Mental health and wellbeing in primary care services: resources

7. Suicide Prevention and Self-harm

7.1 Surviving Suicidal Thoughts

NHS Inform’s Surviving Suicidal Thoughts web-pages provide up to date information and links to resources and support for people experiencing suicidal thoughts, as well as those around them. This includes links to:

• ways to seek urgent help
• national helplines and sources of confidential support for adults, children and families
• sources of support for specific communities (e.g. Switchboard LGBT+)
• a range of practical resources
• video stories from people who have been there and come out the other side of suicidal thoughts and behaviours.

7.2 Samaritans

Samaritans provide free, confidential, non-judgemental support for anyone affected by distress or crisis. Samaritan’s trained volunteers can be contacted day or night, 365 days a year. They can be called for free on 116 123 and the number won’t show up on a phone bill. They can also emailed at jo@samaritans.org. Their website provides more information and a range of information on support groups and practical resources.

7.3 Cruse Bereavement Scotland

Cruse Bereavement Scotland provide support for bereaved adults, children and families across Scotland, including those bereaved by suicide. They run a free helpline Monday to Friday, 9am–8pm and weekends 10am–2pm on 0808 802 6161. Their Grief Chat service is also available for anyone over the age of 18, Monday to Friday 9am to 9pm. The Cruse Scotland website provides information, self-care advice and practical resources for adults, children and families, young people, employers and schools.

7.4 Papyrus UK

Papyrus provide support for young people (under the age of 35) experiencing thoughts of suicide, and anyone concerned about a young person who might be feeling suicidal. A Papyrus advisor can be contacted by phone 24/7 on 0800 068 4141, by text on 88247 and by email at pat@papyrus-uk.org. Practical help and advice resources, including BSL support, are available through the Papyrus website.

7.5 Self-Harm Network Scotland

Self-Harm Network Scotland (SHNS) provides reliable and accessible information, advice and resources via their website for anyone who is affected by self-harm. They also provide support through their webchat, which is open 7 days a week from 6pm to 10pm. The webchat is a confidential service, staffed by peer practitioners and trained volunteers who can offer immediate support, to anyone aged 12 and over across Scotland.

The website also allows people aged 12 and over to self-refer for free one-to-one online support sessions with a peer practitioner. SHNS have also developed specific Loved Ones Group Sessions for those who care for someone who self-harms to get advice, information and a safe space to get support for their experiences.

Most recently SHNS have been working in collaboration with the British Deaf Association (BDA) which has resulted in the development of a BSL Hub for the Deaf Community, with video translations of the main website content.

7.6 Distress Brief Intervention (DBI) programme

Distress Brief Intervention (DBI) is a non-clinical intervention, which can provide support to people who present to some frontline services in distress:

• aged 16 years and over
• in distress/emotional pain
• who do not need urgent medical or clinical treatment and are assessed as appropriate for referral to DBI.

DBI consists of two interrelated parts. Level 1 allows trained front-line staff, from A&E, NHS 24, Police Scotland, Scottish Ambulance Service, Primary care and some unscheduled care services to offer a referral to DBI level 2 – where the Level 1 staff are trained in DBI and the person is assessed as appropriate for DBI support. Level 2 is provided by trained third sector staff who will contact the person, within 24 hrs of referral, and provide problem solving, wellness and distress management planning for a period of up to around 14 days; and signposting to local supports, where required.

The NHS 24 Mental Health Hub have a direct national referral pathway to DBI; this pathway complements the regional expansion of DBI at a local level. NHS 24 Mental Health Hub staff may offer this pathway for those who contact them in distress (again where assessed as appropriate for DBI). (NHS 24 will continue to use the current clinical pathways for those who require a clinical response). This enables more people across Scotland to benefit from the connected compassionate support DBI has created.

In addition call handling centres operated by Police Scotland and the Scottish Ambulance Service (SAS) can refer people for DBI support, again where the caller is assessed as appropriate for referral. This has the additional benefit of freeing up Police and SAS staff on the ground for other tasks.

If primary care staff wish to link with the DBI leads in their local area, they should in the first instance enquire with the DBI Central team dbicentral@lanarkshire.scot.nhs.uk, who will be able to signpost to the relevant local DBI lead.