Introduction-This health profile will discuss suicide rates in Stoke on Trent (SOT) specifically concentrating on males as this is as much as 3 times higher than the rates documented for females (ONS, 2017). It will consider policies, services and strategies that are in place in order to address this health issue. it will address statistical reports locally, globally and nationally to analyse the differences in suicide rates. Although there are many factors contributing to this public health issue for the purpose of this profile mental health and socio-economic factors will be discussed in greater depth. Evidence based practice (EBP) (Sackett et al, 1996) will be considered in healthcare to assure consistency and regularity in healthcare practices toward providing the most effective results in patient care (Paley, 2006), using predominantly clinical research. Furthermore, this report will reflect on how the role of nursing staff and multi-disciplinary team (MDT) Is important in the encouragement of positive health changes and wellbeing.Overview of Stoke on Trent Stoke on Trent’s population in 2019 is now estimated at 384,377 people, this has grown by 5,706 since 2015 which represents a 0.3% annual change (World population review,2019) the population growth is shown below in figure 1, from 2002 to 2017. Overall review shows an almost equal gap amongst male (49.8%) and female (50.2%) (Joint strategic needs assessment (JSNA) 2011). Age breakdownIn contrast to nationally the population of stoke on Trent is similar, the general overview of the population age breakdown displays that over 50% of the residents are at employment age which ranges from, 25-64 years old. Also outlined in the office of national statistics (ONS, 2017) stoke on Trent has a smaller quantity of residents aged 65+ than nationally, where in contrast to the population ranging from 0-24 years old as this is somewhat higher. Figure 2 below shows the age group breakdown compared to percentage of residents, as shown from the ages of 70-74 years old this decreases significantly (Public health England, 2018). EmploymentEmployment rates for men and women have been increasing since 2012, it has been estimates at 3.9% lower than the year earlier (4%). For Stoke on Trent the employment figures appear to be increasing for 2018 figures put SOT employment figure at 114,500 that accounts for a 1.6%-year growth (SOTCC, 2019). Figure 3. the table below shows the percentage of people claiming benefits compared to west midlands (14.8%) and England and Wales (13.3%) Stoke on Trent still demonstrates under the average while employment rates are growing (Johnston, 2014). Deprivation Stoke on Trent is one of the most deprived areas in England, as seen below in figure more than half of the population at 52.8%, are within the most deprived quintile. (SOTCC, 2017)Figure below sows the percentage of people living in the most deprived areas of England, as shown Stoke on Trent (52.3%) Is very high up on the list, with more than double the value when compared to England (20.2%) and is getting worse (Public health England,2018)Factors that influence healthThere are several factors that influence the health of individuals, explicitly for this report socio-economic and mental health factor are particularly relevant when impacting upon mental health (Dahlgren and Whitehead, 1991). These may include differences in employment, education and income to compare from locally, nationally and globally. To assess why the variation of these statistics can determine health inequalities, consequently leaving individuals at a greater disadvantage within society. Health disadvantage can be the result of inequalities which are often distinguished between social class (Smith, Hill and Bambra, 2016). Reviewing this can determine the issue revolving around male suicides in Stoke on Trent, as being a higher ranked deprived area, this can contribute directly to mental health thus having a higher suicide rate. SuicideSuicide (to deliberately cause one’s own death (Martin, 2014) is the leading cause of death amongst young people aged between 20-34 years, in the UK (ONS, 2017). Certain factors are recognised as being connected with increased risk of suicide for instance unemployment, poverty and poor social circumstances these social burdens can subsequently influence an individual’s health and overall mental wellbeing (WHO,2012). Those associated at more risk of attempting and completing suicide also include individuals diagnosed with a mental health condition (Hawton et al, 2003), with only 27% of people who died by suicide between 2005-2015 being in contact with mental health services previously (Healthcare Quality Improvement Partnership, 2017). Figure 5 shows the difference in hospital admissions from Stoke on Trent compared to England, also how it also significantly higher than any other city around England (Public health England, 2018). figure 5. admissions for international self-harm ( red shows stoke on Trent value being significantly higher than England and other cities in England (PHE, 2018). Figure 6. shows male suicide rates in Stoke on Trent compared to England (PHE, 2018). Internationally World health organisation states that Over 75% of all suicides in the region occur in low- and middle-income countries (WHO, 2019). They have come up with numerous strategies to try and attack this heath epidemic as well as generating a national response to include multiple sectors to address suicide prevention strategy, including implement strategies for promotion and prevention in mental health (WHO,2019). Strategies implemented by Restricting access to means of suicide such as firearms and certain medicines and including suicide as a core component of health care services. A strategy to raise awareness has been organised by the International Association for Suicide Prevention (IASP) to hold a ‘World Suicide Prevention Day (WSPD)’ this is held 10th September (Samaritans, 2019).Nationally These interventions can be implemented nationally, regionally and locally systematically. GOV suicide prevention strategy (2012) for England Aims to reduce suicide rates and provide better support for those who are affected by suicide (GOV,2017) The government has more recently announced aims to reduce suicides in England by 10% by 2021 (Steele, 2019). A policy which is intended to cut the suicide rate and improve support for those affected by suicide concentrating on a few keys areas together with what the government will do to contribute to the areas which need action and applying effective interventions and resources to support local activities. A new strategy intended to reduce the suicide rate and improve support for those affected by suicide. The strategy: sets out key areas for action; states what government departments will do to contribute; and brings together knowledge about groups at higher risk, effective interventions and resources to support local action.A national charity working specifically towards improving mental health, although there are many, is Campaign against Living Miserably (CALM) is a specific movement working against male suicide. They run a free and confidential helpline and webchat, open 365 days of the year from 5pm through to midnight, available nationwide (CALM,2019). Locally male suicide Stoke on Trent have recently published a new programme to target men at risk of suicide and self-harm by spending an extra £300,000 on suicide prevention (Steele, 2019). The agenda for this new programme is essentially to improve the support offered to those who attend hospitals for deliberate self-harm and that are at high risk of suicide. It will also offer additional training for staff working within primary care settings such as GP surgeries and pharmacies (Steele, 2019). This has followed new data revealing that one person dies every 90 minutes in the UK as a result of suicide, after identifying specifically that male suicides are significantly above the average. According to data collected by JSNA (2018) Stoke-on-Trent observes 57 suicides per year, 43 in men and 14 in women which is a significant difference in male to female ratio. In addition to this, ‘Saving Lives: Staffordshire Suicide Prevention Strategy 2015/16 – 2020/21. Mind: for better mental health is a charity based in north Staffordshire which is aimed at promoting and supporting good mental health working in partnership with other organisations in order to improve our services and the wider mental health sector, (Mind, no date) Role of the nurse and interprofessional working The nurse follows standards of conduct and behaviour set out by the nursing midwifery council (NMC, 2018) the requirements are to prioritise people, practice effectively; Whilst using evidence to make clinical decisions (Davies, 2014), preserve safety; to use current best evidence when making decisions (Sackett et al, 1996), and promote professionalism and trust. Whilst also being required to participate in clinical research (Polit and Beck, 2006). For the purpose of suicide, it would be necessary to talk about the role of a mental health nurse as they are responsible for planning and providing support to those who have a range of mental health issues. To work within an organised team of specialists of other disciplines is vital in healthcare sectors (Jakubowski and Perron, 2019) in order to take advantage of other fields of expertise and knowledge, for suicide this could involve doctors, psychiatrists and psychologists. Making every contact count is a health initiative which should be at the forefront of all healthcare practice (Craig and Senior, 2018) the consensus was introduced to encourage positive behaviour change (Public Health England, 2016). Essentially nurses are to direct individuals through a brief intervention to additional help and support. The goal is to encourage positive behaviour change, hopefully long term. Models of health promotion such as behaviour change and empowerment are outlined in the appendix. Individuals who are suffering with poor mental health and get to the stage of self-harm or suicide are most likely to come into contact with health professionals at accident and emergency (A&E) and are often responsible in the fist instance to treat any physical injury such as cutes or overdose that may have occurred. They will then be recommended for additional assessment, this can include psychological treatment such as cognitive behavioural therapy (CBT) (NHS, 2019).The role of evidence Evidence based practice (EBP) is used to enhance and build on clinical expertise (Davies, 2014), evidence collected has been from sources such as fingertips, ONS, DOH, and NICE. Using respected institutions such as these to high quality research which can be trusted (Polit and Beck, 2006) and essentially consider the reliability of research methods (Ruddock, 2006). The research required to measure the relevant evidence for this report has been quantitative. This focuses on statistical data and numbers; this research method has been used specifically due to it being measurable. Quantitative data can allow the researcher to assess how the results deviate from others, in this instance how the data gathered for stoke on Trent deviates from the results shown from England as a whole. The patterns noted in the data from previous years can determine if strategies since have been effective.Another research method can be that of qualitative, although the data required for a report such as this is required to be measurable rather than that of thoughts and feelings, therefore wouldn’t have been suitable for this report as it isn’t measurable and therefore results can biased through researcher influence. Conclusion This report evidently specifies that suicide rates amongst men in sill a heath issue that needs addressing. The evidence shown in the statistics collected has suggested that levels for stoke on Trent are decreasing somewhat although remain at a high rate. Consequently, requires specific focus still in the health sector.