National Suicide Prevention Leadership Group minutes: February 2019

Attendees and apologies

Attendees

Ms Rose Fitzpatrick (Chair)

Mr George Dodds

Mr Toni Giugliano

Dr David Hall

Mr James Jopling (from 2pm)

Dr Amy Knighton

Ms Lara McDonald

Ms Ruth Moss

Ms Jane O’Donnell

Ms Angela Scott

Mr Billy Watson

 

Apologies

Mr Nigel Henderson

Chief Superintendent John McKenzie

Dr John Mitchell

Ms Nicky Reid

Dr Michael Smith

 

In Attendance

Professor Rory O’Connor - Academic Advisory Group (via phone conference)

Ms Innes Fyfe – Scottish Government

Ms Siobhan Mackay - Scottish Government

Ms Lyndsay Wilson – Scottish Government

Mr Allan Steele - Scottish Government

Items and actions

1. Welcome from the Chair

Apologies

1.1. The Chair of the National Suicide Prevention Leadership Group (NSPLG) (the Group) welcomed Members to their sixth meeting.

1.2. Apologies had been received from Mr Nigel Henderson, Chief Superintendent John McKenzie, Dr John Mitchell, Ms Nicky Reid, and Dr Michael Smith.

1.3. The Chair noted that the meeting was quorate (9 members) for any decisions to be binding.

Minutes

1.4. It was noted that the December meeting minutes had been updated in line with action 5.1 of last month’s meeting. These were recirculated to the Members on the 13th of February, and have been published on the Scottish Government website.

1.5. The Group approved the minutes from the January meeting for publication with no amendments. Action 6:1

Action Log

1.6. Ms Mackay gave a brief update on actions of previous meetings that are still ongoing. These are all on track. 

Forward Look

1.7. The forward look calendar was recirculated with papers for this meeting. The Group were encouraged to update the secretariat with any important dates that may be missing. It was noted that the calendar was now available on Knowledge Hub for the Members as well.

1.8. The frequency of the NSPLG meetings going forward was also flagged by the Chair. The Group were asked to consider during the course of the meeting the appropriate frequency and duration of future meetings.

1.9. The Chair gave updates to the Group on her recent meetings including the COSLA Health and Social Care Board meeting and the Choose Life Coordinators. Both of these meetings provided an opportunity to give an update on the NSPLG, its work so far and future direction. Both meetings were received positively and continued engagement is planned. 

1.10. The Group welcomed these important forms of engagement and requested the secretariat shared any notes from the Choose Life Coordinators meeting for awareness. Action 6.2

2. Recap on January meeting

2.1. The Chair gave a short overview of the January meeting, centring on the presentation of the Integrated Motivational-Volitional (IMV) Model as a framework for considering suicide prevention.

2.2. The January meeting introduced the IMV Model as a possible lens through which the Group could consider work necessary to make a step change in suicide prevention, and as a tool to support sponsors in mapping their relevant Actions. It was emphasised that this was not a mandatory exercise, though the aim was to stimulate thought on at-risk factors, interdependency of Actions, and infrastructure from a person-centric perspective.

2.3. Members felt mapping against the IMV Model had been more useful for some Actions rather than others at this stage. It was however recognised that there was value in having a shared lens across all the work, particularly with regard to the measurement of Actions, conceptualisation of risk, and core messaging.

3. Work Plan Discussion

3.1. Ms Mackay briefly introduced the Work Plan Discussion Document which had been circulated the previous week. The purpose of this was to prompt thought and Group discussion with regard to:

• Grouping, prioritising, and sequencing of Actions
• How the Group will interact with stakeholders (including the Secretariat)
• Monitoring and reporting
• Funding
• Meeting frequency
• Communication and engagement
• Mapping activity, and
• Engaging effectively with people with lived experience of the impact of suicide

3.2. The first three of these points in particular were covered during the session, in which each set of sponsors gave an update on their relevant Suicide Prevention Action Plan (SPAP) Action.

Action 1 (Local planning)

3.3. The sponsors of Action 1 are in the process of mapping existing local planning. A questionnaire has been developed and circulated to a range of regional stakeholders to inform this. Once it has been received back, NHS Health Scotland will undertake analysis to pull out trends. This work will help provide a basis for the development of local planning guidance. 

Action 2 (Training)

3.4. There are two elements to this Action. The first is the production of refreshed training resources to healthcare staff. The first part of this work will be completed by May. NHS Health Scotland and NHS Education Scotland (NES) are taking this forward.

3.5. The second element is training in the broader public space. The relationship between Action 2 and 3 of the SPAP was re-emphasised and the need for careful coordination. Of note, the sponsors are working with the business community as an important partner in suicide prevention. With 67% of individuals who completed suicide being in employment at the time of their death this interaction will be vital.

Action 3 (Public awareness)

3.6. The sponsors for Action 3 updated that they have formed a sub-group that includes sponsors for Action 2 and have met a number of times. This sub-group had produced a paper for discussion later in the meeting (agenda item 6).

Action 4 (Support for those affected by suicide)

3.7. Sponsors provided an update on work they had been doing to explore what support is available to individuals affected by suicide. To this end, sponsors had developed a research proposal for discussion later in the meeting (agenda item 5).     

Action 5 (Crisis support)

3.8. In contrast to Action 4, there is a significant number of support services operating in this space. The sponsors have noted that the mapping of these services is a challenging process.

3.9. The Group discussed this, and pointed to the fact there is a large knowledge base amongst Members. Members agreed their collective knowledge is a resource which should be utilised as much as possible. In this particular instance Mr Dodds offered further support to the Action 5 sponsors in terms of mapping.

Action 6 (Digital)

3.10. Action 6 sponsors have been drawing connections with relevant stakeholders, including NHS 24. A scoping exercise will be undertaken to explore existing activity within the digital space and a reference group will be established to support the work. 

3.11. A broad perspective of what falls within the remit of ‘digital’ is being taken, noting that there are both positive and negative aspects to much of the technology, social media and associated information. The Group made a number of contributions to this discussion, drawing on previous research and campaigns that may be applicable at the strategic level e.g. sexual health campaigns, and signposting individuals searching specific trigger words towards support. Input from children and young people was discussed here as well as getting a fuller picture of how people are interacting with the digital sphere.

3.12. The UK Government’s recent statements regarding internet safety were also discussed. As this is a reserved matter, the Group were keen to ensure any relevant channels for input into this work were utilised. Although Professor O’Connor welcomed the UK government’s focus on social media and suicide, he urged caution on focusing so much on this relationship over other risk factors such as social disadvantage and treatments for mental health problems.

3.13. The Chair requested that secretariat seek information about the Scottish Government’s position and activities in relation to internet safety. This will inform the Group’s position and any potential opportunities for it to comment on this matter. Action 6.3

Action 7 (At risk groups)

3.14. Following January’s meeting, the sponsors of Action 7 were interested in feedback from other Members on the IMV Model. It was again noted that the way risk is conceptualised will inform other Actions. There was further discussion around risk factors rather than risk groups, and the evidence behind place and environment on suicide risk. An example of this was given with regard to reducing physical access to known suicide hotspots and the subsequent reduction in completed suicides. This ties in with the evidence base presented in January by the AAG and holds opportunities for Action 1’s development of local planning guidance. 

3.15. The sponsors noted they would come back to the Group in March with further thinking on this.

Action 8 (Children and young people)

3.16. As per the Suicide Prevention Action Plan (SPAP), the purpose of this Action is to ensure children and young person’s needs are taken into consideration. There is a significant link to Action 7 here and, as noted, Action 6.

3.17. Ms McDonald updated the Group on plans to meet with the Youth Commission for Mental Health which was in the final stages of its activity. The Group agreed there was merit in making use of this resource now and were encouraged to consider whether there were any matters in relation to their own Actions that Ms McDonald might raise with  the Youth Commission. Action 6.4

3.18. Mr Watson also clarified that SAMH were joint sponsors of the Youth Commission along with Young Scot and that discussions were now taking place about how it might evolve into a resource to support both the NSPLG and the Children and Young People’s Mental Health Taskforce once the Youth Commission has completed its current work. The Group agreed this was an opportunity that should be explored and the Chair would be happy to support this development. Action 6.5

Action 9 (Evidence)

3.19. Professor O’Connor noted that letters of invitation have been sent out to a number of academics and experts to join the Academic Advisory Group. Professor O’Connor and Professor Platt are awaiting final responses to these.

Action 10 (Reviews)

3.20. Ms Scott updated the Group on progress for Action 10. The sponsors have created a sub-group, which had met for the first time that morning. It was noted that there is a complex landscape in this area, and cross-government coordination will be important for learning and efficiency.

3.21. The links to Action 1 and 9 were again drawn in terms of the need for consistency of measurement. Additionally, ensuring that the respective target groups of Action 4 and 7 are considered in any review process will be essential.

4. Suicide Prevention Funding Paper

4.1. Ms Mackay gave an overview of the paper produced by Scottish Government which outlined roles and responsibilities of the Group and the Scottish Government in relation to the £3 million investment announced in the Suicide Prevention Action Plan. This clarified that the Group would be responsible for making recommendations to the Scottish Government on possible activity to be funded from the £3 million.  To mitigate against perceived conflicts of interest, the paper specified that the Group should not seek to recommend specific routes for delivery. It would be for the Scottish Government to consider whether to approve any recommendations for activity and then identify an appropriate route to progress it, allocating and managing any required funding as appropriate.   

4.2. The Group welcomed the paper, noting that it was very helpful. By outlining the duties of the Group and giving examples, the document provides a good anchor for decision making. The Group did have a few suggestions to add to the document including; specifiying the role of the Scottish Government accountable officer, setting out timescales for Scottish Government response, stipulating that reasons for Scottish Government decisions would be provided to the NSPLG and offering an opportunity for the Group to challenge rejection of recommendations. The Group supported the paper, subject to the Scottish Government updating it as per the suggestions. Action 6.6

4.3. The Group also suggested the establish a sub-group to initially consider funding recommendations before they came to the wider Group. This could be a way to expedite some decisions or make use of particular expertise within the Group. The Secretariat will facilitate the creation of this sub-group. Action 6.7

5. SPAP Action 4 (Support for those affected by Suicide) Research Proposal

5.1. As per the Group’s delivery plan, the first step for the Action 4 sponsors is to review and map current practice for supporting those affected by suicide. There is a limited evidence base in the Scotland setting for this. As such, the sponsors proposed a short research project to uncover existing models of intervention.

5.2. It was noted that the AAG had provided advice on an early version of the proposal, and their comments had now been incorporated.

5.3. There was robust discussion of the proposal by the Group including alternative ways of gathering the information, why this needed to be Scotland-specific, and the breadth of participants with regard to gathering lived experience input. During this discussion it was noted that this would be preliminary research to  allow the Group to gain insight into Scottish-specific experiences within a short timescale. The research would be a first step in a programme of work to inform future activity. Subsequent work (e.g. tests of change or piloting) would build on the research to create and use further evidence.

5.4. It was agreed that the proposal for research be recommended to the Scottish Government for funding from the SPAP £3m investment on the proviso that that additional detail summarising the points above (to be signed off by the Chair) be added. The Group agreed that this had been a useful discussion and one that had added further value to the research proposal. It was noted that in agreeing to recommend funding of this work to Scottish Government, it would be for Scottish Government to decide the best way to undertake the work. Action 6.8

6. SPAP Action 3 (Public awareness) Discussion Paper

6.1. Following the publication of the NSPLG Delivery Plan, the sponsors of Action 3 presented their approach in more detail.

6.2. The Group were supportive of the proposed approach and offered a number of potential stakeholders to work with in moving things forward (i.e. Celcis, ScotSID, and COSLA). Discussion also touched on the requirement for this to be a targeted approach as population-wide campaigning was already in existence.

7. Communications and Engagement

7.1. Ms Gordon gave an overview of the Communications and Engagement plan draft that she had put together. It was noted that Ms Gordon has spoken with a number of Members individually and will continue to do this as a way of collecting ideas and getting an understanding of the work of the NSPLG.

7.2. Parts of the paper that were discussed in detail included the need to consider a ‘brand’, the Group’s public identity, and the interaction with SPAP Action 3.  Specifically this covered whether the focus of any brand would be the Group itself or messaging around suicide prevention. That conversation would also need to include a discussion around the future of the ‘Choose Life’ materials which have been in existence for some time. The recent meeting of the Choose Life Co-ordinators had indicated a desire for these materials to updated to reflect the new Suicide Prevention Action Plan.

7.3. Given limited time, it was agreed that a session at the next meeting should be dedicated to these questions. Ms Gordon would compile a list of questions for Members to consider in advance of the next meeting. Action 6.9

7.4. The Group discussed the need for a sub group to support this work moving forward. It was agreed that Members would put their name forward for this. Action 6.10

8. Engagement with People with Lived Experience of the Impact of Suicide

8.1. Ms Wilson and Members gave an update on a recent meeting of the Lived Experience Engagement sub group.

8.2. The Group were supportive of a thoughtful approach to the creation of a Lived Experience Panel. The Group noted that it was important to take time to get this right. The sub group will be seeking guidance and protocols from a wide range of sources on how to best do this. They will keep the Group updated on how this progresses.

8.3. Following this discussion, Members agreed that it be useful to produce a list of the various sub-groups that are emerging from this work. Action 6.11

9. Meeting Close

9.1. The Chair thanked Members for their attendance and for a constructive and supportive conversation on the progress being made on each SPAP Action by each set of sponsors. It was clear that the momentum that had been established by the Group had carried over from December’s production of the NSPLG Delivery Plan.

9.2. The importance of working together outside of these meetings was noted, with the wealth of knowledge and contacts available being shared generously.

9.3. Frequency of NSPLG meetings had been discussed at several points during the meeting, and a consensus of moving to meetings at six week rather than monthly intervals to allow work to be progressed was achieved. A draft calendar will be created based on this and meeting dates circulated for Members’ diaries. Action 6.12

Summary of Actions from the NSPLG Meeting held on 20 February 2019:

6:1 – Secretariat to publish January minutes

6:2 – Secretariat to send the Group Members notes from the Chair’s meeting with the Choose Life Coordinators

6:3 – Secretariat to create and share a document overviewing what Scottish Government is currently doing in the social media space

6:4 – NSPLG to send any issues it thinks should be raised with the Youth Commission to Ms McDonald

6:5 – Chair to provide supporting letter for extension of the Youth Commission

6:6 – Secretariat to update Suicide Prevention Funding Paper

6:7 - The Secretariat to facilitate the creation of the sub-group for funding recommendations

6:8 -  Action 4 sponsors to add an explanatory paragraph to their research proposal outlining the preliminary nature of the research and that subsequent steps will work towards a pilot

6:9 – Ms Gordon and secretariat to forward list of questions relevant to the Communication and Engagement Plan through to Members before the next Group meeting

6:10 – A sub-group for the Communication and Engagement Plan to be established

6:11 – Secretariat to create list of sub-groups that have been created so far, and their membership

6:12 - Secretariat to create a draft calendar based on the Groups decision to move to six weekly meetings

Future NSPLG meeting dates:

20 March 2019  - Hampden Park – Glasgow

National Suicide Prevention Leadership Group minutes: February 2019

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