National Suicide Prevention Advisory Group Annual Report 2023/2024

5. Recommendations by the National Suicide Prevention Advisory Group

Recommendation 1

Tackling Inequalities – Moving from Engagement to Action

As independent and impartial advisors, the NSPAG welcomes the commitment set out in Scotland’s Suicide Prevention Strategy 2022-2032 to tackling the inequalities which contribute to suicide. We have seen a strong focus in the suicide prevention Delivery Plan 2023/24 on engagement activities aimed at laying the foundations for tackling the inequalities which contribute to suicide. As set out in this report, our NSPAG members have offered specific advice and help to Suicide Prevention Scotland to make connections and take up opportunities to further this approach.

Tackling the social determinants which impact on the risk of suicide will always be challenging; all those we have talked with in 2023/24 who are passionate about suicide prevention both recognise the scale of this challenge and are proud to see Scotland take it on in order to reduce inequalities, save lives and prevent the tragedy which each life lost to suicide causes.

Together with the NSPAG, those stakeholders are now eager to see Suicide Prevention Scotland build on its initial engagement and move to action specifically focussed through the lens of inequalities in communities and groups where the greatest risk of suicide can be reduced.

Recommendation 1: The NSPAG recommends that, using its new tackling inequalities prioritisation framework, Suicide Prevention Scotland’s engagement work should move as early as possible in 2024/25 to testing and delivering measurable action with the specific groups and communities most at risk of suicide and impacted by the tragedy it brings.

Recommendation 2

Urgent Improvement in Child and Adolescent Mental Health Services (CAMHS)

The NSPAG strongly commends the intention of the Suicide Prevention Strategy 2022-2032 to build a whole of government and whole of society approach to suicide prevention in Scotland. We recognise that all policy areas and sectors have a role to play in saving lives and have been honoured to use our multi-sector knowledge and networks to progress this approach.

What we also recognise, based on listening carefully throughout the last year to the consistent messages arising from the experience of individuals, families and practitioners, is that timely access to effective core mental health services continues to be critical to reducing the risk of suicide. Broadening the policy areas working to prevent suicide should not weaken the focus on mental health policy and services.

In particular and of great concern it is clear that systemic issues with Child and Mental Health Services (CAMHS) - identified through expert review involving users of those services before the suicide prevention strategy was created - persist and that they continue to heighten the risk of suicide. These sit alongside resourcing and improvement concerns for universal and early intervention services to support the mental health of children and young people. At a time when evidence suggests an increasing trend in suicide among children and young people, urgent and effective intervention is required, including the implementation of recommendations previously made.

Recommendation 2: The NSPAG recommends that urgent attention and resourcing be focussed by the Scottish Government on improvement in the capacity and performance of Scotland’s Child and Adolescent Mental Health Services (CAMHS), in order to reduce the risk of and prevent suicide among children and young people.

Recommendation 3

Costing Plans in Order to Prioritise Action Effectively

In providing independent and impartial advice during 2023/24 and in this our first annual report, the NSPAG has highlighted the importance of considering funding for suicide prevention not only in terms of that provided for specific activity under the Suicide Prevention Strategy 2022-2032 and associated implementation plans, but also in terms of the broader funding landscape for work which also contributes to saving lives from suicide.

Costing plans is even more important when both national and local government finances and funding for all services, public and social sector, are under intense pressure as they so clearly are at present.

The NSPAG is certain that introducing a process for costing proposed action plans under the suicide prevention strategy so as to inform the allocation of resources, rather than simply allocating budget as at present, is necessary for effective evidence-based prioritisation of actions against the outcomes framework. Without it opportunities and gaps may be missed, and choices – undoubtedly sometimes very difficult choices – on which actions are to be undertaken, at what scale and in what priority cannot effectively be made in a transparent, evidence-based and accountable way.

Recommendation 3: The NSPAG recommends that in 2024/25 work is undertaken by Suicide Prevention Scotland to develop and introduce a process for costing implementation plans under the Suicide Prevention Strategy 2022-2032. This should begin with the Delivery Plan 2024/25 and the results should inform both the resources allocated by the Scottish Government and COSLA to support the plans and the process of prioritising action.