Suicide Bereavement Support Service: final evaluation report

3. Service activity and people supported

This chapter provides an overview of service delivery activity and a profile of the people supported by the SBSS.

3.1 Overview of service activity

The text below sets out the monitoring data covering the period since the service launched in August 2021 to the end of September 2023.

Suicide Bereavement Support Service, service data: 12th August 2021 (date of service launch) to 30th September 2023

• Referrals received: 242
• First contact attempt within 24 hours of receipt of referral: 99%
• Referrals that became active cases: 215
• Current active caseload: 132
• Total number of support sessions delivered: 2,670
• Average number of support sessions per person being supported: 12.4
• Total length of time spent on support sessions: 2,089 hours
• Average length of each support session: 47 minutes
• Number of outward referrals: 33

Number of people supported and support sessions delivered

The SBSS received 242 referrals over 25 months of delivery, from August 2021 to September 2023, an average of almost 10 per month. This average represents an increase from the previous reporting point in April 2023 (using service data to the end of February 2023), where the monthly average was roughly eight referrals per month. From March 2023 to the end of September 2023, the service received 87 referrals (40 in Ayrshire and Arran, 47 in Highland), an average of just over 12 per month. This period represents the highest average level of referrals received by the service and is a good indication of increasing awareness and further embedding of referral pathways to the service.

At the end of September 2023, 132 people were receiving support from the service, 69 in Ayrshire and Arran and 63 in Highland. This is a marked increase in overall caseload in the service since the last reporting point in April 2023 (when a caseload of 90 was reported), and most notably in Highland, which had a caseload of 37 as of February 2023.

From August 2021 to September 2023 a total of 2,670 support sessions and 2,089 hours of support have been provided via a mix of telephone, video call, text message and face-to-face delivery, with most support sessions being delivered over telephone. Across both delivery areas this equates to an average of 12.4 sessions per person being supported, each lasting an average of 47 minutes. However, the average number of sessions is lower in Ayrshire and Arran (11 compared to 14 in Highland) though with a longer average session length (55 minutes compared to 41 minutes in Highland)

Referral routes to the service

Referrals from Police Scotland account for 26% of all referrals received by the SBSS from August 2021 to September 2023, a slight decrease from the previous reporting point (30% as of the end of February 2023). However, there are differences across the two service areas. In Ayrshire and Arran, 14% of referrals came from Police Scotland, whereas in Highland, they account for 38% of referrals.

Levels of self-referral are similar in both areas, with this pathway resulting in 30% of all referrals in Ayrshire and Arran and 34% in Highland for the period August 2021 to September 2023. Referrals from health services such as GP/Medical practices, mental health professionals and community link workers account for 34% in Ayrshire and Arran (compared to 22% as at February 2023), which suggests those pathways are becoming more embedded. In Highland, health pathways account for 15% of all referrals. Small numbers of referrals from a range of other services and organisations in each locality make up the remaining referrals in both areas.

Outward referrals

The data demonstrates that there has been a low level of outward referral activity, with 14 in Highland and 19 in Ayrshire and Arran. While there has been no change in the level of outward referrals in Highland during the extension period, Ayrshire and Arran made 10 outward referrals during the same period. Overall, this equates to an average of less than one outward referral per month in each of the pilot areas since the service launched.

As detailed in the Year 2 evaluation report, SBSS staff explained that, as appropriate and necessary, they speak to the people they support about different support and external services that are available to meet their wider needs. SBSS staff reported that people often prefer to receive details about different external support options and then decide if and when they want to access it. When people supported by the SBSS would like a referral or help to contact and engage with another service, practitioners will do this. Examples of referrals made to other organisations and services include:

• Distress Brief Intervention Service
• The Lennox Partnership
• Hope Wellbeing Centre
• Circles Advocacy
• Change Mental Health Money and Advice Line
• Befrienders Highland

Signposting to resources and sources of information relevant to people’s needs was reported to happen more frequently than formal referrals being made.

3.2 People supported by the SBSS

Detailed description of infographic presenting demographic data

The following sets out the demographic profile of those that have been supported by the SBSS across both pilot areas:

Sex

• 71% female
• 24% mal
• 0.5% non-binary
• 4.5% unknown

Age

• The youngest person supported by the service was 10 years old, and the oldest was 86
• Average age of supported people was 43.5

Living arrangements

• 57% live with a spouse, partner, or other family
• 17% live alone
• 3% share or live with friends
• 22% unknown

Employment status

• 11% unemplyed
• 8% student
• 2% carer
• 7% other
• 1% volunteer
• 25% unknown
• 43% employed, of which:
• 31% full time
• 10% part time
• 1% self employed
• 1 casual or zero-hour contract

Relationship to the deceased

• 28% parent or step parent
• 19% spouse, fiancé or partner
• 14% sibling
• 13% daughter or son
• 9% friend
• 6% ex-partner or ex-spouse
• 2% Grandparent
• 2% Uncle/Aunt
• 2% cousin
• 1% in-law
• 1% colleague
• 5% other

Year of bereavement

• 24% 2023
• 33% 2022
• 29% 2021
• 5% 2020
• 5% pre-2020
• 5% unknown

Ethnicity

• 67% white, made up of 55% Scottish, 10% British and 2% other
• 1% mixed race
• 0.5% African
• 31% unknown or prefer not to say

Differences in the profile of people supported across the two service delivery areas

Demographic data for each pilot area is provided to demonstrate the differences and similarities in the profile of people accessing the service in each area, not to draw comparisons:

• Sex: In Ayrshire and Arran, the proportion of males receiving support is lower (18%) than in Highland (30%). However, 9% were recorded as unknown in Ayrshire and Arran, which could change the proportions.
• Age: The average age of supported people is slightly higher in Highland (44.5) than in Ayrshire and Arran (42.3). Ayrshire and Arran supported a higher proportion of people aged 31-40 (29%) than in Highland (16%). Highland had higher proportions of 18–30-year-olds and those aged 70+. All other age brackets had almost equal proportions across the two pilot areas.
• Living arrangements: Across both service areas, most people receiving support live with a spouse, partner or family (63% in Ayrshire and Arran, 52% in Highland). However, the proportion of ‘unknown’ in both areas prevents describing a fully accurate picture of this (16% in Ayrshire and Arran and 29% in Highland).
• Employment: There is a slightly higher proportion of employed people receiving support in Highland (45%) compared to Ayrshire and Arran (39%). In Ayrshire and Arran 14% are unemployed, while this figure is 7% in Highland. However, high proportions of unknown/prefer not to say or ‘other’ in both areas could be skewing the breakdown.
• Relationship to the deceased: Both areas have very similar levels of parents/step-parents, spouse/fiancé/partner, and siblings supported by the service. Highland have a higher proportion of daughter/sons (19% compared to 8% in Ayrshire and Arran), whereas Ayrshire and Arran have a higher proportion of ex-partners (10% compared to 2% in Highland).
• Year of bereavement: Bereavements occurring in 2021 are almost identical in both areas (28% in Ayrshire and Arran and 29% in Highland). There is a slight difference in the proportion of bereavements in 2022 (36% in Ayrshire and Arran and 30% in Highland) and 2023 (20% in Ayrshire and Arran and 27% in Highland). Pre-2021 represents smaller proportions in each of the service areas.
• Ethnicity: The high proportion of ‘unknown/prefer not to say’ in the service data from Ayrshire and Arran (37%) and from Highland (25%) means an accurate description of supported people’s ethnicity is not possible.

Differences in the profile of people supported by the SBSS over time

Some changes are evident when the data for the period August 2021 to September 2023 is compared to data for the period August 2021 to February 2023:

• Sex: The proportion of males accessing the service in Ayrshire and Arran has reduced from 25% to 18%, though the level of unknown (9%) categorisations may be skewing this. In Highland, there has been very little change (30% male, 70% female compared to 32% male and 68% female in February 2023).
• Age: The average age of supported people has increased slightly in Ayrshire and Arran, rising to 42.3 compared to 41.6 previously. In Highland, the average age has decreased slightly, from 46.5 previously to a current average of 44.5.
• Relationship to the deceased: Immediate family members remain the most commonly supported people by the service in both areas, though there have been some changes in relationship type. In Highland, there has been a reduction in the proportion of parents/step-parents (29% compared to 39% previously). Very slight increases in the proportions of grandparents, uncle/aunt, daughter/son and friends of the deceased were observed. In Ayrshire and Arran, there were very slight changes across most categories (less than or equal to 3% variation), though the service in this area is now also supporting colleagues, in-laws, cousins and grandparents.
• Year of bereavement: The proportion of supported people that experienced a bereavement in 2023 has increased in both service areas (Ayrshire and Arran 4% up to 20%, Highland 3% up to 27%). This has reduced the proportions of prior-year bereavements across both areas, indicating that recent referrals are likely related to recent bereavements.