Suicide prevention strategy development: early engagement - summary report

Overarching Considerations - common to multiple themes

“Need to move away from silos and see all topic areas as part of a journey and crisis support should be embedded throughout so we address the underlying issues leading to suicidal ideation.”

Training and Capacity Building

Training and ongoing learning was consistently identified as key across all themes and it was emphasised that this should not only be aimed at professionals but should be widely available to all. It was stated that building capacity, particularly in communities, would help individuals to recognise the early warning signs of suicidal ideation and at the same time reduce stigma. Others suggested a more targeted approach should be adopted; this could include frontline service providers such as GPs and GP receptionists, other NHS staff, and teachers. These individuals would then be capable of identifying issues and would know how to respond appropriately and could act as champions by developing the knowledge, understanding and skills of others. This was considered particularly relevant for teachers and those working in educational settings.

Communities should be actively involved in planning and delivering training/learning opportunities and the possibility of identifying and upskilling community champions considered. In Borders there have been facilitated sessions for community groups such as rugby clubs to raise awareness. Clarity on what signs to look for and how to intervene should be the goal of such training.

Some survey respondents mentioned that training should be made available in all workplaces to tackle ignorance and preconceived notions around suicide. Others felt that every workplace should have a trained Mental Health First Aider, similar to existing legislation that requires physical first aid provision to be made available in all workplaces.

There were also many positive reviews of the Distress Brief Intervention (DBI) programme, delivery of Applied Suicide Intervention Skills Training (ASIST) and the more recent Ask Tell Respond learning resources on mental health, self-harm and suicide prevention. Requests were made that there be more funding and provision of this training as it was suggested it is effective, and already has a degree of familiarity. However, offering a range of options including shorter courses should be provided. It was strongly opined that any learning programme needed to focus on what is known to be effective.

Skills building was a stronger theme among organisations than individuals; while both emphasised the importance of active listening, organisational representatives attached greater weight to trauma-informed approaches and training for primary care, social care and education staff.

Campaigns

To help prevent suicide and get rid of any stigma and shame it was stated that campaigns premised on the principle that ‘suicide is everyone’s business’ should be run. These should be delivered both nationally and locally, be linked to training and built on evidence of what works. Suggestions as to the form of campaigns included celebrity endorsements, sharing lived experience and adopting a multi-agency approach similar to the approach adopted successfully in tackling knife crime.

Language

Language was identified as a potential barrier on multiple fronts - in reducing stigma, encouraging people to seek help and in service delivery. It was agreed more guidance around language was required, especially for the media. In particular, people need to be informed about the right language to describe suicide, moving away from using the phrase “commit suicide”, which could imply illegality and instead using “died by suicide” or “took their own life”.

Communities

Many respondents stated that community involvement was critical at all stages from reducing stigma and increasing awareness of suicide to providing locally based support. It was suggested that communities could be involved in many ways. For example, training and upskilling could be provided for ‘community champions’ and relevant strategies and policies could be included in Local Outcome Improvement Plans.

Lived Experience

A recurrent theme was that it was crucial to involve and listen to those individuals who have lived experience of suicide. This should include those who had experienced suicidal thoughts, or attempted to take their own life or supported someone who had been bereaved by suicide.

Focus on Schools

There was a widespread recognition of the importance of schools across all themes. It was suggested that instilling in young people an understanding that life involved both pleasure and pain and that support could, and should, be sought when challenges occurred was essential. Support should be provided by adopting a ‘whole school’ approach which could include an enhanced role for the school nurse, compulsory teacher training in suicide prevention, the creation of youth champions and greater availability in counselling services at all stages. Suggestions for awareness raising activities included advertising within schools and participation in school events by representatives from local or national mental health organisations

Strategic Support

It was stated that adequate funding and resources needed to be made available to ensure that a range of support services were provided across Scotland on a consistent basis, but which could be tailored to meet local needs. This was particularly important when awareness raising campaigns that are likely to result in additional demand are planned. In addition, the provision of potential frameworks or guidance to plan and support service delivery would be helpful. Improved communication and connection between national and local levels it was noted would increase the impact of activities. It was posited that a regular newsletter might help with this.