Suicide prevention strategy development: early engagement - summary report

Policy Areas

Many respondents both within the workshops and survey noted that there are a wide range of policy areas that can impact on suicide prevention strategies.

Mental Health

Alcohol, drug and gambling addictions and their potential to have an adverse impact on mental health were frequently mentioned by respondents. It was suggested that addiction is a “huge issuein the grip of addiction”. Others suggested that mental health services should be provided to those still “” -in some areas this does not appear to be the case.

Perinatal mental health can also be a contributory factor to suicide ideation, and it was suggested that it would be beneficial to “dovetail this area with others to ensure that the focus is on where the need for intervention is”.

Social Care

The main areas of focus were adult social care, care leavers and looked after children. Respondents in the survey mentioned that there needs to be an understanding of the “support and experiences of difficulties” in care settings.

Criminal Justice

Police and prison services were mentioned frequently as officers in these services have a high probability of coming into direct contact with individuals with suicide ideation. Many respondents noted that those who are experiencing suicidal thoughts and seek help may phone emergency services and are incarcerated whilst the relevant organisations are contacted. It was suggested this should be avoided, and that workers from relevant services and police officers offer support simultaneously. Training for police officers, call handlers and for staff and prisoners in the prison service was referenced on a number of occasions.

Education

Consideration should be given to raising awareness of suicide prevention at all educational stages from primary to tertiary. Many respondents noted the need for earlier intervention in a school setting as the “earlier people are able to talk and build resilience to challenges that often lead to suicide the better for their future”.

Survey responses from organisations mentioned that tackling bullying and discrimination in schools could alleviate suicidal deaths in individuals who are LGBTQI, experience disability or are BME.

Transport

Access to affordable transport can play a key role in enabling individuals who have to travel to get the support they require that is not locally available.

Housing

Ensuring individuals have access to affordable housing along with support to sustain their tenancies was frequently mentioned by respondents. It was also suggested that individuals in hostels and residential units might need extra support to tackle loneliness and isolation.

Poverty

Poverty, according to some individual survey respondents, was an “enormous factor” that had to be considered in any suicide prevention strategy. It was suggested that addressing social, health and economic inequalities at a strategic level would assist in preventing suicide. At a local level specific community based activities targeted at the most vulnerable individuals were seen as offering practical support aimed at suicide prevention and crisis intervention. However, it was acknowledged that to continue to provide support services such organisations will need to be “better resourced and supported.”

Examples of Training, Interventions, and Activity

There were many examples of activity highlighted in the workshop sessions and survey results. Information came from a wide range of individuals. A selection of the suggestions put forward are listed below. Please note these are based solely on participant responses and cover Scotland, the UK, and internationally.

Scotland - National & Local Initiatives

• Midlothian HSCP - Local mental health and wellbeing website Midspace - localised and consistent across all of Lothian
• Midspace | Mental health - information and support | Midlothian Council
• Support in Mind - https://ruralwellbeing.org/past-events/
• Fife HSCP - Suicide Prevention Network https://sway.office.com/DsmOtrNxCFtjYRMH?ref=Link
• Edinburgh Crisis Centre - http://www.edinburghcrisiscentre.org.uk/wordpress/
• Suicide review group in Tayside uses learning from deaths by suicide to influence action
• Perinatal mental health service in Fife - https://www.nhsfife.org/services/all-services/maternity/antenatal-care/enhanced-midwifery-support-services/perinatal-mental-health/
• Ayrshire Bairns app in Ayrshire & Arran – provides information on perinatal wellbeing and connect to health visitors - https://www.nhsaaa.net/news/latest-news/early-years-children-have-it-picture-perfect-for-new-ayrshire-bairns-app/
• The “S” word Ayrshire College - https://www1.ayrshire.ac.uk/news-events/news/2021/ayrshire-college-is-talking-about-the-s-word/
• Penumbra’s Crisis Centre, Edinburgh http://www.penumbra.org.uk/
• ‘Lyrics for life’, Edinburgh https://www.edinburghhsc.scot/lyrics-for-life/
• Mental Health nurses are located in all GP practices in Forth Valley
• DBI – Distress Brief Interventions https://www.dbi.scot/
• TRiM – Trauma Risk Management – a model of support for Police Officers and support staff involved in potentially traumatic incidents. https://www.scotland.police.uk/wellbeing/trim.html
• @_FCUnited to Prevent Suicide - “raising awareness and enabling conversations to happen” - https://mobile.twitter.com/_fcunited and https://unitedtopreventsuicide.org.uk/
• Scotland’s Mental Health First Aid (SMHFA) training – http://www.smhfa.com
• Learning from the work around trauma informed practice and Adverse Childhood Experiences (ACES) - http://www.healthscotland.scot/population-groups/children/adverse-childhood-experiences-aces/overview-of-aces
• See Me - https://www.seemescotland.org/
• NES Trauma Training Programme - https://www.nes.scot.nhs.uk/our-work/trauma-national-trauma-training-programme/
• Step on stress course - https://www.accesstherapiesfife.scot.nhs.uk/step-on-stress/
• Hot Chocolate Trust - https://www.hotchocolate.org.uk/
• 1000 students at UWS have participated in safeTALK training - https://prevent-suicide.org.uk/training-courses/safetalk-suicide-alertness/
• NHSGGC have developed peer support will include elements of suicide prevention but will also support wider MH and wellbeing
• ‘How are you Dad’ – Fathers Network Scotland. https://www.fathersnetwork.org.uk/so_how_are_you_dad
• 13 reasons why tv programme led to development of ‘13 ways to help your friends’ for CYP https://young.scot/get-informed/north-ayrshire/13-ways-to-support-your-friends-if-they-are-struggling
• HUG Action for Mental Health - https://www.spiritadvocacy.org.uk/hug
• Seasons for Growth Training - http://www.seasonsforgrowth.org.uk/
• Talk to Me Scottish Prison Services - https://www.sps.gov.uk/Corporate/Publications/Publication-4678.aspx
• Chris’ House Suicide Awareness - https://chrisshouse.org/
• Training in low intensity interventions for anxiety (for school nurses via CAMHS)
• Ask-tell-respond or ask-tell-ask approaches e.g. https://cepc.ucsf.edu/sites/cepc.ucsf.edu/files/Curriculum_sample_14-0602.pdf

Ask Tell Respond learning resources on mental health, self harm and suicide prevention for Scottish workforce (sign up to TURAS required for access).

Course: Mental health improvement, self-harm and suicide prevention (publichealthscotland.scot)

• Suicide Prevention training (including safeTALK and ASIST) Suicide prevention training courses and resources - Suicide - Health topics - Public Health Scotland
• Samaritans 24/7 helpline - https://www.samaritans.org/?nation=scotland

UK

• 4 Mental health training developed in Wales https://4mentalhealth.com/
• Cancer care e.g. death cafes or bereavement support offered by Maggie’s Centres. Could a similar approach be taken to talking about suicide?
• Postvention service in prisons in England and Wales; volunteers train staff - https://media.samaritans.org/documents/Samaritans_Postvention_in_prisons_FINAL_pdf.pdf
• Coroner’s inquest (English model - Independent individual (i.e. coroner) takes responsibility for gathering info from all services and communicating it to the family
• Ripple initiative – https://rippleinitiative.wixsite.com/makearipple
• Stepping back safely - https://www.nsft.nhs.uk/news/news-stepping-back-safetly-1611/
• Roman Kemp documentary –Our Silent Emergency - https://happiful.com/roman-kemp-our-silent-emergency/
• Trieste model - https://www.coe.int/en/web/bioethics/-/trieste-model-open-door-no-restraint-system-of-care-for-recovery-and-citizenship-
• Decider skills - https://www.thedecider.org.uk/
• Beautiful Inside and Out - https://www.facebook.com/beautifulinsideandoutscio/
• VictimFocus - https://www.victimfocus.org.uk/
• New Medicines Service, England (increase adherence to medication) https://www.nhs.uk/nhs-services/prescriptions-and-pharmacies/pharmacies/new-medicine-service-nms/
• Psychiatry UK access, England https://psychiatry-uk.com/right-to-choose/
• WELL services https://www.wellshealthcentre.nhs.uk/

International

• Training in livingworks courses https://www.livingworks.net/
• Blue Knot Foundation, Australia (empowering recovery from complex trauma) https://blueknot.org.au/
• Orygen, Australia (Youth Mental Health Org) https://www.orygen.org.au/
• SUPRANET, Netherlands (mental health org network for suicide prevention) https://psychiatryamsterdam.nl/project/supranet/
• Vision Zero, Sweden
• http://www.welivevisionzero.com/vision-zero/
• Well man clinic 40-45 https://www.wellmanclinic.org/mens-health-services/mens-health-screening/
• Access to means intervention, farmers and pesticides sri lanka https://www.thelancet.com/pdfs/journals/langlo/PIIS2214-109X(17)30208-5.pdf
• Zero suicide approach, US https://zerosuicide.org/
• Suicide 1^st responders for postvention, Netherlands (not found online)