Ripples of Despair -  Shining a light on the impact of lives lost to alcohol, drugs, and suicide (2024)

Good jobs, safe homes, strong communities and access to health and social support are the foundations of a healthy life. When these building blocks are missing or broken, people are more vulnerable to death and harm from alcohol, drugs and suicide. Efforts to prevent harm are often focused on specific individual interventions (30), like the system and services factors; however, addressing these issues requires co-ordinated action across multiple factors and sectors beyond healthcare.

Solutions addressing the social, political, economic, and commercial factors that impact health have the greatest potential impact, as they affect the whole population (30) and do not require high levels of individual agency or behaviour change. These approaches aim to reduce harm at the population level, before people reach crisis or become ill.

Gateshead's Health and Wellbeing Strategy provides an action framework across society, as a joined up, whole system approach; we call this the Population Intervention Triangle. The triangle focuses on three areas:

1. Civic-level interventions: tackling social, political and economic factors like licensing laws and housing policies.
2. Service-based interventions: offering high-quality care and support for those affected
3. Community-centred interventions: engaging with people's lived experiences to co-design solutions

To reduce harm, Gateshead can act across these levels, strengthening the seams where these approaches meet, to create a cohesive, whole-system response.

While harm from alcohol, drugs and suicide can affect anyone, some groups are at much higher risk. Effective prevention requires targeted approaches tailored to specific risk factors, alongside universal strategies that address the entire population.  The prevention pyramid is informed by a wide range of existing research, theory, and frameworks on prevention, and helps frame these efforts (205-212).  Universal approaches target the entire population, such as campaigns to raise awareness about alcohol harm or mental health support. Targeted interventions focus on high-risk groups, such as young people, those in poverty, or individuals with mental health issues. Crisis responses and harm reduction provide immediate help for people already struggling, from suicide prevention to addiction treatment. Postvention supports those left behind after a death, aiming to prevent further harm.

By applying this model within Gateshead's civic, service and community efforts, we can take wide-ranging, co-ordinated actions to save lives.