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

Part 5: Links with Suicide Prevention and Mental Health and Wellbeing Strategies

Our work to support people who self-harm sits within the broader Mental Health and Wellbeing context, where we seek to take action to prevent the escalation of poor mental health. Evidence suggests that the underlying drivers of poorer mental health and wellbeing often overlap with increasing risk of self-harm. We know that to achieve our self-harm vision, we need to realise connections between the self-harm action plan and the Mental Health and Wellbeing Delivery Plan. This will require ongoing engagement and collaboration with policy makers and delivery partners.

Furthermore, as we discuss in the Self-Harm Strategy, we know that many people who self-harm do so without any suicidal intent. However, for others it is not always clear where the line between a suicide attempt and an act of self-harm is. Evidence suggests that 63% of people who complete suicide will have a history of self-harm^[2]. In fact, self-harm is the biggest risk factor for suicide.

Therefore, we are confident that our work to support people who self-harm can also contribute towards reducing suicide. It is worth highlighting that there are elements of our respective self-harm and suicide prevention action plans where we will take forward the actions through one programme of work; for example, our work to embed the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) recommendations and guidelines.

The alignment between the three strategies supports a joined up approach to monitoring and evaluation. Where possible, we will seek to ensure that our monitoring and evaluation achieves the following:

• A reduction in duplication of reporting in areas where there is overlap. This is particularly important where actions across the strategies are taken forward together, such as the work in clinical settings to improve support for people who have self-harmed and for people who are experiencing suicidal crisis.
• Putting into practice a cohesive approach which increases consistency and high levels of governance.
• Acknowledgment of the contribution of self-harm work to Creating Hope Together outcomes whilst retaining independent evaluation of the Self-Harm Action Plan.

It is important to recognise the interlinked nature of self-harm and suicide prevention. The Self-Harm Outcomes Framework works to support the long-term outcomes and overarching vision of Creating Hope Together, which are outlined below:

Long-term outcome 1: The environment we live in promotes conditions which protect against suicide risk. This includes our psychological, social, cultural, economic and physical environment.

Long-term outcome 2: Our communities have a clear understanding of suicide, risk factors and its prevention, so that people and organisations are more able to respond in helpful and informed ways when they, or others, need support.

Long-term outcome 3: Everyone affected by suicide is able to access high quality, compassionate, appropriate and timely support - which promotes wellbeing and recovery. This applies to all children, young people and adults who experience suicidal thoughts and behaviour, anyone who cares for them, and anyone affected by suicide in other ways.

Long-term outcome 4: Our approach to suicide prevention is well planned and delivered, through close collaboration between national, local and sectoral partners. Our work is designed with lived experience insight, practice, data, research and intelligence. We improve our approach through regular monitoring, evaluation and review.

Our vision is to reduce the number of suicide deaths in Scotland, whilst tackling the inequalities which contribute to suicide.