National Suicide Prevention Advisory Group Minutes: October 2023

Attendees and apologies

• Rose Fitzpatrick CBE QPM, Chair
• Cath Denholm, Equality and Human Rights Commission
• Dr Linda Findlay, Royal College of Psychiatrists Scotland
• Louise Hunter, Who Cares? Scotland
• Dr Douglas Hutchison, Association of Directors of Education Scotland
• Peter Kelly, Poverty Alliance
• Catherine McWilliam, Institute of Directors Scotland
• Brendan Rooney, Healthy n Happy Community Development Trust
• Professor Andrea Williamson, University of Glasgow

Apologies

• Sheriff David Mackie, Scottish Association Care and Rehabilitation of Offenders (SACRO)
• Shirley Windsor, Public Health Scotland (Agenda Item 5)

In Attendance

• Professor Rory O’Connor, Co-Chair of Scotland’s Suicide Prevention Academic Advisory Group (AAG)
• Professor Steve Platt, Co-Chair of Scotland’s Suicide Prevention Academic Advisory Group (AAG)

Agenda Item 5

• Haylis Smith, Scotland’s National Delivery Lead for Suicide Prevention
• Neil Mathers, Samaritans
• Dan Farthing, SAMH
• Jane Cumming, Penumbra

Secretariat

• Morag Williamson, Scottish Government
• Craig Wilson, Scottish Government

Items and actions

Welcome

The Chair welcomed members to the second meeting of the National Suicide Prevention Advisory Group (NSPAG) (“the group”).

Apologies

Apologies were noted.

Minutes and matters arising

The Chair noted that the minutes from the group’s meeting in May had been circulated for comment and requested that any further comments be collated by the secretariat and sent to her to sign off. Action 2.1.

At the group’s first meeting in May, members were asked to consider the group’s draft terms of reference and ‘working together’ principles. Revised versions of these papers containing feedback from members had been issued to the group prior to the meeting. The Chair thanked members for their feedback and the group formally agreed both papers.

Meeting with Creating Hope Together sponsors

The Chair welcomed the co-sponsors of Scotland’s Suicide Prevention Strategy and Action Plan, Maree Todd MSP, Minister for Social Care, Mental Wellbeing and Sport and Cllr Paul Kelly, COSLA Spokesperson for Health and Social Care, to the meeting. 

Ms Todd and Cllr Kelly thanked everyone for taking up the role as members of the group, noting the breadth and depth of expertise across the group, and their shared ambition to reduce suicide deaths in Scotland. The group’s expertise would be invaluable in driving forward the Suicide Prevention Strategy: Creating Hope Together. Ms Todd and Cllr Kelly each spoke of their own personal commitment to suicide prevention. 

Ms Todd and Cllr Kelly made it clear that Scottish Government and COSLA were keen to hear members’ views on the challenges and opportunities in preventing suicide across Scotland. They would always be keen to receive advice from the group, and would respond accordingly. It was agreed that the group could constructively support delivery of the Strategy by: providing strategic guidance to delivery partners (including sharing insights and making connections to new opportunities and networks); providing advice and feedback to Scottish Government and COSLA on progress in delivering the Strategy; and, championing suicide prevention across their individual sectors and networks.

There was a wide ranging discussion on the strategic context in which the Suicide Prevention Strategy was being delivered. In discussion the following points were made:

• Working at a grassroots level within communities - to build connections and understanding of suicide – was seen as critical to embedding suicide prevention locally. The work of the Scottish Professional Football League (SPFL) Trust was cited as a good example of this. 
• A key challenge to preventing suicide was identified as the current strain across public services. This could be mitigated by services prioritising vulnerable groups, and potentially suicide prevention could be used as strong lever for change in re-prioritising resources and in supporting the wellbeing of the workforce, including across health services such as primary care, education and social work. Prioritising resources could be particularly impactful within socially deprived areas, and it would be important to identify and tackle barriers to partnership working early.
• It was considered important to prioritise activities which were of high value and which had a clearer delivery path. Examples could include improving public understanding of suicide and how to respond to someone who is suicidal (business leaders could provide an effective route to widen reach), and scaling up effective ways to reach and support people, such as through sport.  
• It was noted that there were legal obligations on workplaces to ensure trained physical first aid provision was available, but that this did not apply to mental health first aid or suicide prevention training at this time. It was agreed suicide prevention training would be arranged by the secretariat for the group so members were equipped to have sensitive conversations around suicide as part of their role. Action 2.2.
• It was highlighted that the Joseph Rowntree Foundation (JRF)’s report on ending destitution had been published in October 2023. It was felt that the strategic commitment to tackling the inequalities which contribute to suicide would require strong focus on the most disadvantaged and most vulnerable and the group noted that tackling poverty, particularly child poverty, remained an absolute priority for government. 
• It was considered essential to understand and meet the needs of children and young people across the work to prevent suicide. This should include effective messaging, ensuring services take a joined-up approach. It was reported that the Suicide Prevention Academic Advisory Group (AAG) was looking at suicide prevention interventions for children and young people, and that the Distress Brief Intervention (DBI) programme was being piloted for 14 and 15 year olds and showing positive results. The secretariat undertook to share the published DBI evaluations with the group. Action 2.3.
• It was highlighted that alongside the strategic focus on children and young people, there should also be consideration on how to support adults, including carers – recognising that all parts of society were affected by suicide. 

The Chair thanked Ms Todd and Cllr Kelly for meeting with the group, and confirmed the group would continue to engage with and report to the Scottish Government and COSLA with candour.

NRS Suicide Statistics 2022

The National Records of Scotland (NRS) Suicide Statistics for 2022 had been published on 5 September 2023. Suicide Prevention Scotland had engaged with Scottish Suicide Information Database (ScotSID) colleagues to provide an analysis at the time of publication, which had been shared with the group prior to the meeting. Prof Platt gave an overview of the 2022 statistics, noting that while there was a 1% increase to 762 in the number of suicides on the previous year it was always important not to rely on a single year in isolation and that five year rolling averages gave a better understanding of trends over time. The number of deaths by suicide in 2022 was below the rolling five year average of 771.

There was a discussion in the international context on how economic conditions and policy decisions impacted over the long term on the suicide risk for particular groups in society. It was agreed that these impacts needed to be considered generationally and suicide prevention interventions understood in terms of the personal, social and economic costs of suicide, the latter currently estimated academically as being £1.7m per life lost . Prof Williamson highlighted a recent report by the Glasgow Centre for Population Health that explored these areas and undertook to provide it to the secretariat to share with the group. Action 2.4.

Creating Hope Together 2023/24 Delivery Plan

The Chair welcomed the Suicide Prevention National Delivery Lead (NDL) and Strategic Outcome Leads (SOLs) for a discussion around the current strategic opportunities and challenges in delivering the Creating Hope Together 2023-24 Delivery Plan. The NDL thanked members who had each individually given her their time to discuss development of the delivery approaches to date and each SOL then gave an overview of priorities for their respective Outcome.

Outcome 1 – The environment we live in promotes conditions which protect against suicide risk

Mr Mathers highlighted the year one priorities.  These were: developing a whole of Government and society approach; addressing access to means of suicide and locations of concern; and, improving media reporting.

It was reported that work under the whole of Government and society action included looking at the social determinants of suicide and prioritising action to support high risk groups, whilst also focusing on equalities and human rights. Work was underway to produce a prioritisation framework to support this, which would be shared with the group when available. Action 2.5. The group contributed views and advice on: (1) the intersectionality of characteristics (which included and went beyond protected characteristics) as well as personal circumstances and experiences, could compound risk; for example, how people with disabilities experienced the benefits system; (2)  the value in exploring the potential for a cross-cutting health equity approach to suicide prevention, similar to the Health in All Policies approach used in other parts of the UK; (3) the value members could add in influencing Government policy across portfolios, for example into areas such as the Tackling Child Poverty Programme Board.

Work was ongoing to develop a national action plan for locations of concern (with a focus on preventing jumping from height) that supported local action and interventions, with a series of workshops planned for early 2024. 

It was planned to engage with stakeholders and the media sector to test media guidelines, and develop a better understanding of how to effectively support the sector to improve media reporting of suicide. A media advisory service would then be established. 

Outcome 2 – Our communities have a clear understanding of suicide and are more able to respond with support

Mr Farthing set out the year one priorities. These were: developing the social movement; building suicide prevention learning; improving understanding of help-seeking and help-giving, and developing an online information and advice portal.

On the United To Prevent Suicide (UTPS) social movement, strategic planning was underway to consider how to develop this further, including to shift it to a more grassroots-led social movement. Work was also underway to plan future public awareness campaigns, and to take forward the findings from the ongoing learning review, on which members’ advice would be sought. Ms McWilliam highlighted the potential value of working with employers as part of future campaign work.

The AAG would be providing support on help-seeking and help-giving, as would the Suicide Prevention Lived Experience Panel (LEP) and practice experts to inform the programme of work. Prof Williamson highlighted the ‘Inclusion health and missingness in health care’ research as a helpful resource and the secretariat would provide this to members. Action 2.6. 

Work was also underway to develop an online portal to provide information on support and advice to people who might be suicidal and those caring for them, together with information for professionals working in suicide prevention. This work would include engaging an expert digital partner, researching users’ needs, and working closely with the existing suicide prevention network. 

Outcome 3 – High quality support for everyone affected by suicide 

Ms Cumming outlined the year one priorities. These were: building on the Time Space Compassion (TSC) approach to suicide prevention; supporting new peer support groups across Scotland; building understanding of and improved responses to suicide risk and behaviour amongst children and young people. Taken together this work would support systematic improvement for people affected by suicide, both in community and clinical settings.

Work was underway to build on the existing TSC approach and continue to build the practice framework, recognising that compassion needed to be present across the continuum from service planning decisions to front line provision. Work was also underway to consider options for rolling out suicide bereavement support beyond the initial pilots in Highland and Ayrshire and Arran, as well as building understanding of the specific suicide prevention needs of children and young people. The peer support work led by Scottish Recovery Network was progressing well. Consideration was being given to opportunities for tests of change and members were invited to make suggestions via the secretariat. Action 2.7.

Outcome 4 – Effective, evidence-based and evaluated planning and delivery 

Ms Shirley Windsor, representative of Outcome 4 SOL Public Health Scotland, was unable to attend the meeting. It was noted that a programme of data improvement work was underway which would underpin many aspects of the Delivery Plan. Members were invited to share via the secretariat data sources which could provide additional intelligence on the social determinants of suicide. Action 2.8.

Following consideration of progress on specific Outcomes there was discussion on how the SOLs could most effectively engage with and seek advice from the Group.  It was agreed that the Chair, the NDL and the secretariat would develop a structured approach for bringing specific strategic issues to the group for consideration at and between meetings. Action 2.9. It was agreed that while the group’s meetings would serve as formal discussion forums and milestones throughout the year, discussions with members (as a group and individually as appropriate) outside these meetings would be necessary to maintain productive momentum. The NDL and SOLs undertook to continue to connect with members to seek advice on strategic issues between meetings as well as at those regular checkpoints.

Actions and close

The Chair thanked members and attendees for the quality of their engagement and contributions. The next meeting of the group would take place at Glasgow City Chambers on 24 January 2024 and in line with Action 1.3 from the group’s May meeting, the secretariat was progressing options for engaging at the January meeting with members of the Suicide Prevention Youth Advisory Group and Lived Experience Panel.

Summary of Actions from the NSPAG Meeting held on 26 October 2023

• members to send amendments to the May minutes to the secretariat
• secretariat to explore suicide prevention training options for members
• secretariat to share DBI evaluation with the group, and the DBI website
• Prof Williamson to share Glasgow Centre for Population Health report with the group
• Mr Mathers to share whole of Government and society prioritisation framework, when available
• secretariat to share the ‘Inclusion health and missingness in health care’ research with members.
• members to make suggestions for tests of change across outcomes via the secretariat
• members to share via the secretariat data sources which could provide additional intelligence on the social determinants of suicide
• Chair, National Delivery Lead and secretariat to develop a structured approach for bringing specific strategic issues to the group for consideration at and between meetings