Suicide Bereavement Support Service: evaluation report - year 2

8. Appendix 1: Detailed Alt-text descriptions for infographics and charts

8.1 Demographic information infographic – detailed description

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

Sex

• 72% female
• 28% Male

Age

• The youngest person supported by the service was 10 years old, and the oldest was 79
• Average age of supported people was 44

Living arrangements

• 65% live with a spouse, partner, or other family
• 19% live alone
• 4% share or live with friends
• 12% unknown

Employment status

• 11% unemployed
• 10% student
• 4% retired
• 3% carer
• 7% other
• 21% unknown
• 44% employed, of which
  • 30% full time
  • 11% part time
  • 1% self employed
  • 1 casual or zero-hour contract

Relationship to the deceased

• 33% parent or step parent
• 21% spouse, fiancé or partner
• 15% sibling
• 12% daughter or son
• 7% friend
• 6% ex-partner or ex-spouse
• 9% other

Year of bereavement

• 2% 20 23
• 43% 20 22
• 43% 20 21
• 6% 20 20
• 3% pre 20 20
• 4% unknown

Ethnicity

• 66% white, made up of 55% Scottish, 9% British and 2% other
• 2% mixed race
• 1% African
• 31% unknown or prefer not to say

8.2 Service structure hub and spoke infographic – detailed description

The centralised functions carried out by the hub include:

• Quality assurance
• Service model design and implementation
• Links with national networks and partnerships
• Receipt and allocation of referrals
• Core staff training and development
• Promotion and communication fo the service
• Service team meetings
• Service branding
• Buzz sessions
• Networking
• Service monitoring, data collection and recording
• Impact analysis

The functions carried out locally in each pilot area by the service management and delivery teams include:

• Staff recruitment, ongoing training and support
• Delivery of support to people that have accessed the service
• Development of local referral pathways
• Gathering local data and intelligence
• Local networking, awareness raising, promotion and communications
• Developing internal policies
• Local team meetings and buzz sessions

8.3 Service delivery model infographic – detailed description

The five main components of the service delivery model are as follows:

• A referral or self referral is received by the service. Sources of referral has included Police Scotland, community mental health services, schools and colleges, GP practices, Procurator Fiscal’s Office and other service providers
• The referral is then allocated to a practitioner in the service. Various considerations are made when allocating a referral to a practitioner which can include:
  • Capacity and caseload of practitioners
  • Whether the person referred is known to a practitioner
  • Whether a practitioner is already working with someone else connected to the same bereavement
• Initial contact with the person referred to the service is attempted within 24 hours of receiving the referral. The initial contact provides an opportunity to explain more about the service and the support it provides. The practitioner begins to build rapport with the person referred to the service and explores their preferences for engaging with support
• The practitioner and person receiving support agree a date, time and format for the first support session to take place
• The first support session is then delivered, and thereafter, support is tailored to the practical and emotional needs of the service users. Support can also include onward referral and signposting to other services and types of support. The support provided is led by the person receiving support and empowers them to choose the frequency of support sessions, the duration of each sessions and the format of the session which can be carried out by text, telephone, video call or face to face. The type of support the person receives is aligned to their needs at all times.

8.4 Logic Model – detailed description

The breakdown of the logic model categories, and the components within each of those categories is as follows.

The first category is actions, which detail the components that relate to how the service is set up and gets delivered. These are:

• Component 1 - The service identifies and works with local organisations to develop and maintain referral processes and pathways into and from the service.
• Component 2 - The service carries out awareness-raising activities, including the development and distribution of materials about the service for referral organisations and people bereaved by suicide.
• Component 3 - The service recruits appropriate support staff and provides them with appropriate induction and ongoing training and development to equip them for their role.
• Component 4 - The service allocates support staff in a timely manner to people bereaved by suicide who access the service.
• Component 5 - The service provides appropriate ongoing support and development to service support staff.
• Component 6 - The service develops and embeds required risk assessment, safeguarding and governance processes.

The second category is mechanism of impact, which details the mechanisms through which the service works and generates outcomes for those being supported by the service. These include:

• Component 7 - Organisations referring to the service are aware of and understand the service and how to refer appropriately to the service.
• Component 8 - People bereaved by suicide are aware of or able to find out about the service and how to access it.
• Component 9 - Organisations receiving referrals from the service are aware of and understand the service and are able and willing to receive referrals.
• Component 10 - Service support staff understand the support and services available from other organisations in the locality and appropriately refer or signpost people to these organisations.
• Component 11 - Service support staff are able and supported to provide compassionate, responsive, and person-centred support to people bereaved by suicide.
• Component 12 – The service provides a consistent, high quality and cost effective service.

The third category is short term outcomes, which details the positive change that the service is trying to achieve with those receiving support from the service. The intended short term outcomes include:

• Component 13 - People bereaved by suicide are able to access (referred or self-referred) the service easily and in a timely manner.
• Component 14 - People bereaved by suicide are signposted/referred to and are supported to access local sources of support that are relevant to and able to support their needs.
• Component 15 - People bereaved by suicide experience the service as providing support that is compassionate, relevant to their needs and is person/family centred.
• Component 16 - People bereaved by suicide are better able to cope with day-to-day life because of the support they have received.
• Component 17 - People bereaved by suicide experience improved mental well-being because of the support they have received.
• Component 18 - People bereaved by suicide become more hopeful about the future.
• Component 19 - People bereaved by suicide are less likely to feel suicidal or to experience suicidal ideation.
• Component 20 - People bereaved by suicide feel less shame or guilt about their experience of being bereaved by suicide.

The fourth category is intermediate and long term outcomes, which details the outcomes that the service is intended to contribute to through its work. The intended intermediate and long term outcomes are:

• Component 21 - People bereaved by suicide are less likely to attempt or die by suicide.
• Component 22 - People bereaved by suicide are able to accept their loss and move forward in their lives.
• Component 23 – The service contributes towards a reduction or stabilisation in suicide rates.
• Component 24 – The service contributes towards a reduction in the personal, societal and economic costs associated with bereavement from suicide.

The final category details the assumptions that underpin the theory of the logic model. These assumptions describe the conditions that are necessary for service activities to deliver the intended outcomes. These assumptions are:

• Assumption 1 – That people locally who have been bereaved by suicide will want to use a suicide bereavement service.
• Assumption 2 – That demand for the service, particularly in response to the impacts of COVID-19 on mental wellbeing, does not exceed capacity.
• Assumption 3 - There are sufficient trained support staff in each of the delivery organisations with capacity to ensure an effective and responsive service.
• Assumption 4 - That there are appropriate local resources available with capacity to respond to people referred or signposted via the bereavement service.
• Assumption 5 - That COVID-19 restrictions do not impede effective delivery of the service.
• Assumption 6 - Not being able to provide support in the service users’ preferred format does not create barriers to take up.
• Assumption 7 - That other local support organisations want to engage with the suicide bereavement support service.
• Assumption 8 - Staff in referral organisations are equipped and confident about having the discussion about the referral with potential service users.
• Assumption 9 - That suicide bereavement support service users will want to engage with another support organisation to address needs not able to be met by the service.
• Assumption 10 - Referring organisations recognise the benefit and value of the service to the target client group and buy in to it (e.g. refer into it, invest time in learning processes).