National Suicide Prevention Leadership Group minutes: October 2020

Attendees and apologies

Attendees

• Ms Rose Fitzpatrick (Chair)
• Ms Rachel Cackett
• Ms Fiona Drouet
• Dr David Hall
• Mr Nigel Henderson
• Dr Amy Knighton
• Ms Lara McDonald
• Dr Michael Smith
• Mr Alan Thornburrow

In Attendance

• Professor Steve Platt
• (Academic Advisory Group)
• Ms Ruth Moss
• (NSPLG Action 5 Delivery Lead)
• Mr Andy Grierson (Programme Manager)
• Mr Dan Curran (Scottish Government)
• Ms Innes Fyfe (Scottish Government)
• Ms Amy Kirkpatrick (Scottish Government)
• Mr Craig Wilson (Scottish Government)

Guest Speakers

• Ms Carolyn Lochhead
• (SAMH, NSPLG Action 7 Delivery Lead)
• Mr Craig Smith (SAMH)

Apologies

• Dr Alastair Cook
• Mr George Dodds
• Chief Superintendent Davie Duncan
• Mr Toni Giugliano
• Ms Jane O’Donnell
• Ms Angela Scott
• Mr Billy Watson
• Professor Rory O’Connor

Items and actions

1. Welcome

1.1 The Chair welcomed Members to the eighteenth meeting of the National Suicide Prevention Leadership Group (NSPLG) (the Group) and thanked everyone for attending via videoconference. Ms Fyfe was invited by the chair to address the group on structural changes being made in the Mental Health and Social Care Directorate of Scottish Government. Ms Fyfe said she would be moving on from her current role as Head of the Public Mental Health and Suicide Prevention Unit to become Head of Wellbeing and Prevention Unit.  Her new unit will be looking into the wider determinants of mental health and she said she would welcome an opportunity to come back to group to update members on this work.  She also added that the Suicide Prevention and Self-Harm Policy Team would come under a new unit — the Distress Intervention and Suicide Prevention Unit — to be headed by Mr Niall Kearney on an interim basis. Ms Fyfe agreed to share an organogram of the Mental Health Directorate’s new structure with the Group.  Action 18.1 The Chair welcomed Ms Kirkpatrick to the meeting. Ms Kirkpatrick had joined the policy team and would be supporting the work on Action 5 – Crisis Support and the new Suicide Prevention strategy. The Chair noted that since the last meeting the United to Prevent Suicide campaign was launched and the Group’s second Annual Report was published on 30 September. The Chair thanked everyone for their contributions to these pieces of work.

Apologies

1.  

1.2The Chair reported that Mr Warren Hawke would be standing in at the Scottish Professional Football League (SPFL) Trust during Ms Nicky Reid’s period of maternity leave, and would keep a watching brief for her on the NSPLG. Mr Hawke has been introduced to the Group via email but unfortunately had to send his apologies for this meeting. Other apologies were noted.

September 2020 Minutes

1.3 The Chair noted that the minutes from the Group’s meeting in September had been circulated for comment and requested that any further comments be collated by

2. Covid-19 Statement Update

2.1. Mr Curran gave an update on the recommendations made in the Group’s Covid-19 Statement. He reported that the Scottish Government's Mental Health Transition and Recovery Plan was published on 8 October 2020. The report set out a number of deliverables and a link to this and a summary document had been sent to the Group. He reported that work was ongoing around the establishment of Mental Health Assessment Centres throughout Scotland. These centres would provide the assessment of unscheduled mental health needs for anyone presenting in crisis or distress. Work was also underway for an enhanced model of the Distress Brief Intervention (DBI) programme.
2.2. Mr Curran noted that over 1700 people had signed up to the United to Prevent Suicide movement to date and the campaign advert had been running on television. In addition to this there were ongoing discussions with Network Rail around the use of mural spaces and an article by the Chair appeared in the Scotsman on 13 October 2020. The Group noted its thanks to the sponsors and delivery leads for their work on this action.
2.3. Mr Curran noted that an update on real time data would be presented at the Group’s meeting in December and Public Health Scotland were finalising an information sharing statement with Police Scotland. Ms Shirley Windsor, Public Health Scotland, was meeting with stakeholders including Mental Welfare Commission, Network Rail, Scottish Prison Service, the Distress Brief Intervention (DBI) programme, Childline and the Royal National Lifeboat Institution (RNLI) to discuss the use of real time suicide data. An update on progress would be reported at the December meeting. 
2.4. Mr Curran reported that there was little evidence around access to hanging as a means of suicide and the Academic Advisory Group (AAG) were looking at developing a Delphi consensus statement using data gathered from suicide prevention experts around the world. It was noted that this had the potential to be a world leading piece of work.

3.  Action 5 Crisis Support Workshop

3.1. Ms Cackett outlined the work that has been ongoing around Action 5 of the Suicide Prevention Action Plan. Action 5 set out to use evidence on the effectiveness of differing models of crisis support to make recommendations to service providers and share best practice. Ms Cackett reported that the sponsors and delivery leads were working to present these recommendations to the Group at the next meeting in December. Action 18.3 She noted that there was a lack of evidence on service models but a focus on sharing best practice amongst those who were providing crisis support for people considering taking their own life was important. 
3.2. Ms Cackett reported that engagement had taken place with the NSPLG Lived Experience Panel; a review of a survey on crisis support had been undertaken by the Academic Advisory Group (AAG) and a second piece of analysis was due by the end of October. The Members then took part in a workshop to discuss the emerging themes and help shape the recommendations to take forward this action. Following the workshop  sponsors thanked the Members for taking part in the vibrant conversations and invited them to send any comments on the Action 5 paper to Ms Kirkpatrick. Action 18.4
3.3. Mr Henderson highlighted that Ms Moss’ secondment from NHS was coming to an end and thanked her for her important contributions to the work around the Suicide Prevention Action Plan as a Delivery Lead for Actions 4 and 5.  The Chair noted that Ms Moss had been a founder member of the Group before moving to take up her role as Delivery Lead, and that her generosity in sharing her own and her daughter Sophie‘s experiences with the Group had been hugely influential on its work.  The Group wished Ms Moss every success and happiness for the future.

4. Action 7 Update

4.1. Dr Smith, Ms Lochhead and Mr Smith gave an update on the progress of Action 7 of the Suicide Prevention Action Plan which set out to identify and facilitate preventative actions targeted at risk groups. It was reported that fieldwork had been undertaken over the summer which involved a rapid synthesis of scientific evidence by the Academic Advisory Group (AAG) and a range of engagement events. These events included focus groups and interviews with people who had experience of suicide. The sessions explored people’s experience of suicide; helpful and unhelpful practice and interventions during periods of suicidality; and suggestions for positive change. The team had analysed the findings of both the AAG report and the engagement events and reported on the common themes that emerged. It was noted that, in line with the Integrated Motivational-Volitional (IMV) Model, all groups who took part described experiencing defeat and entrapment as motivators for suicidal ideation and behaviour. 
4.2. Other themes included the long term impact of trauma and abuse; stigma both against and within minority groups; and the experience of not being taken seriously by emergency staff and first responders. Peer support was viewed positively and support for families and the role of lived experience across suicide prevention activities were seen as essential. It was highlighted that there was some recognition of the importance of limiting access to means of suicide among specific groups. It was noted that the literature suggested that face to face therapies, peer support and approaches focused on problem-solving were effective in preventing suicide and self-harm among at risk groups.
4.3. It was highlighted that while the engagement events had interacted with the majority of groups identified as ‘at risk’ in the Suicide Prevention Action Plan, there were a number of communities (including some not mentioned in the SPAP) who had not been reached or with whom the team achieved only limited engagement. These included migrant communities; gypsy/traveler communities; wider black and minority ethnic (BAME) communities; people who had experienced homelessness; people with experience of self-harm; and veterans. In addition, it was highlighted that none of the participants had had experience of the Distress Brief Intervention (DBI) programme. It was noted that this might have been because their experiences of suicidal ideation and/or crisis predated this service or that the service was not available in their area.
4.4. The Chair thanked the sponsors and delivery leads for providing a thought-provoking paper and presentation which reached across all the work the Group are doing.  The Group was pleased to see practical themes emerging from the IMV theory. There was discussion around the themes highlighted in the presentation, including how the blurred line between stigma and discrimination could be addressed. 
4.5. The Group then discussed the four recommendations that were made. The Group supported the recommendation to approve a second period of fieldwork which would focus on the experiences of people from BAME backgrounds, with support from appropriate partners. It was noted that the existing funding supported the work with the BAME group but more funding would be required if additional groups were to be included. 
4.6. The Group supported the recommendation to commission the AAG to undertake a rapid literature review of evidence around BAME communities and suicide, including effective prevention activities. Prof. Platt advised that the literature on this was thin and would come from worldwide sources. 
4.7. Before approving the third recommendation – for additional funding – it was agreed that the sponsors would firm up their proposals based on the current discussion requirements. The fourth recommendation, to consider how findings from the Action 7 fieldwork could form the basis of further academic research for publication, prompted a discussion around how the data from this exercise, together with the learning and other work undertaken by the Group could best be used and made more widely available for the long term, and it was agreed the AAG would discuss this at a later date.

5. NSPLG Meetings - 2021

5.1. Dates for the Group’s meetings in 2021 were circulated prior to the meeting and agreed. Four meetings were planned in the run up to the end of the programme in August 2021. The meetings would continue to take place virtually until such a time as the Covid-19 restrictions were lifted. The secretariat  would issue diary requests. Action 18.5

6. Member and Policy Updates

6.1. The Chair reported that she would be meeting with the Minister for Mental Health at the end of October and intended to give an update on progress of the programme. She noted that she would discuss the development of the next suicide prevention strategy and highlight the importance of starting with an engagement plan. She would also discuss with the Minister the mechanisms that needed to be in place to support the next strategy and, highlighting the strong network between Members, what role, if any, the Group may play in that. She proposed and it was agreed to use the Group’s February 2021 meeting as a development session to explore these issues.
6.2. The Group congratulated Ms Drouet on being awarded an MBE for her work with EmilyTest, the charity she set up in memory of her daughter Emily, to prevent gender-based violence and improve support for individuals among student populations.

7. Close and Date of Next Meeting

7.1. The Chair thanked Members for their contributions and proposed the following agenda items for the next meeting: Action 5 recommendations for discussion/agreement; an Action 6 workshop; an update on the Suicide Prevention Action Plan audit; and the latest report on real time data. The next meeting would take place by videoconference at 10:30am on Wednesday 2 December 2020.