From the very start of its development, partners and stakeholders shared the view that the new strategy should be outcomes focused to bring about the changes that were needed to reduce suicide in Scotland. The four outcomes were developed based on the feedback received during the first phase of engagement. People were clear about three key areas for improvement, which reflect outcomes one, two and three. These are:
- The environment we live in should offer protection against suicide.
- The powerful role that people in our communities can play in suicide prevention.
The importance of people affected by suicide having access to effective and compassionate support, when they need it.
In addition, feedback confirmed the importance we needed to give to creating the right conditions and enablers to support the delivery of these three improvement aims / outcomes. We have therefore created a fourth outcome which sets out our commitment to:
- ensuring data and evidence of all types (lived experience, practice and academic evidence) are central to how we take forward design and delivery of the strategy and action plan;
- evaluation and review being built into every stage; and
- an integrated approach to planning suicide prevention which brings together our national, local and sectoral levels.
Respondents were asked for their views on the following outcomes:
Outcome 1: The environment we live in promotes the conditions which protect against suicide risk – this includes our psychological, social, cultural, economic and physical environment.
Outcome 2: Everyone has a clear understanding of suicide, its prevention, and associated risk and protective factors. Everyone is able to respond confidently and appropriately when they, or others, need support.
Outcome 3: Everyone affected by suicide is able to access appropriate, high quality, compassionate, and timely support - that promotes recovery. This includes people of all ages who experience suicidal thoughts and behaviour, anyone who cares for them, and anyone affected by suicide in other ways.
Outcome 4: All suicide prevention activity is designed with lived experience insight. Action will be informed by up-to date practice, research, intelligence, and improved by regular monitoring, evaluation and review.
There were 200 responses to this section of the consultation with more than 100 follow-up comments.
The table below shows how people responded to questions relating to the outcomes we outlined.
|Strongly Disagree||Disagree||Neutral||Agree||Strongly Agree||Not Answered|
Due to rounding, the total of some of these figures may add to 99%, rather than the expected 100%
In all outcomes, over 75% of respondents said that they agreed or strongly agreed with those originally presented.
However, more than 22% of respondents did not agree with outcome 2 which was focussed on the understanding of suicide and the ability to respond confidently when someone required support. This quote highlights the point: "For outcome 2, while the gold standard would be 'everyone' having a clear understanding of suicide, this is something which will take time to achieve and may not be realistic".
The other key messages which came from this section of the consultation were:
- A real need for investment in current services and early intervention. This quote highlights the point: "It is crucial that easy, timely access to support both statutory and non-statutory becomes a reality rather than an aspiration. This strategy and its accompanying outcome frameworks / action plan must set out how it will achieve this, with detailed outlines of timings, the evidence base for action, and how the work will be funded".
- Clarification on care options and pathways should be included, for example, self-referral routes and expansion of peer support offerings.
- As already mentioned, addressing stigma was also highlighted as a specific aspect that merits inclusion in the outcomes. This quote highlights the point: "Currently there is no mention of (stigma) in the guiding principles, outcomes, or the priorities, which we believe leaves a major gap".
- There was a call for the strategy to be more accessible and relevant to those it was aimed at supporting, and highlighted the ways in which society could protect against suicide. This quote highlights the point: "We wonder if the population would be more likely to engage with more specific messaging, which feels more immediate to their everyday lives - around the associated risk and protective factors. Examples, all pertinent to suicide prevention include: using social media safely, social isolation and community cohesion, a society with values where people can feel hopeful, engaged, and able to better understand and develop relationships".
- As mentioned under the vision section, the commitment to tackling the causes of suicide needs to be more explicit in the outcomes. This quote highlights the point: "We would agree with the outcomes set out in the strategy, however, there is little mention of early interventions and addressing the causes of suicide, no mention of alcohol and drugs, homelessness, criminal justice etc. To prevent suicide, other issues have to be addressed and intertwined into the strategy and correlate with other policy areas".
We listened to what people said about the outcomes, where there was a high level of agreement with the outcome wording, such as outcome 1, there were no changes made. However, where necessary, the outcome wording was changed to reflect suggested improvements. This included:
- Moving away from the use of 'everyone' in outcome 2 to wording which not only reflected what we had heard through the feedback for outcomes, but also the strength of opinion that communities needed to be at the core of suicide prevention.
- Being explicit that the strategy's outcomes relate to both adults and children and young people.
- Ensuring the outcomes reflect the broad range of work required across early intervention, crisis response, postvention and recovery. We have also embedded these different types of responses that need to be there for people right across the action plan.
We were extremely grateful for the feedback we received on the draft outcomes. Some of the specific areas highlighted within the feedback on outcomes were incorporated into the changes we made to actions, within the action plan. For example, a focus on peer support became a key action under outcome 3 rather than included in the wording of the outcome – as it would have been difficult to itemise all types of support in the outcome descriptor.
- Outcome 1: The environment we live in promotes conditions which protect against suicide risk – this includes our psychological, social, cultural, economic and physical environment.
- Outcome 2: Our communities have a clear understanding of suicide, risk factors and its prevention – so that people and organisations are more able to respond in helpful and informed ways when they, or others, need support.
- Outcome 3: Everyone affected by suicide is able to access high quality, compassionate, appropriate and timely support – which promotes wellbeing and recovery. This applies to all children, young people and adults who experience suicidal thoughts and behaviour, anyone who cares for them, and anyone affected by suicide in other ways.
- Outcome 4: Our approach to suicide prevention is well planned and delivered, through close collaboration between national, local and sectoral partners. Our work is designed with lived experience insight, practice, data, research and intelligence. We improve our approach through regular monitoring, evaluation and review.
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