Suicide prevention strategy development: early engagement - summary report

Theme Four- Postvention

From the outset respondents highlighted that there was limited awareness and understanding of the term postvention. As with other themes, issues relating to the use of appropriate language and the need for widespread training were identified. Many comments focused on the need to take earlier action to reduce the number of individuals reaching this stage and indeed one respondent suggested, “postvention is suicide prevention for the next generation.”

There were widespread concerns about the lack of support available. Some respondents suggested that the support they have been led to believe would be on offer had failed to materialise. As a result, it was proposed that services should be held accountable for delivering support that it is claimed is being provided.

“Audits should be taken to ensure services are being delivered”

Support

In their responses participants differentiated between the people who needed support and the organisations and staff that should provide it.

It was stressed by many participants that support was required for anyone who had been affected and that this should be provided on an ongoing basis. There should be a recognition that the stage at which this support was required would vary from individual to individual. Some might need support in the immediate aftermath whilst others would prefer to wait a few weeks or months.

“Tailored support for all is needed from first responder to family members”

“Multicultural society needs multicultural solutions; is enough being done to reach groups who speak different languages?”

“Need to understand the pathway of an individual – a long bumpy road with multiple touchpoints – so we can provide something of value so that suicide is not the only answer.”

“Need to ensure the wider circle of people affected by suicide can access support. Friends don’t feel as ‘entitled’ as family members do.”

In terms of who should provide support, and how it could be provided, there was a degree of uncertainty and a variety of responses were received. Some participants suggested that specialist staff could fulfil this role and others noted that whilst there were lots of online support groups not all of them were free.

“Dedicated liaison officer (suicide bereavement) to help families/relatives is needed – should be flexible so they can look for support when ready.”

“Clinicians fear they will be blamed if they engage with families post suicide.”

Although there was universal agreement that bereavement by suicide support is needed, a model that could be tailored to meet individual needs has not yet been identified.

“No model yet which fills all the gaps after a death by suicide, even the pilots won’t fill all of these – what are the referral routes, support for those beyond the wider family, who speaks to the family so we can get the right support to them at the right time.”

A continuing theme was the lack of parity in how to access and receive support services. This was also reflected in the wide variations in post suicide debriefs which were described as part of responses, however, it is unclear where or who this relates to.

Concerns were expressed about the consequences of digital exclusion experienced by some individuals.

As has been indicated in other themes, options for support varied depending on where individuals lived.

“Huge geographical variations, a lottery for people who need support, need more equality across the country.”

Information and Access

As with other themes it was suggested that Information and visual aids should be available in a wide range of settings and in a form that meets the needs of all. It was noted that mental health and national telephone hubs could be provided.

“Age-appropriate materials to help children understand – everyone in a small community tends to know about a suicide – can miss the impact on children.”

Wider Assistance

It was proposed that a wide range of support activities should be considered. This might happen in different ways. It could involve identifying other groups/ individuals who would need support. Another option might be follow up activities targeted at individuals who had experienced suicide indirectly and hence as a consequence might themselves experience suicidal ideation. It was acknowledged that initiatives that address the wider impacts of suicide can be resource intensive and there was interest in exploring how this approach could be replicated in communities.

Several participants suggested that work continue to develop the suicide bereavement pilot activities to make sure people get help when they need it.

“Bereavement support pilot for families – learning needs to be part of the new strategy and needs to be built on into a national plan.”

“Postvention work is also required in workplaces, prisons, armed forces all ‘communities’ where there has been an impact by suicide.”

“Follow people up for two weeks post suicide attempt”

Improving the Evidence Base

Several respondents stressed that there was limited information on which to base effective decision making and this should be addressed both in terms of data collection and sharing examples of effective practice. As has previously been noted these suggestions came almost exclusively from respondents representing organisations.

“Mapping of incidents which helps us understand who has been impacted by the suicide – vicarious trauma.”

“Need to learn from the activities undertaken during covid which support connection and not lose sight of this and build on.”

“Don’t have access to the data needed to help shape services and responses.”

“Need a consistent response – a protocol for people in suicide prevention roles to follow when a suicide happens rather than an ad hoc approach,”

“Guidance around managing suicide clusters is needed from a national level”.