only by sharing, exploring, and investigating mental ill-health that we are going to be able to make the necessary progress to improve not only the lives of the one in six people in the UK who will experience mental ill-health but those too of their families and carers who have to witness the anguish of their loved ones.

Mental health is a subject about which I care passionately. For over 10 years I’ve been working alongside public health professionals to improve mental well-being amongst the general population. And then in 2009 my professional and personal lives collided when my mother, at the age of 61, developed severe depression and tragically made the fateful decision to end her own life. Since then I have sought every opportunity to increase awareness, challenge attitudes and raise funds through a wide range of different initiatives with which I am now involved, including being the Founder of a suicide prevention charity, a Trustee of a mental health research charity and an advisor to various government programmes.

As Emma notes, mental health problems are surprisingly common and their impact is huge. Many people manage their conditions alone, but for those that do seek help a conservative estimate suggests it accounts for over 30% of GP consultations, and 14% of the NHS budget. The reduced life expectancy of those with mental health problems is said to be as great as 20 years for men and 15 years for women because of a host of associated complications. And the wider costs to the national economy in terms of welfare benefits and lost productivity at work amount to some £77 billion a year.

I believe there are three key challenges that need to be urgently addressed to lessen the devasting effect of mental ill-health.

Firstly, we need much more significant and accelerated progress to improve our scientific understanding of the issue. Ultimately, we must hope that we might learn how to prevent mental ill-health altogether; until then we need to find more successful ways to cure or treat it; and become much better at managing and mitigating the symptoms (including reducing the often debilitating side-effects of prescribed medication).

We’re a long way off achieving the breakthroughs that are needed. Scientific research of mental ill-health is woefully underfunded. For example, the Medical Research Council spent just 3.4% of their total 2009/10 £758.2 million spend on mental health research. A proportion that has barely changed despite the growing incidence of the problem.

Furthermore, even if more money were to become available, there is a dearth of academics and clinicians dedicating themselves to the field of mental health study.  We urgently need younger people to be attracted into pursuing their studies and developing their careers in this area of medical research. Without it, the absence of both breadth and depth of top minds is going to make exploring and solving the complex problems of mental ill-health unattainable. Please Bedales do whatever you can to build the appeal of mental health applied science to your budding future researchers and medics.

Secondly, we need to take steps to mitigate the scale of the problem that is facing our children and future generations. Currently, one in ten young people are experiencing mental health-problems, and the incident is rising so fast that it’s expected to reach one in six by 2020. The ever-increasing pressures of growing up today mean that half of all lifetime mental health problems start by the age of 14.

To improve children’s well-being, both whilst they are young and when they become adults, society needs to accept our responsibility to building mental health resilience building. Humans have the capacity to face, overcome and ultimately be strengthened by life’s adversities and challenges. These resilience techniques are not something that you either have, or do not have, they are learnable and teachable. This shouldn’t be focused on those who have already demonstrated mental health issues, or who are thought to be vulnerable, but instead requires a whole population approach to practising the management of stressful events as you never know who, when and how the techniques needs to be employed.

Resilience building is not a quick fix to solving everyone’s mental health problems, but it is a positive, hopefully and increasingly evidence based approach to improving well-being. I would hope that Bedales, celebrated masters of inspiring children to engage with life and learning, recognise this and are leaders amongst schools in equipping young people to develop the coping strategies to deal with difficult circumstances.

Thirdly, and probably the least glamorous of these challenges, and far and away the most difficult, will be the revolution of kindness that is required for us as individuals, and also as a society, to show empathy, understanding and inclusion of those facing mental distress.

Sadly, too many misconceptions abound about mental health, such that people with mental health issues are attention seekers, that they bring it onto themselves, that they are violent and a risk to others. This ignorance breeds misunderstanding and fear and acts as a barrier preventing people extending basic compassion and care.

It’s to address this that the voice and experience of people like Emma are so vital. By humanising and normalising the experience of mental ill-health it helps people to understand how the illnesses can manifest themselves, it encourages rather than prevents social contact, and tackles stigma and discrimination. By having a more supportive environment I hope too that it will reassure more individuals to talk about how they are feeling and to seek help. And from every shared story we can learn more about the condition, treatment, management techniques and in so doing build wider strategies and tactics to help others.

I believe that talking can save lives. For perhaps if my mother didn’t have grossly out-dated notions of psychiatric care, shaped by the pre-1960s images and stories that are still peddled in novels and films, then she may have been less fearful of any prospect of in-patient treatment and less desperate to ensure that it would never happen to her.  If an old student acquaintance had felt more confident that she wouldn’t be judged about her self-harming then she might have talked to her GP rather than taking a lethal overdose. If the City executive hadn’t been brought up to believe that you don’t share your problems and that stress is ‘just’ a sign of weaknesses then he wouldn’t have thrown himself in front of a train.

For me, even one life saved has got to be worth the fight to ensure that mental ill-health doesn’t stay in the shadows of people’s lives but is able to be talked about, shared and solved together.

Come Together for HIV awareness

My teenage years were spent with the AIDS tombstone naysayer advertising. So it’s with a gasp of excitement that I watched the International HIV Alliance’s new campaign to instil in our psyche the ongoing dangers of unprotected sex and contracting the HIV virus.  Sex here is being celebrated in some style (whilst, without casting dispersions, not exactly in a normalising way for the average strictly missionary position practitioner). I love the idea that everyone, of all creeds, races, sexualities need to Come Together to provide around this issue. I hope this advert’s refreshing take on the HIV epidemic will convert titillation into some genuine behaviour change.  For too long HIV has been ignored by health professionals and educationalists. So full credit to the International HIV Alliance’s attempts to get us talking about it once again. PS. And it was great to spot an old school mate as one of the featured pleasure seekers!

Are some cancers better than others?

The Pancreatic Cancer Action charity have today released a new advertising campaign that makes the provocative statement “I wish I had breast cancer”. There intentions are honourable, they are wanting to illustrate the desperately poor cancer survival rates of people diagnosed with pancreatic cancer when compared to people diagnosed with say, breast, testicular or cervical cancer. But the execution of the message leaves me feeling cold. I find it hard to believe that anyone would wish to have any cancer, even a type that has better treatment outcomes and life expectancy. The lack of authenticity is further exacerbated by the decision to have very stylised images of people, and not to attribute the quote to a named individual. I’d like to know if Pancreatic Cancer Action have robust insights undertaken with a sizeable number of people with pancreatic cancer to really give credence to this dramatic message. Without this, to my mind all cancers are bad cancers, and the message offends rather than enrages.

Smoking promotion on our streets

I was taken aback and confused yesterday as I crossed the road in front of this London bus. It’s over a decade since The Tobacco Advertising & Promotion Act 2002 ended cigarette advertising on billboards, posters and the like. So what on earth is this all about. Here’s a packet of cigarettes with the brand name clearly enblazed in metre high letters and confidently peddling its wares down the high street. I stood looking incredulously.

And as I stared I then noticed that the get out of jail free card – this was an advert for e-cigarettes. I’m not interested in debating the relative health advantages of nicotine delivered without tobacco. In fact, although many users of e-cigarettes like to believe e-cigarettes eliminate the harm, my understanding is that it’s not yet possible to categorically state how much less harm they may cause as there have been no large-scale randomised controlled trials into their effects (there are also no regulations to standardise what manufacturers are/are not allowed to put in them) . But what I am very interested in is that a product that looks so remarkably similar to a product that has irrefutable health consequences is now being allowed to be promoted so openly.

Surely it makes a mockery of the government’s annual high cost stop smoking campaigns if smoking cigarettes can be normalised by continuing to appear on our streets. Whilst it’s still unproven whether e-cigarettes help smokers cut down from normal cigarettes we do know that images of cigarettes can trigger cravings and smoking behaviour. So if there’s any chance that images of e-cigarettes (especially when masquerading closely as normal cigarettes) may encourage young people to experiment with either form, or motivate a smoker to lit up another fag, them decisive action is needed. I would urge the government to urgently introduce much tighter regulation of the advertising of e-cigarettes. Let’s not allowed e-cigarette advertising any chance to make any form of smoking more familiar, acceptable and desirable.

Building the future’s entrepreneurs

It’s Global Entrepreneurship Week and we are delighted that the Prime Minister’s Enterprise Advisor, Lord Young has visited one of the school that our clients, Ready Unlimited, have been supporting to embed an enterprising education.

Herringthorpe Infant School in Rotherham have been working with Ready Unlimited to up-skill their teachers to prepare pupils as young as four years old, for the world of work and business, by teaching about enterprise and entrepreneurship across the curriculum.

Ready Unlimited are a new social enterprise, that has evolved out of Rotherham Metropolitan Borough Council. They offer educators a range of training and consultancy services alongside tools and frameworks to help build knowledge, skills and confidence in developing an enterprising education. With the ONS reporting that over 20% of young people are unemployed it’s critical that children leave school much better prepared and equipped to lead rewarding and fulfilling lives.

We have been working with Ready Unlimited throughout 2013 to develop their brand and a range of marketing materials.

Celebrating Chicken Shed

Last night I attended the 25th Annual Chickenshed Gala at London’s iconic Guildhall. I got to rub shoulders with  Jeremy Irons, Sinead Cusack, Derek Jacobi and Christopher Biggins. But pushing celebrities and sequins aside, most importantly, I got to be spell bound by the enormity of Chickenshed’s message and achievements. Over 150 young people performing breathtaking dance, music and drama.

Chickenshed is a theatre company with a difference. A big difference. They bring together young people from all social and economic backgrounds, races and abilities together to be creative together. Many of these young people have previously been marginalised and they be excluded from mainstream education (66% of the students on our BTEC course would not be permitted to start a course at any other college or university). Chickenshed provides the young people with whom they work with the opportunity to transform their lives because of the experience of being included and valued. They find each individual’s strengths and enable these to flourish.

I’d like to see their inspirational vision be the ambition for  many more community settings, across schools and workplaces. Our whole society should in fact work to celebrate diversity and inspire everyone to achieve to the best of their strengths.

Chickenshed you are life affirming. Thank you.

Brighton strives to become the first suicide safer city

Today is World Suicide Prevention Day, and a broad range of mental health and other well-being organisations unite to use the opportunity to shine the spotlight on suicide and to tackle the stigma that surrounds the issue. I was emboldened and intrigued to read of Brighton and Hove’s ambitions to become the world’s first suicide safer city by September 2015. They report that they are already on their way to delivering their three year plan to significantly improve access to suicide intervention services and suicide bereavement services; train staff in suicide alertness and intervention skills and bring the community together to mark World Suicide Prevention Day. This is laudable as suicide prevention is sadly rarely seen to the public health priority that it should be, given the lives lost and impact on health that suicide has. I’m disappointed that it’s a year since the National Suicide Prevention Strategy was launched by Government, and as yet there has been pitifully little that Public Health Departments across the country have done to seek to embed prevention activity, and support for those bereaved. I will find out more about this inspiring Brighton and Hove vision and hope it inspires others to follow their lead.

Isle of Wight breastfeeding and smoking in pregnancy work attracts attention of Public Health England

We were delighted to hear that Duncan Selbie, Chief Executive of Public Health England was today visiting the Isle of Wight today to learn about local efforts to increase breastfeeding rates and reduce the high rates of smoking in pregnancy. We have had a long relationship with the Isle of Wight Public Health team and in 2012 undertook a significant social marketing project to understand the attitudes and behaviour of mothers to be and new mothers around breastfeeding and smoking. The findings and recommendations from our study have formed the basis for a new strategy and action plan which is now being successfully rolled out.  This has included embarking on the UNICEF Baby Friendly Initiative, embedded staff training, working more closely with children’s services and Children’s Centres and improving the information available. We are pleased the impact of this work is being nationally recognised. Simon Bryant, acting director of Public Health, says about the visit: “We are looking forward to welcoming Duncan Selbie and providing him with an overview of our work and the particular successes we have had on the Island in meeting local health needs.”

A win win solution to empty houses and weakening community cohesion

The media regularly reports on England’s growing housing crisis, with ever growing estimates of the shortfall of homes. With news last week that there were £6.9 million births between 2001 and 2011, but yet only 1.6 million new homes built (source: National Housing Federation), it would seem as though this situation is unlikely to abate.

But then take a look around you. It’s obvious to see that not all houses are being fully occupied. In fact, based on council tax information there are 710,000 empty properties sat unused across England, and over 72,000 in London alone (source: Empty Homes Nov 2012). So if we used our housing stock to full capacity then the pressure on building homes, and acquiring development sites, would be significantly eased.

So that’s why I applaud the efforts of Dot Dot Dot, an innovative social enterprise who are striving to see empty homes generate social value. They provide landlords with a ‘guardian’ service whereby they will find renters who will live in their empty properties, without the usual tenancy rights, thereby providing a flexible security solution and also an income. In return for keeping the property tidy and cared for the guardians pay below market rent which reduces their financial pressures. Crucially though, Dot Dot Dot also requires their tenants to commit to volunteering to contribute to their local community for at least 16 hours a month.

That way, it’s win win. Not just for landlords and tenants, but also neighbours and the community.  The blight of an empty house is replaced by a person who not only restores the space to being a home, but works to bring other value to local places and people. For instance, by volunteering to tend a local garden, visiting a lonely older person, or lending a hand at a youth group.

We are really delighted to have recently been working with Dot Dot Dot’s dynamic team to help them to build their communications skills, and ability to segment their target audiences. We hope many more empty properties will be filled and communities benefit from their very own guardian angel next door.

A lasting legacy from the Games

The latest figures produced by the Active Sport survey show that the number of people playing sport has dropped, when compared with levels before the London Olympics. The naysayers who delight in scorning the Games as a vast waste of money  will jump on these figures in delight, and claim the legacy commitments have failed. The defenders are insisting the cold weather has been the contributing factor and that rise in participation that started before the Games will be recovered after this temporary blip (from 14.5 million people playing sport at least once a week in October 2012 to 15.3 million in April 2013).

Our work on behaviour change indicates it’s too early for either side to claim a victory. Encouraging people to adopt a sporting habit for life is no easy feat. As with other desirable life-improving habits such as stopping smoking or healthy eating, the biggest test is in maintaining the behaviour over the long-term. So it’s vital that everyone involved with promoting sports participation is able to, and committed, to measuring levels for the next 10 years, in order to genuinely determine if the Games have succeeded in touching the lives of ordinary Britons by transforming their commitment to sport. Short-term fluctuations such as this six-month drop tell us nothing about the overall trend.

For me, the Games will have succeeded if inspires and motivates those who have previously been uninterested in sport. To do this, people need to be provided with opportunities to try the broadest range of sports that are out there. I believe there is a sport out there for everyone, but they have to be given the chance and means to find it. I love swimming, as do £2.8million other Britons who regularly swim. But I’m aware, and often reminded by friends, that it doesn’t appeal to everyone. Just like team sports fail to interest me because I don’t want my sport participation to be subject to the changing availability and commitment of others. So it’s essential that all sports advocates, from national governing bodies, sports facility providers and local youth groups all look to broaden access and appeal.

Last week I heard of a scheme that seemed to be an excellent example of this. Zoggs, the swimwear company have provided free open access events for children at swimming pools around the country at which they can try not just swimming and diving, but also water polo and synchronised swimming. In turn this was followed-up with a free invitation for parents to go and swim locally. Brand promotion aside, I really hope that more companies will get involved in helping to provide taster sessions, targeted at particular community/social groups. Only then, once we have people starting sport, can we truly turn our attention to long-term maintenance.

Innovation offers solutions to Councils’ financial plight

The London Government Association (LGA) have warned today that non-statutory Council services will be decimated if significant further cuts are made to council budgets ( The LGA Chairman Sir Merrick Cockell has described it as a “mathematical certainty” that there will be cuts to local services. It is predicted that libraries, sports centres and museums could be closed, that road potholes will go unfilled and street-lights turned off.

There is no doubting that local authorities are indeed facing a period of unprecedented financial pressure. Difficult decisions have, and will continue to be made. It requires local authorities to find new ways of working to continue to deliver essential high quality services to citizens whilst making savings.

Our work with Nesta, the independent charity that helps bring great ideas to life by providing investment and mobilizing research, networks and skills, demonstrates how innovation offers local authorities the opportunity to address this funding challenge. Their Creative Council programme sees six councils from across the country provided with a grant to implement radical innovations that address a long-term challenge affecting their area.

In Derby, taking an innovation led approach has seen Children’s Services develop a bespoke package of support for looked after children with the aim to raise aspirations. In Stoke, they are pursuing the goal of becoming an energy sufficient working city by taking control of local energy supply. Whereas in Monmouthshire their ambition is to fundamentally shift the behavioural norms of their civil servants by changing the way in which cultural change is supported.

Each of these programmes of work offer the opportunity to explore how establishing new ways of thinking, at the heart of service design, can help to redefine the role for the local authority, and the nature of its provision. Showcasing the Creative Councils such that others can be inspired, and learn from their endeavours is therefore vital. You can find out more by visiting

We are working with each of the Creative Councils to provide strategic communications advice that will support their innovation become reality and to have genuine impact on their target communities. We are challenging the ways these local authorities think about the role of communication, the management of their relationships with both internal and external audiences and the need to shape their messages accordingly.

We’re confident that if local authorities can indeed embed radical new ways of approaching their statutory and non-statutory duties then councils can not only protect, but expand the quality and quantity of the services they provide.

The recent MMR outbreak – what do we really know about the choices parents have made?

There are now over 850 cases of people infected with measles in southwest Wales and one linked death. It is reported that 330,000 children aged 10-16 years old remain unvaccinated and the Department of Health have launched a massive vaccination drive.

The Times are reporting ‘one million children may not have received the full course of the MMR vaccine, in large part because of discredited fears it leads to autism’ and other news outlets are making the same foregone conclusion that the unvaccinated teenagers are the result of informed decision-making by their parents who weighed up the Andrew Wakefield ‘evidence’ published in 1998 and decided they didn’t want to take any possible risk with their children.
It would seem to be an obvious connection to make. Back in 1998 there was a monumental exercise in scare-mongering with newspapers, TV and radio catapulting Wakefield’s scientific paper published in a specialist journal into every family’s home. It is thought that the impact of his supposed findings have extended for years, even despite Wakefield subsequently being struck off by the General Medical Council for misconduct.

It does seem to be an obvious connection to make that the parents were swayed by the autism-link arguments are opted not to have their children vaccinated.We wonder though whether this assumption has been put to the test by actually asking the families involved?

Our work for the NHS and health charities on a broad range of issues reveals time and time again the high levels of apathy that people have about making conscious decisions to maintain or promote their health. Despite the overwhelming case for eating fruit and vegetables, reducing alcohol intake, stopping smoking, attending screening and the list goes on, people regularly do nothing to adopt the behaviours that are recommended by the evidence. In part this can be because they develop ways to dispute the macro, population-level statistics which are the basis for much government guidance.  For every official recommendation some people point to their own micro ‘evidence’ to disprove what they are being told, such as their 90 year old lifelong smoking grandfather, or burger and chip eating mother who has no problems with her heart not diabetes. So it could well be the case that for some people, the evidence for vaccination is not meaningful enough to overcome their apathy.

It might be the case that for some of the parents they don’t believe in the benefits of vaccination in general, rather than just MMR specifically? Given past vaccination programmes have been so successful at almost eradicating certain diseases, people may have become complacent and even disbelieving that their children is at a genuine risk,  or that the impact of the disease is really so catastrophic. So do we know how many of the teenagers without the MMR vaccine have also not received protection for other diseases such as polio, diphtheria, tetanus, whopping cough, meningitis C? For it may be that for some parents feel the benefits of vaccination are too low.It’s possible too that we could be overlooking a host of real practical problems that some parents may experience in getting their children vaccination, such as not being able to reach the clinic or keep their appointment because of transport issues, work commitments, or other illness at that time.

There could too be demographic characteristics, beyond their age cohort, that link these young people and their vaccination behaviour and attitudes. Are there revealing patterns to where are they are in the country, or their income level, or educational attainment of the family that might this help to explain the attitudes and behaviour that have prevented vaccination?

So is it the case that this cohort of parents with young children in the late 1990s and early 2000s have been influenced solely by the the Wakefield MMR and autism debate? Taking a deeper look and unlocking the motivators and barriers to taking up particular health behaviours is complex, but ultimately absolutely essential.  We urge the health officials behind the current MMR vaccination drive to ensure they are truly reaching parents and young people with messages that will speak to how they are seeing the issue.

Suicide requires sensitive handling

The car manufacturer Hyundai and their advertising company,  Innocean Europe, have made a gross error of judgment in producing an online video commercial featuring a man seeking to take his own life in a Hyundai car.  In an effort to illustrate the car’s environmental credentials of zero emissions, the middle-aged man is shown connecting a hose to the car exhaust. His efforts are prevented as the car emits only water vapour.

The advert has thankfully now been pulled, following the very personal plea of Londoner Holly Brockwell who wrote a devastatingly powerful letter about the profound impact the advert had on her given her father’s suicide using the same method when she was five years old.

Understanding the impact that a commercial can have on its viewers, both desired and inadvertent, must surely be a critical element of the creative process? Advertising companies know, and capitalise on the power they hold. But given this, they need to also exercise the responsibility that comes with it.

Suicide is a valid subject for discussion, and in fact, it is essential that conversations about suicide take place publicly, in order to tackle the surrounding stigma and enable people experiencing suicidal thoughts to feel able to come forward and seek help.

Yet it must be done with caution, as rigorous and extensive research has demonstrated an indisputable link that the inappropriate portrayal of suicide can lead to imitative behaviour. This includes providing details of the mechanisms and procedures used to carry out a suicide given that the descriptions of suicide methods can lead to other deaths that imitate the same method. Hence, the fury of protestors to this advert, as it clearly demonstrates the ‘how’.

We hope this case, played out in the world-wide high stakes arena of corporate reputation management, will demonstrate the urgent need for advertising agencies, and their clients, to follow the lead of newspapers and broadcasters in implementing the suicide media reporting guidelines from the Samaritans and other leading mental health organisations.

 In 2003, Amy was involved in producing the media reporting guidelines for Mind Out for Mental Health, the Department of Health’s campaign to target stigma and discrimination in mental health. This programme was the precussor to the excellent high impact Time to Change programme, in which Amy was also involved producing the brand and undertaking audience insights research. 

To improve cancer survival rates British stoicism must be challenged

The British Journal of Cancer has today reported on a study of 20,000 people across six developed countries about their knowledge of cancer symptoms and motivation to seek help. The results provide cultural evidence to explain why the UK’s cancer survival rates are the lowest of Australia, Canada, Denmark, Norway and Sweden, despite similar levels of awareness about cancer symptoms and access to medical professionals and treatments. British respondents are more reluctant to seek help, and by failing to seek help early, if at all, their cancer is detected at a later stage where treatment and survival can be comprised. This comes as no surprise to us, as our work talking to people with lung cancer and bowel cancer echoes these findings. So many people have said to us that they would feel embarrassed to share their symptoms, they are fearful of wasting doctors’  time, and worried about not been a serious enough case when compared with others. Public health and other health promotion initiatives have tried to tackle these barriers and reinforce the importance of seeking help with recognised symptoms.  And yet, as this report shows, the public aren’t convinced and they stay away, with the result that over 5000 people are losing their lives unnecessarily (if we were to match the survival rates of other countries). It seems to us that whilst the public feel that our GPs are over-worked and appointment times restricted, that they will be reluctant to be seen to contribute to this problem. And so we must convey that health professionals are both approachable and accessible. Older people in particular want to be granted ‘permission’ to visit. Realistically, this can’t come from GPs. We all know the pressures they face, and even more so with their commissioning responsibilities. Isn’t it time then for practice nurses and health care assistants to be given greater opportunities to provide a frontline service, that is steeped in being personal, caring and welcoming. And for this to become an expected norm amongst patients to see nurses rather than doctors in the first instance? Without a fundamental rethink, it doesn’t seem otherwise very realistic to expect the public to swallow their somewhat misplaced sense of concern for GPs.

Suicide happens. We need to talk about it.

I want to applaud the personal story of Andrea Sutcliffe, Chief Executive at SCIE (Remembering Adrian) for her courage in sharing her story today, the day the Office of National Statistics published the worrying news that suicide numbers increased 8% in 2011 across the UK (and shockingly 30% in Wales).

My mum took her own life in 2009. Like Andrea Sutcliffe though, I refuse to allow this to be our family’s dirty secret. Instead, I believe that in order to positively influence the work of care and support services, that it is vital to be able to talk about suicides such that we can learn lessons and look to improve. It is also absolutely critical that suicide is spoken about more openly in order to challenge public opinions. People need to recognise that suicides do happen. And that they will continue to happen, often in the most tragic and preventable of ways, if people aren’t willing to talk about mental health problems, suicide ideation and even death. So I wish to thank Andrea, and the others who are willing to bring a name and human dimension to the statistics and the word ‘suicide’.

I hope that given these new suicide statistics from the ONS that Clinical Commissioning Boards will seek to prioritise suicide prevention work and help to ensure that the National Suicide Prevention Strategy moves beyond policy. I hope too that the care providers SCIE works with will never underestimate the devasting impact that every suicide has.

What impact will the new government stop smoking campaign have on quit rates?

This week the government has launched their new stop-smoking advertising. Featuring a cigarette that mutates into a cancerous tumour, the message to smokers is stark ‘if you smoke you increase your risk of developing cancer’.

The £2.7m campaign will feature across TV, billboards and online for the next two months. Smokers are encouraged to visit their local pharmacies to get a quit-pack.

It follows-on from the government backed Stoptober campaign which encouraged a mass quit attempt, and is reputed to have had 270,000 sign-ups (although there are no published statistics on successful four-week quitters at the end of the month).

Given that smokers have been calculated to contribute to over a quarter of all cancers it’s no surprise that the government is taking action.

These high profile, co-ordinated campaigns have an important contribution to make in providing a trigger for smokers to attempt to quit, as well as shifting our culture from one that has condoned smoking for most of the last century, to one that is more condemning.

We have experience of speaking with groups of smokers and from them we have gathered some interesting attitudes and behavior that providing valuable insights into motivators and barriers to quitting.

  • Smokers know the population-wide risks that are associated with smoking. However, they are skillful at deflecting the personal risks by celebrating the long ‘healthy’ lives of other smokers they know. The macro-data about the diseases smoking causes need to be made genuinely believable and relevant for each smoker.
  • Smokers can have a tendency to deflate the impact of smoking as compared with other risk-taking behavior, such as the consumption of drinks or drugs, which reduces their compulsion to take action, and heightens their sense of injustice that society ‘has got it in for smokers’.
  • Smokers feel that smoking provides them with ‘me’ time and that they have an entitlement to this pleasure, particularly if they are facing adversity in their life. Stopping smoking must therefore provide a suitable alternative that can become similarly highly valued.
  • Smokers who are attempting to quit feel they are easily derailed from their efforts by small set-backs. They require immediate encouragement, often from multiple sources, to persevere rather than opt out of their attempt.
  • Smokers who provide regular carbon monoxide readings find this a very motivating way to reducing, or ceasing their smoking.
  • For some smokers, nicotine replacement products, and other quitting aids can be essential props to becoming smoke free. The free, and easy availability of such products is therefore essential.
  • Smokers who are/have attempted to quit say that advertising provided a timely ‘reminder’ or ‘nudge’ to take action having previously contemplated wanting to stop. Impact on ‘committed’ smokers was minimal.
  • Smokers are not generally motivated to quit by the cost savings that they will make. Despite the high, and ever rising cost of cigarettes they are often perceived to be ‘good’ value for the pleasure they provide.
  • Smokers who would like to quit, but who live with other smokers who are not willing to stop, find it extremely difficult to sustain their efforts, and in most cases rarely succeed in their attempts. Stop smoking services need to be better able to take a co-ordinated whole household approach.

To us, the insights we have gathered from the public, illustrate strongly how it is essential that stop smoking campaigns need to combine national high profile messaging and reminders of the perils of smoking and the quit tools available, with a more local, personalised and ongoing support service that is tailored to the needs of particular smoking groups. Without this, advertising alone it’s unlikely to achieve sustained change.

From April-September 2012 we spoke with young women on the Isle of Wight who smoke whilst pregnant. We used our findings to draw up recommendations for adaptations to the local NHS stop smoking service. This builds on previous smoking research undertaken with a broader cross-section of adults in North-East Essex and people with lung cancer in the South-West of England.

World Aids Day

On 1 December it is World Aids Day, an event that has been marked around the world for over twenty years, and which is synonymous with the red ribbon – the first of what are now a plethora of ’cause-related’ badges, ribbons and wristbands. Back in 1989, I was just sixteen, and along with three friends, I was chosen by my school to visit London for an AIDS education event. I spent the day hearing from scientists, campaigners and people living with HIV. They inspired us to return to our school and talk about the disease, the risks and encourage safe sex. So, armed with facts and inspired by the personal stories, I returned on a mission to demystify the disease and make it real for my friends. Talking about using a condom in school assembly certainly helped me gain some confidence in public speaking.

Looking back, I realise it was my first taste of communicating public health messages to an audience. I now have almost twenty years delivering behaviour change programmes, particularly in the health arena.

It’s a useful reminder to recognise why that day continues to be so memorable. HIV was presented as being relevant and meaningful to the lives of students living in the UK. And the messages were communicated directly, and with conviction, by young people affected by the disease, powerfully illustrating the strength of the ‘personal’ to build connections. We were also made to feel like we had the ability to think, act and change other’s hearts and minds, and as a teenager I found that extremely motivating.

These elements have subsequently been the essential building blocks of a broad range of health campaigns I’ve worked on; from reducing the stigma and discrimination around mental health problems, to increasing breastfeeding and reducing smoking.

HIV in the UK no longer makes headline news. Although 90,000 people in the UK, more than ever, are living with HIV, scientific advancements have meant the detection and treatment of the disease is almost unrecognisable from the 1980s. And that’s serious cause for celebration. I hope though that the low priority it is now accorded won’t come back to haunt us as current and future generations of young people grow up without the memory of the unforgettable early HIV education campaigns.

The value of a celebrity’s story

This week, comedian, actor and children’s author, David Walliams is the latest celebrity to publish his autobiography and to reveal his long-standing battle with depression. Simon Cowell recently spoke out about feeling unable to cope with juggling the demands of his US and UK show commitments. And since the tragic suicide of Gary Speed the Football Association are encouraging footballers to seek help early, recognising the potentially damaging impact of top-flight competition.

The cynical and uptight are all too quick to dismiss celebrity discussions about emotional well-being as a part of an increasingly tired arsenal to achieve column inches and raise book sales.

But for me, and others I know working in mental health promotion and suicide prevention, we welcome their honest accounts of facing emotional distress. I recognise their lives, laced as they are with the trappings of fame and wealth bear little relation to the lifestyle of ordinary Britons, but as role models (even when earned with dubious measures of talent or success), they can help to shine the light on an issue, that despite affecting 1 in 4 of us, continues all to often to be closeted away.

So today, World Mental Health Day, I renew my call for people from all walks of life to talk about mental health. By talking, listening, sharing, comparing and learning from each other’s experiences we are better equipped to manage our own well-being and improve the lives of others.

Talking openly applies to suicide too. 5,500 people take their own lives in the UK every year. And we need to face up to the fact that suicide happens and talk about it. How else can we possibly hope to help others who may be feeling suicidal if we don’t learn from the suicides of loved ones. Making society face up to suicide is an important step in suicide prevention. And, importantly, the evidence shows that if someone has feelings of wanting to take their own life that, contrary to popular opinion, if you explore those emotions with that person, they are less, not more likely to go through with the act. My mum experienced three episodes of depression, and went on took her own life in 2009.

For us as a family we always talked openly about her illness and since her death about her suicide. In so doing, we have avoided one of the biggest burdens associated with mental health problems, the pressure of having to watch what you say, and hide what you’re doing. Being frank requires strength and confidence that it is the right thing to do. And it requires society to accept the people that do speak out, and not turn away, shun or discriminate against them.

It’s a risk I’m willing to take. My legacy to my mum is to refuse to accept the mantle of public stigma and talk openly in order that it may encourage others to both seek the help they need and learn how to better support others. I hope World Mental Health Day will encourage others to do the same.