MENTAL HEALTH21 Like many places in the UK, Carlisle is experiencing unprecedented demand for mental health services for adults, children, and young people, leading to growing waiting lists for diagnostic and treatment services. Public sector partners, and voluntary and community groups are working tirelessly to address this demand, including addressing the underlying causes of mental health concerns, but they too report being overburdened by the volume of people seeking assistance, many of whom present with multiple and complex issues. Over the last three years, referrals to specialist mental health services in Cumberland have increased by more than 50%.22 In Cumberland during 2022/2023, over 40,000 people, or 18% of the adult population, were recorded as having depression, a rate that is over a third higher than the England average. Additionally, over 3,000 Cumberland residents had a diagnosis of schizophrenia, bipolar disorder, or other psychotic disorder, around 10% higher than the England average.23 There are growing concerns for particular groups of people in Carlisle: firstly, refugees and asylum seekers. As well as arriving with physical health conditions (including communicable diseases, chronic conditions, untreated wounds, dental problems and eye conditions) many also have mental health conditions including posttraumatic stress disorder (PTSD), depression, and anxiety, as well as instances of torture, sexual violence, or exploitation. The uncertainty and challenges of resettlement, combined with language and cultural barriers, can further exacerbate mental health issues.24 Secondly, evidence from the Farmer’s Network suggests a growing mental health crisis amongst farmers, particularly in the north of Carlisle. These mental health concerns are linked to business prospects, family relationships, loneliness, long working hours and financial concerns.25 I think there is a mental health crisis in Carlisle. Anyone who was poorly before the Covid-19 pandemic is now very poorly. Anyone who was on the cusp of being poorly has now tipped over. Anyone who didn't know they were poorly or had suspicions they were poorly have lost all their coping mechanisms. A lot of people were just expecting things to open up or go back to how they were. But it has never happened, and it isn't going to. Now we have people who are just waiting and waiting and waiting for help without the resilience, support or resources they need to move forward. Health Sector Representative SELF-HARM, ADDICTION AND SUICIDE Cumberland currently has high rates of selfharm, addiction and suicide, with drug-related deaths and suicides substantially higher than England averages. The latest available data for Cumberland suggested that in 2023/2024, emergency hospital admissions for intentional self-harm per 100,000 people stood at 157.7, significantly worse than the England average of 117.26 Deaths related to drug poisoning, including drug misuse, were substantially elevated across Cumberland, and rates have increased year on year over the last eight years in Carlisle and now stand at nearly three times the national rate. Cumberland had the fourth-highest rate of all local authorities in England for the number of lives lost to suicide for persons aged 15-74 years in 2021-2023, with 19 per 100,000 (10.7 England). This equates to 133 lives lost in 2 years. Cumberland also had the fourth-highest rate of suicide for women 15-74 years in 2021– 2023, at 11.2, compared to the national rate of 5.4. The male rate was 27.5, the tenth highest in the country, higher than the England rate of 16.4.27 Suicide rates in Carlisle, and the wider Cumberland area remain some of the highest in England. Each one of these deaths is an avoidable and preventable tragedy that effects many other lives. Suicide is a very complex issue, with multiple factors behind each death. Though suicide can affect anyone, people living in areas of the highest levels of deprivation are now more likely to die by suicide. Perhaps suicide is like the canary in the mine, an indicator of generally more challenging conditions that our local population is living under. Regardless of the pressures though, suicides are preventable deaths. We need to challenge the stigma, particularly in men, about seeking help. We need to educate the general public about the risk of suicide, the role we can all play in supporting people living with thoughts of suicide and dispel some of the damaging myths and misperceptions. And we need improved access to support when people do reach out. Support that is compassionate, keeps people safe and gives people hope. Third Sector Suicide Prevention Representative There is a research project underway at the moment. It is called ‘the Big Question’ and it is trying to understand why our suicide rates are so high in Cumberland. We get real-time data from the emergency services, on who has attempted or has committed suicide and of the six areas, Carlisle has been highlighted as one of the highest. Local Authority Researcher The combination of mental health challenges and isolation has contributed to rising suicide rates in rural areas. Addressing this crisis requires targeted mental health support and community outreach initiatives. Rural Business Leader 30,000 25,000 20,000 15,000 10,000 5,000 0 2020 2021 2022 2023 North Cumbria Referrals to CNTW for Mental Health Services Mental Health - Unspecified Mental Health - Children Mental Health - Adults Total Mental Health 30 25 20 15 20 5 0 Deaths related to drug poisoning (including drug misuse) All persons (Age-standardised rate per 100,000) Copeland Allerdale England Carlisle 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-10 2009-11 2010-12 2011-13 2012-14 2013-15 2014-16 2015-17 2016-18 2017-19 2018-20 2019-21 2020-22 25 20 15 10 5 0 Suicides (Persons 10+ years, DSR per 100,000) Copeland Allerdale England Carlisle 2010-12 2011-13 2012-14 2013-15 2014-16 2015-17 2016-18 2017-19 2018-20 2019-21 2020-22 Carlisle: Opportunities & Challenges 2025 58 59
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