Public Health Educational Resource: Mental Health in the UK

This report details the development and application of a public health educational resource aimed at preventing suicide among males in the UK. The rationale for the resource is based on the high suicide rates among UK males and the associated risk factors, including social stigma, cultural determinants, and economic disparities. The report explores the role of social determinants, such as the pressure on males to suppress emotions, and cultural factors, including the experiences of ethnically diverse communities. It also examines economic factors like poverty and the impact of political initiatives. The resource aims to educate and enhance awareness of these factors. The target population includes males with mental health issues and those from at-risk groups. The role of the nurse is central, involving education, assessment, and collaboration with a multidisciplinary team. The transtheoretical model of behavior change is applied to encourage timely reporting. The report emphasizes the need for gender-specific and culturally competent interventions to improve public health literacy and outcomes. The report discusses the importance of educating both patients and their families on suicide prevention strategies.

Running head: MENTAL HEALTH EDUCATIONAL RESOURCE
MENTAL HEALTH EDUCATIONAL RESOURCE
Name of the Student:
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Introduction
It has been estimated that suicide is the contributor to approximately 800, 000 global
deaths of which, a predicted 6507 of deaths as a result of suicide (or 11.2 deaths for every 100,
000 individuals) have been contributed solely by the United Kingdom (UK) in the year 2018.
There is thus a need to educate and increase public awareness, via public health promotional
resources, concerning the timely identification and reporting of such factors for suicide
prevention and symptom management (Flood et al., 2018). The following paper will thus provide
an elaborate and extensive discussion on the key components underlying the rationale,
development and application of a public health educational resource, with respect to raising
awareness and encouraging early reporting for the prevention of suicide among males in the UK.
Discussion
Rationale
According to the Office for National Statistics (ONS) approximately 6507 suicides were
reported in the UK during 2018, which was approximately 11.2 deaths for every 100, 000 of the
population. Of these, three-fourth or 4903 deaths were reported to be suicide deaths across
males. Since the late 90s, there has been increasing trend of higher reports of suicides by males,
with a suicide death rate of 17.2 deaths for every 100, 000 males in the UK population. Deaths
due to suicide were observed to be higher in case of older males within the age group of 45 to 49
years, which was reported to be approximately 27.1 deaths for every 100, 000 males aged as
above within the UK population (ONS, 2018). Thus, the prolonged high rates of suicide deaths
across UK’s male population forms a key rationale for the need to develop a public health
educational and promotional resource addressing this issue.

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A number of risk factors have been evidenced to be associated with the high risk of
suicide ideation and suicide attempts by males. Of these a key factor may be the prevalent social
stigma and stereotype which males are subject to, that is, a perception that suppression of
emotions or emotional distress are acceptable signs of masculinity while the opposite denotes
weakness. Such perceptions are likely to discourage men from reporting any mental health issues
(Chan et al., 2016). Additionally, such perceptions are likely compel men to express their
emotional distress in ways otherwise undetectable and unrecognizable by suicide management or
preventive organizations due to the lack of gender specific suicide assessment and screening
tools (Hunt et al., 2017). Additionally, older males, the group contributing to the highest rates of
suicide across UK’s male population, may be prone to a range of age associated social,
emotional, familial issues – all of which, if left undetected and unreported can pave the way for
suicide ideation (ONS, 2018). These is thus a need to develop a public health promotional
resource in this context, which will not only comprise of suicide management information, but
will also deliver gender-specific information on suicide risk factors for males in order to improve
public awareness, public health literacy and timely reporting of suicide ideation symptoms
(Gholamrezaei, Heath & Panaghi, 2017). Thus, such gender specific suicide risks and the need
for administering gender specific educational interventions for an additional key rationale for this
resource development.
Social Health Determinants
Prevalent social determinants associated with the societal stigma and stereotypes attached
to males form the key influencers underlying the development of this resource. There is a
prevalent social stigma attached to males regarding a misperception that suppression of emotions
by men are signs of masculinity and strength. Such misperceptions often encourage the

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prevalence of social bullying and ridiculing where men expressing emotions are stereotyped as
weak or incapable (Oliffe et al., 2016). Such misperceptions are likely to contribute to passive
feelings of suicide ideation and lack of timely reporting in case of emergence of such symptoms
by males. Thus, such social perceptions are the key social determinants contributing high suicide
rates across male. There is thus a need for educating men – the target group focused by this
resource – on the need to normalize emotional expression (Batterham et al., 2019). Additionally,
based on the above gender specific social determinants, there is also a need to educate the
general public, especially the families of males with a history of suicide attempts or high risk of
suicide ideation, on the importance of acknowledging emotional expression in a non-judgmental,
empathetic, compassionate and transparent manner (Scocco et al., 2017).
A number of cultural determinants are also associated with a higher risk of suicide across
males. As per the Adult Psychiatric Morbidity Survey conducted in 2015, a positive association
was found between poor socioeconomic status, mental health issues and individuals belonging to
Black and Asian Minority Ethnic (BAME) communities (Dais et al., 2017). Culturally and
linguistically diverse groups usually constitute a minority of the UK population and are likely to
face difficulties in terms of acquiring cultural sensitive and cultural competent mental health
services. Individuals identifying themselves within the black community have a history of racial
discrimination and thus, continue to have their mental health issues associated with stereotyped
perceptions of violence, crime and aggression within the society (Kaplan & Harrow, 2019). Such
cultural issues not only raise the possibility of ethnic minority males encountering suicide risk
factors of discrimination and traumatic experiences but are also likely to face cultural
discrimination in terms of mental health service accessibility. Thus, cultural determinants
associated with high risk of suicide across males include prevalence of cultural and racial

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discrimination encountered by ethnically and culturally diverse communications in the
population (Khalifeh et al., 2016). Thus, in addition to educating the public on key risk factors
associated with high prevalence of male suicides, this public health promotional resource will
also consider the importance of implementing culturally competent and culturally sensitive
communication, assessment and reporting practices for timely detection and management of
suicide ideation across ethnically diverse minority males.
One of the key economic determinants influencing high prevalence and risk of suicide
across males is poverty. According to a recent report by The Guardian as well as the UK based
mental health organization ‘Samaritans’, socioeconomic disadvantage is a key risk factor of
suicide ideation. The report estimates a 10 fold risk of suicide across UK males residing in
deprived areas of the nation as compared to affluent areas due to the high prevalence of
unemployment, occupational insecurity, financial debts and inadequate housing facilities in the
former (Davies, 2017). Such economic disparities are likely to yield mental distress as well as
unaffordability of required mental health services. Economic factors like financial insecurity may
also be contributing to high suicide rates across older males as evidenced previously. This is
because premature retirement, business failures and age associated multiple health concerns are
likely to financially impact this group and thus pave the way for suicides across males (Kerr et
al., 2017).
In addition to social, cultural and economic aspects, the political scenario of a nation is
also a key determinant of a population’s health status and suicide prevention is no different. In
response to the high rates of suicides however, the National Suicide Prevention Strategy in
England was formulated in 2012. The policy aimed to reduce the nation’s suicide via
emphasizing upon six essential areas of action, namely: suicide reduction across at-risk groups,

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deliverance of preventive approaches customized to meet the unique needs of at-risk groups,
provision of mental healthcare based educational resources, blockage of means with which
suicide can be attempted, collaboration with media for projection of sensitive information and
funding for enhanced research in the field of mental health and intervention research (Mackley et
al., 2019). Despite assessing the progressing of policy initiatives, there the Second, Third as well
as Fourth Annual Reports from 2015 to 2017 have been evidenced to focus extensively on the
need to address high suicide rates across prisoners and the youth as well as the need for
collaborating with healthcare organizations for deliverance of grief support services to bereaved
families. There has been a lack of specific policy initiatives targeting gender centric interventions
or deliverance of educational resources especially with respect to prevention of suicide across
males in the UK (Windsor-Shellard & Gunnell, 2019). Thus, the prevalent political inadequacies
of current suicide prevention policy interventions were thus the key political determinant
influencing the selected topic of this public health resource.
Public Health Resource and Application to Practice
The overarching aim of the public health resource, is to educate, enhance awareness and
health literacy on the high prevalence of suicide across males in the UK, the possible risk factors
and health determinants contributing to the same as well as the importance of timely reporting
and associated interventions for support. The target population will comprise of male patients
admitted in the mental health unit of a local healthcare organization, upon complaints of mental
health issues associated with suicide ideation like depression, post-traumatic stress disorder and
anxiety (Maher, 2019). Likewise, at-risk participants, such as those identified to be belonging to
culturally diverse minority groups as well as poor socioeconomic groups, will be specifically
targeted due to the role of culture and economic disadvantage in the prevalence of suicide. To

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further enhance participation of males from at-risk groups and ensure equity, the resource
developer will collaborate with the selected mental healthcare organization for the purpose of
demonstrating a public health educational campaign on male suicide prevention at the
community level (Davidson et al., 2018).
The health promotional resource will comprise of educating the selected participants as
well as their families, on the previously mentioned alarming statistics of male suicides in the UK,
the possible political, social, cultural and economic determinants as well as the importance of
timely reporting. This will then be followed by engaging participants in suicide assessment and
screening sessions and communicating the results and possible self-management strategies using
patient centered and family centered approaches by the nurse (Till et al., 2018).
Role of Nurse
The role of the nurse will be centered primarily around the need to teach, communicate
and educate the participants on the above identified educational resource components of the
resource. This implies the role of nurse in adopting to standard 2 of professional standards of
practice enlisted within the Nursing and Midwifery Council (NMC, 2015). Thus, with the help of
patient centered approaches, not only will the nurse educate clients on the prevalence and risk
factor of suicide across males, but will allow the client to share their own views concerning the
same and the prevalence of any suicidal thoughts (Vedana et al., 2017). This will then be
followed by the nurse adhering to standard 3 of the NMC Code where the nurse will play a key
role of comprehensively assessing the psychological, social and physiological needs of the
clients via including them in holistic suicide screening sessions (NMC, 2015). To further ensure
nursing role of family centeredness as well as standard 14 of the NMC Code, the nurse will
specifically deliver the educational components of this resource by collectively including both

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patients and families in this session. This will include the nurse, working with an inter-
disciplinary team of family counselors, psychiatrists and practitioners on self-management skills
of reflection, mindfulness and resilience as well as possible behavioral interventions like
cognitive behavioral therapy which can be utilized by such clients and their families for
prevention of suicidal thoughts. This will allow the nurse to adhere to NMC standard 8 of
collaborating cooperatively with a multidisciplinary team (NMC, 2015; Vedana et al., 2017).
Relevant Theories
Considering that this resource targets educating at-risk clients on the importance of
establishing behavior change in terms of early reporting, the transtheoretical model of behavior
model will be used (Hoy, Natarajan & Petra, 2016):
 Precontemplation and Contemplation: Considering the previously identified stigma
and stereotypical perceptions on emotional expression by males, it is likely that clients
will be reluctant on engaging in timely reporting on comunicaiton. To stimulate behavior
change, the educational session comprising of families and clients will be continued for a
month followed by a follow up after ever 3 to 6 months.
 Preparation and Action: Clients demonstrating an interest towards change will be
included in the assessment and intervention teaching sessions involving the
multidisciplinary team so as to instill habits of engaging in communication, reporting and
help-seeking behaviors.
 Maintenance: A follow up session will be undertaken comprising of feedback sessions
as well as re-assessment for evaluating the prevalence of any suicidal thoughts or
ideation.

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Evaluation of Impact and Effectiveness
To evaluate the impact and effectiveness of this resource at the individual as well as the
family level, a feedback session will be undertaken where clients as well as families will be
interviewed before and after resource implementation. Clients and families will be requested to
share their views on strengths and limitations of the resource implementation process. Positive
feedback will demonstrate success in terms of the effectiveness and impact of this resource.
Clients will be assessed for suicidal thoughts before and after resource implementation using
screening tools such as the 4 item Suicide Behavior Questionnaire as well as the Patient Health
Questionnaire. Low risk scores after resource implementation will demonstrate positive impact
and assessment (Na et al., 2018).
Conclusion
This paper thus elaborately and extensively discussed on the key components of a public
health educational resource, with respect to raising awareness and encouraging early reporting
for the prevention of suicide among males in the UK. The developed resource was influenced by
social, political, economic and cultural determinants of health promotion as well as evidence
based assessments for the purpose of evaluating its impact and effectiveness. To conclude, there
is a need to educate and increase public awareness, via public health promotional resources,
concerning the timely identification and reporting of suicidal thoughts and ideation.

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