Self-harm strategy and action plan 2023-2027: outcomes framework

Part 3: Measuring and reporting against the Outcomes Framework

How we will measure change

To assess progress towards our vision, we need to understand what and where we expect to see change to happen, and how that change can be measured. We will explore all opportunities to appropriately and proportionately measure the impact of our work on an ongoing basis, ensuring that we capture the difference we are making, and for whom. We will use a contribution analysis, which considers all the collective efforts that multiple delivery partners are making to achieve the outcomes and work towards the vision.

Our data collection approach

Some of the proposed measures set out in Annex A will be drawn from existing sources of data (e.g. Self-Harm Network Scotland evaluation data). Other measures will require consideration of new or adapted data sources where appropriate, such as using bespoke tools to capture qualitative measures.

We know that measurement for some of the outcomes will pose challenges. Research evidence, including insights from people with lived experience, confirms that often people who self-harm do not seek support from statutory services. We also know that there are differences in recording practices between clinicians and Health Boards. When a person attends a medical setting for treatment following self-harm, this can be recorded in multiple ways and on different systems. These factors mean that data on self-harm is currently incomplete and inconsistent. Addressing these data gaps and issues is a key priority in our self-harm action plan.

Achieving the strategy’s vision will also require targeted efforts to reach and support groups who may be at higher risk of self-harm. In line with this, we will measure change at both population wide and targeted group levels, with both the data available, and by seeking new sources of evidence, with a focus on higher risk groups, while fulfilling the expectations on data collection laid out in the Verity House Agreement.

Measurement challenges

Through our work to improve the data and evidence, as new evidence becomes available and as our measurement approach develops, it is possible that the recorded numbers of people who self-harm could increase. This may indicate changes in data collection rather than any changes in the incidence and prevalence of self-harm across the population.

It is also possible that as new supports, such as Self-Harm Network Scotland (SHNS), become more widely known, more people may come forward for support, which may indicate an increase in help-seeking rather than an increase in self-harm. It is important to recognise that many settings do not currently collect data on self-harm. This lack of baseline data will present challenges to our understanding of changes over time.

Another complex area of reporting involves measuring changes in stigma and discrimination. Available evidence suggests that many of the approaches in our action plan should reduce stigma and result in more compassionate and person-centred support and care being available. For example, we expect our work on deepening knowledge and understanding of self-harm, including the ways stigma and discrimination creates barriers to people accessing and receiving the support they need, will change attitudes and improve practice.

Whilst we will attempt to measure changes in the levels of stigma and discrimination, we recognise this may be challenging to capture and it is unlikely that we will be able to directly attribute our work to any reduction in stigma. However, by using a contribution analysis approach, we hope to show how our work delivers outcomes that can contribute to a reduction in stigma and discrimination.