New national suicide figures have been released by @ONS. It’s the big release of the year, taking us to 2024. But this year it’s more important for what it says about the trend over several years. Remember last year’s headlines about “the highest rate this century”? 🧵 & TW.

Guardian’s best film of 2025 is One Battle After Another. Brilliant, my favourite too - this doesn’t usually happen.

Many comments on royal assent for new MH Act have implied its use is inherently negative, seeing it as primarily an overturning of patient autonomy. But it is also life-saving, a responsible society ensuring that people vulnerable & at risk are protected. That balance matters.

Finally. Every 20y or so, the MH Act should be updated, to reflect society’s changing values. New Act does this well. But it is not a substitute for good care. We need that too. (Disclosure: I was Govt’s adviser on 2007 reform of Act & on review group this time).

On the issue of restricting access to suicide methods, an early @NCISH_UK impact was on wards where removing curtains/shower rails led to fewer deaths. But the benefit went beyond wards & to other methods. https://t.co/qQF4h5WBRa

Over the festive period, maximum suicide risk is in early January. We found peak on Jan 1st. Of course we should support people who are alone at Xmas but New Year carries more risk. https://t.co/y6OVUjTpsX

Restricting access to suicide methods is one of the best evidenced approaches to prevention. Barriers on bridges, limits on paracetamol & in developing countries, a ban on pesticides. New review by my Manchester colleagues & friends. 1st author @SarahESteeg

📢 New Research 👇🏼 Does restricting access to lethal means prevent suicide? An umbrella review in @BMJMentalHealth finds strong evidence for physical barriers, pesticide bans & reduced paracetamol pack sizes, though study quality varies & LMIC data are scarce. Read more 👇🏼

Good example of how under- & over-diagnosis can exist simultaneously. We may be over-diagnosing well-functioning adults & missing young offenders for whom treatment of “ADHD” will change the course of their lives.

Much comment on “domestic” violence. Our paper showed the link to victims’ suicidal behaviour. This will take society-wide prevention. Of course it should support women but its target should also be male perpetrators: past abuse, alcohol, culture. https://t.co/4pbZM4TCSo

@wendyburn Yes, exhausting & unacceptable. But 40y on, we have too few doctors but turn away brilliant applicants. We bring in docs from countries facing their own shortages. Training system leaves young docs disillusioned, looking elsewhere. And basically, we don’t treat them well.

So the finale to #DownCemeteryRoad had its own Larkin reference, its ominous title “What Will Survive”. Not to mention the earlier homage to Hitchcock’s “39 Steps”, on the train to Scotland. Plus a secondary theme of delayed grief. Brilliant.

We don’t hear enough about this - how medical training works against the interests of young doctors & by extension, the health of the public. Far worse than when I qualified.

Fascinating discussion of #Frankenstein with Guillermo Del Toro @RealGDT & Jacob Elordi, director & star of recent film, at @britishlibrary (online for me). Very nicely interviewed @DrMatthewSweet

The Govt proposal is here. https://t.co/f73F6MC1HX

In the end, what would make the review a success? More than anything, a strategic plan for young people that offers a future.

Does over-diagnosis matter? Yes, as long as we realise over- and under-diagnosis can exist at the same time. As long as we are able to challenge the private sector who have an interest in lowering the diagnostic threshold.

Yet the public have right to ask how their money is spent. Dominant sense is that ordinary people are doing their best but are at a disadvantage. They see their taxes supporting people not too different from them. This could undermine all the progress we have made on stigma.

I have certainly seen people facing delay, harsh & unreasonable challenge & the unsettling effect of uncertainty. Reminder that suicide risk is often the consequence of feeling trapped & unjustly treated.

The review needs to be brave but also sensitive. There are many people who will see this as another attempt to reduce welfare payments. I have supported many patients in their benefit applications. I’ve never seen anyone getting something they weren’t entitled to.

Welcome review but the stakes are high. It is about far more than over-diagnosis. Is mental health a “card” people play? Are the public, many of whom are also struggling, losing sympathy? https://t.co/5VPaTBGv2V