Self harm strategy and action plan 2023 to 2027

Our Approach to Delivering this Action Plan

Guiding Principles

We have been guided by the principles on page 8 while developing this strategy, and we will continue to ensure they are embedded in our ways of working as we work to implement the action plan. Taking these principles into account, this section outlines how we will approach delivery, evaluation and governance of the plan.

Supporting Delivery

Recognising the significant value that lived and living experience of self-harm, and insights from a range of services bring to our work, this will remain at the heart of our work and will guide delivery of the plan.

We also know that to achieve our self- harm strategy vision, we will need to realise connections between the self- harm action plan and a wide range of other national and local policy priorities, such as the Mental Health and Wellbeing Strategy and Delivery Plan, Suicide Prevention Strategy, The National Trauma Transformation Programme, GIRFE, GIRFEC, and The Promise, adopting an approach that recognises the flexibility required to meet local need. This will require active and ongoing engagement and collaboration with policy makers and delivery partners.

We will take an approach to delivery which will have two key functions:

• Drive delivery of the national action plan with clear accountability for each of the actions.
• Support local partners to progress actions on self-harm, including in the context of existing priorities.

To support these two functions there will be continuous feedback and learning between national and local partners. By using evidence and insights from practitioners working across a range of settings, we will ensure that all relevant programmes of work continue to be impactful in achieving change.

Our approach to delivery will also:

• ensure continued focus on reaching and supporting higher risk and marginalised groups
• act as a self-harm community for Scotland by creating a space for collaboration and shared learning
• bring together our growing data and evidence, alongside qualitative research, to deepen our understanding about self-harm and use that to improve responses for people who have self-harmed and those at risk of doing so.
• provide visible leadership on self- harm, which we recognise is also needed to achieve positive change in our communities (of place and interest) right across Scotland.

Our approach to delivery will include the following elements:

• We will ensure that key public sector partners, including NHS Boards (territorial and special boards), education and criminal justice partners, are supported to deliver actions - so that they make a measurable difference on the ground. This will be in line with their organisational remits.
• We recognise third sector partners have been progressive and compassionate in their approach to supporting people who self-harm in Scotland for many years, and with Scottish Government funding, have delivered a new level of bespoke support over the last few years. The sector has also played an instrumental role in shaping this strategy; and we look forward to continued working with the sector as we implement this action plan.
• We will also continue to work closely with data and evidence experts such as, leading academics, analysts and researchers to underpin our work and lead on the delivery of the data and evidence actions.

By Spring 2024 we will have co-designed a partnership-based approach for this action plan, which will specifically include consideration of how to build-in regular advice and guidance from people with lived experience.

Governance

Governance of the strategy will be provided by the new Mental Health and Wellbeing Leadership Board which will be put in place to oversee the implementation of the wider Mental Health and Wellbeing Strategy. This will ensure policy alignment and maximise learning between the Self-Harm Action Plan and the overarching Mental Health and Wellbeing Delivery Plan, as well as the, connected, suicide prevention action plan (Creating Hope Together).

Membership of the Leadership Board will include representation from a range of Scottish Government portfolio areas, Local Government, NHS Boards, Integrated Joint Boards (IJBs) and the Third Sector. The Board will have direct access to advice from key groups, including the Equality and Human Rights Forum and the Diverse Experiences Advisory Panel. This Board will:

• provide national leadership and strategic oversight of priorities
• ensure activity delivers clear benefits, aligned with this strategy’s vision, outcomes and principles
• provide constructive support and challenge to ensure progress against actions set out in this action plan.
• play a key role in evaluating the impact of interventions and sharing learning.

Evaluation and Monitoring

Evaluation and monitoring will be embedded in our delivery, allowing us to assess the progress and effectiveness of our actions. Our approach will align with the Verity House Agreement and wider work on data and monitoring, for example through the wider Mental Health and Wellbeing Strategy and the Health and Social Care Data Strategy.

We will seek to ensure our monitoring and evaluation approach is fit for purpose, transparent and proportionate. We have included an illustrative set of draft outcomes which we expect our actions to achieve, and will work with partners to refine these and consider options for measurement by Spring 2024. We then intend to use the agreed outcomes to understand the difference and impacts our actions are making to achieving the strategy’s vision.

We recognise there will be ongoing data challenges which will affect the monitoring of this action plan. These include:

• The limitations of existing data means a baseline assessment will be challenging to establish for mainstream support, and in turn it will be difficult to measure the specific contribution this strategy is making at a population level.
• This strategy has a clear aim to improve support for people who self-harm and to tackle stigma and discrimination, which we hope will lead to an increase in help seeking. However, the way data is currently collected will mean it is challenging to differentiate increases in the level of help seeking from trends on prevalence of self-harm; in fact an increase in help seeking is likely to show up as an increase in prevalence.

We recognise these challenges and in the initial stages of our work, we will seek to better understand and develop available data sources so that the prevalence and trends in self-harm can be better understood. We will also seek creative ways to evaluate our actions to overcome these challenges.

Reviewing this plan

This action plan will be reviewed at 18 months, drawing on early learning, monitoring and evaluation data, as well as qualitative feedback and delivery insights. We will consider the need for any redirection or reprioritisation as part of that exercise. The impact and learning from the delivery of this action plan will be used to inform future policy development.

Resources

We recognise that adequate funding will be required to support effective delivery. The Scottish Government will continue to invest in the provision of self-harm support and learning, which has been in place over the last two years and has informed the development of this strategy. This provision includes nationally available online support and peer support for individuals affected by self-harm, and learning for professionals and families. We will continue to review the effectiveness of this provision to ensure it meets the needs of people affected by self-harm.

This strategy also sets out the significant contribution that existing services, such as education and criminal justice, already play in supporting people who self-harm, and how this action plan will complement and strengthen this. To help achieve this ongoing improvement, we will play an enabling role by developing tangible resources and creating a platform for shared learning and expertise.

We recognise that the publication of this strategy coincides with significant financial challenges across the system which are likely to continue over the next few years and that, by nature, this first strategy is exploratory in nature. Where additional funding is needed to support delivery we will work across local and national government, and with relevant partners, to determine costings and funding options. This will be grounded in evidence and learning obtained through the delivery of this action plan.