Suicide prevention strategy development: early engagement - summary report

Themes Six and Seven - Raising Awareness and Capacity Building

Responses to this section of the survey were similar to those in the previous section which covered the theme “tackling stigma”. Several respondents referred to answers they had already provided and hence the focus will be on information that has not already been covered, nevertheless, there still remains some overlap in themes between the sections.

Offer training/learning opportunities (with a link to an awareness raising campaign)

By far the theme most often referenced in this section was to offer training and develop a national resource set to be used for building capacity. Some workshop attendees proposed that training should be mandatory across all public sector employees. As noted above in the stigma section, there was a suggestion to initially target this training to specific groups such as NHS staff, social workers, and health visitors as promoted through Ask Tell Respond resources.

In addition, it was noted that training and capacity building could also stress the importance for individuals to take care of their own mental health, with strategies for self-care. Similarly, others noted that long training sessions that last multiple days are less appealing to many who may otherwise have taken part and suggested that short day courses or even courses lasting a few hours would be more accessible.

The offer of training should also be linked to a wider awareness raising campaign, which would point to the availability of these resources, as well as potentially offering advice for the less formal aspects of training such as questions to ask.

“Stay clear of interventions that require in-depth knowledge and training. Teach peers how to ask relevant questions and how to talk with someone in emotional distress. Leave the psychology to the professionals. Be confident that resources are actually available and current.”

“People need to be aware that just being there is hugely supportive - and not to be afraid of saying or doing the wrong thing. What is far more important in families and communities is not skills but relationships and caring.”

General Promotion Campaign

As mentioned in the “Tackling Stigma” section, and above, a large proportion of survey respondents suggested that a major advertising campaign to raise awareness and to promote training opportunities was required. This theme was also picked up in the workshops.

There were several suggestions as to how best to do this including through television, social media campaigns, art, posters, football and other sports clubs, and radio adverts. There appeared to be some desire to share this outwith digital platforms, such as social media, which it was recognised may not be accessible to all. Several responses suggested having celebrities sharing their stories and sharing details of the campaign on their social media accounts and through traditional media outlets would be particularly effective.

Some of the key messages to be promoted were that suicide prevention and mental health are everyone’s business, encouraging conversations, how to ask questions and what questions to ask, as well as a more general message around mental health, such as “It's OK to not be OK.” However, others pointed to the requirement for a campaign to promote positive action and interventions as awareness itself is not adequate to address the problem.

As with many themes, survey and workshop participants were very keen for those with lived experience, including families of those who have died or survivors, to be involved in the development of the campaign.

“Only people going through crisis can explain what it's really like and what they really need.”

Lastly, it was suggested that an evaluation exercise could take place to find out “what works” from current and historic promotional campaigns to raise awareness.

Schools, Colleges, Universities

As mentioned previously, schools and further and higher education settings were highlighted as key locations to raise awareness and to equip children and young people with the confidence and skills to have conversations around mental health and suicide prevention. Several respondents suggested that younger children should be educated in what mental health is and how to discuss it. Targeting messages to younger people was seen as a good way to practice early intervention and build support networks amongst peers. It was noted that while support was available for over 16s, that there was insufficient guidance for those under 16. Good work done by guidance teachers was mentioned, but it was suggested that more could be done and that teachers delivering Personal and Social Education and guidance teachers should be given further training in suicide prevention. As mentioned, it was also suggested that mental health and suicide prevention should be part of training for all teachers.

“Schools and guidance teams do what they can in PSE lessons and in general incidents and issues. Please remember that Guidance teachers are not trained counsellors or medical practitioners. They are trained History teachers or Maths teachers.”

“Schools need more external support / Family Support workers etc. to support the complexities of the students’ welfare concerns. Simply training up Guidance teachers seems the logical answer and most cost-effective one.”

For young people at university and college it was highlighted that they often face challenging situations, perhaps living by themselves for the first time. Many young people are without suitable support networks or knowledge of how and where to seek support.

“School, colleges and universities should be more involved in tackling the crisis. I am aware that most offer support, but from people's experiences it seems to not be functional. I think this currently happens because of how impersonal the message comes across and because of the fact, after all, that universities are organisations that need to preserve a certain image. However, especially young, isolated people (maybe that recently moved to a new city for uni or that just started high school) are at risk of falling in a cycle of dark thoughts.”

Scotland’s Mental Health First Aid Programme

A specific form of training and support that was raised by many respondents was Scotland’s Mental Health First Aid and access to trained Mental Health First Aiders. This was in recognition of the important link between mental health and suicide.

“Focus on suicide prevention should not be on just suicide, but on mental health more generally. Focus on suicides is not necessarily the best way to stop suicides.”

It was suggested that mental health should be put on a par with physical health and legislation ought to be introduced to give effect to make training mandatory, or at least mandatory within the public sector in Scotland.

“You could make it compulsory for every workplace to have a mental health first aider the same way as every workplace requires a physical first aider.”

“The ACSAT system in NHS Lothian works well, with an on call mental health team able to deploy at request of police or ambulance service.”

Target Workplaces – private sector buy-in

Survey respondents and workshop attendees were keen to highlight that suicide prevention was a public health issue and should be addressed with interventions across society. This included a desire to see the Scottish Government and wider public sector engage with the private sector in recognition that “suicide prevention is everyone’s business.”

Workplaces were seen as key places to share messages and build capacity. It was noted that many people may feel uncomfortable in discussing these issues with their colleagues and that workplaces can be a source of negative stigma. Having at least one person in each workplace who is trained and can act as a champion for suicide prevention and postvention would help to address these issues.

“Leadership being taken by orgs regardless of their ostensible relevance, if suicide is everyone’s business”

“Workplace mental health training was felt to be critical. Without this, stigma and perceptions around mental health and wellbeing would continue to negatively impact people in the workplace, making it less likely they will be properly supported. Considerations around this can and should include specific duties around suicide and mental health awareness for our public sector, recognising its role as a ‘gold standard’ employer.”

World Suicide Prevention Day & Mental Health Awareness Week

Survey respondents noted that World Suicide Prevention Day is on the 10^thth of September annually and local initiatives around this, as well as Mental Health Awareness Week in May, were very effective in generating conversations and raising awareness. Many noted that it was frustrating that this was confined to a single day or week and suggested that the success of the day could be useful for further campaigns. One respondent pointed to National Suicide Prevention Week (4 – 10^th September) in the United States as a successful example of building on World Suicide Prevention Day.

“More awareness during year rather than focus on the national week.”

“Making mental health a topic for everyday and not one day/week a year”

Involve Community Groups/Communities

Many were keen for communities to be involved in awareness raising and capacity building work. Communities can play a key role in offering personal support and safe spaces for discussing and listening to issues, as well as signposting crisis and other support services. Community-led sessions displaying empathy and active listening were generally seen as far more effective than health-led medicalisation or assessment. It was also recognised that training could be delivered by community groups to help further develop awareness and capacity within members of those communities. To enable this, however, it was recognised that greater engagement with communities and community groups would be required and affordable or free training made available to them. In addition, they would require additional capacity, such as spaces to act as hubs or drop-ins. Provision of safe spaces in the community where support ranging from someone to talk to through to crisis support and support for bereaved families was a popular theme.

“Non-medical crisis recovery centres are needed. Resources around towns that are not necessarily medical or mental health focused but can provide small measures of comfort for people approaching crisis or just having difficulty.”

“Groups in the community instead of only doctor/hospitals etc. I need to travel 30 miles to get to my local hospital and 10 miles for a doctor. This excludes certain groups that may have difficulty travelling or may put others off getting support as not easily accessible. More remote counselling sessions, more group sessions in local communities i.e. village halls etc”

“For communities perhaps an easy to access website with information on what to do when helping someone with suicidal thoughts.”

Building on and resourcing existing work: Local networks and partnership working, charities

Survey respondents and workshop participants were keen to build on existing good work to raise awareness and develop capacity. Survey responses from organisations in particular referenced good work done by local networks and partnerships. More broadly, there was a desire to build on any ongoing work, and to develop interventions based on “what works”.

Proper resourcing for dedicated local suicide prevention capacity was also promoted. Respondents suggested that every local authority area could have a dedicated ‘champion’ who would promote the cause of suicide prevention, encourage partnership working across key agencies, highlight and deliver training activities, and share and learn from best practice nationally. It was also noted that sometimes service accessibility varies, with rural areas less likely to have the same range of available services, and that these local champions would help to ensure equity between areas.

“The new strategy needs to provide ring fenced funding for local areas and ensure that there is……(a) dedicated suicide prevention lead in every local authority area in the country. These people should have a dotted line into a national organisation to ensure that best practise and learning is being shared equally across the country and implemented across the country.”

“Feedback suggests that there is a need for increased and easier signposting of support within local communities and in particular equity of access within remote and rural localities. This is supported from feedback that states that National organisations supporting work (raising awareness/groups) in less populated areas needs to develop working with local organisations to support the agenda.”

There was praise for the existing work of many third sector bodies and a recommendation that they be properly resourced. Many respondents noted that rather than simply consider the total resource invested in this area a key success criteria would be how quickly resources could be accessed. It was suggested that the process to access small amounts of funding was too bureaucratic. Support and funding should be provided to allow good work to be scaled up. It was also felt that access to long-term funding was essential, particularly for smaller charities, which would provide security that could, for example address staff shortages.