Suicide prevention action plan: public engagement analysis

Executive Summary

Introduction

1. Between 8 March and 30 April 2018 the Scottish Government undertook a public written engagement exercise to gather views for consideration in preparing their new Suicide Prevention Action Plan. The engagement received a total of 290 responses, with the majority (n=196) submitted by individual members of the public and the remainder (n=94) submitted by organisations. This engagement was structured around four action points: the formation of a "Knowledge Into Action" group, the modernisation of training arrangements, the establishment of a Suicide Prevention Confederation and the development of an online suicide prevention presence in Scotland. This report gives an overview of the responses.

Main Findings

Action 1: The Formation of a "Knowledge Into Action" Group

2. A majority (93%) of respondents agreed that a "Knowledge Into Action" (KIA) group should be established. Respondents from all sectors commented that any KIA group must be informed by evidence. Most sectors agreed that the sharing of evidence and good practice was important, and that there needed to be more monitoring and evaluation of existing suicide data. There was agreement that the KIA should have a varied membership, to enable collaboration between different stakeholders, and should include the voices of those with lived experience. Respondents stressed that the KIA should be action focused, investigating factors that contribute to suicide and targeting groups that may be at risk.

3. Some respondents raised concerns over the proposed KIA group. They felt that more clarity was needed regarding its purpose and how it differs from the proposed confederation (see Action 3). There were questions about the group's hierarchy and governance, with some respondents commenting on the need for strong leadership. There were also concerns over whether KIA was an appropriate acronym. In addition, it was noted that the KIA proposals would require increased resources and funding.

4. A number of respondents commented that there was not enough data or evidence available to practitioners and some organisations called for greater sharing of information between partners. However, some individual and third sector respondents mentioned a potential over-reliance on data and not enough emphasis on the experience of those affected by suicide.

Action 2: Modernising the Content and Accessibility of Training

5. In total, 83% of respondents agreed that a new mental health and suicide prevention training programme should be developed. Respondents expressed a broadly positive view of existing training provision. However, they also suggested that a modernisation or refresh would be welcome, to update the presentation of training materials, tailor training to the Scottish context and to address the stigma of suicide. It was recognised that increased funding and resource would be required to modernise training. Some respondents highlighted that there needs to be wider access to mental health training and there should be parity with physical health. It was also suggested that youth should be prioritised, including training in schools.

6. A majority of respondents (90%) supported mandatory suicide prevention training for specific groups. There was a consensus that suicide training should be mandatory for healthcare workers and frontline service staff (e.g. emergency responders). Some felt that mandatory training should be implemented within schools and for care workers. Non-mandatory training was suggested for communities and the private sector, including for public facing services (e.g. bar staff, taxi drivers, hairdressers). There was a general sense that training should be tiered to an employee's need or context, and should be regularly updated (continuous/rolling).

7. Many respondents expressed concern regarding mandatory training for specific groups from a resource and capacity perspective. There were also concerns that existing training packages would be removed and about what would happen to trainers currently trained in these programmes.

8. There were a number of additional comments and suggestions on the content and/or accessibility of mental health and suicide prevention training. These included requests for multiple media formats (video, images, podcasts etc.), evidence-based training content, the retention of current training methods, training to increase the understanding of mental health medicines, for training to be delivered in schools and communities, and for barriers to access to be addressed. There were also calls for awareness raising to provide help and advice, to increase the understanding of suicide and to tackle stigma.

Action 3: The Establishment of a Suicide Prevention Confederation

9. A majority (78%) of respondents agreed that a Suicide Prevention Confederation should be established. They felt that the confederation should improve collaboration between stakeholders and that it should be at a national level. Some respondents called for greater leadership or for the confederation to report to Scottish Ministers to ensure impact and accountability. Others wanted a flatter hierarchy or requested a flexible leadership model for the confederation that included multiple partners. Some wished to maximise impact through community-focused activities and involvement of those with lived experience of suicide.

10. Some respondents had concerns regarding the establishment of a suicide prevention confederation. For example, some felt there was a lack of clarity and detail around the proposal, some questioned how it would practically reduce suicide or queried the level of investment required. It was also noted that a national group could overshadow local efforts and there was the potential for unnecessary duplication with others' work. Others disliked the name or wanted to retain the ChooseLife branding.

11. There was little consensus about where local leadership for suicide prevention should be located. The most popular answer was Health and Social Care Partnerships (37%), followed by "other arrangements" (17%), Community Planning Partnerships (15%) local authorities (13%) and the third sector (5%), (with the remainder saying they did not know or did not have an opinion). The most popular "other arrangement" suggested was a hybrid leadership between partners/agencies.

Action 4 The Development of an Online Suicide Prevention Presence

12. A majority of respondents (93%) agreed that an online suicide prevention presence should be developed across Scotland. Respondents generally thought that online platforms should be developed to support awareness campaigns, and that any online activity should provide accurate information and signposting. It was also suggested that social media platforms should be used to promote suicide prevention messaging and that apps could be developed to support any online presence. There were also calls for an online platform to be created for professionals. It was acknowledged that an advantage of an online presence is that a wide range of people can be accessed.

13. However, some respondents were concerned that an online presence could end up replacing face-to-face contact, or that online education or training would replace traditional delivery. Others noted that some populations do not have the same degree of internet access or that the tone of messaging can sometimes be lost online. Some individual respondents noted that social media can be considered a contributory factor to suicide and some had concerns about moderating online services to tackle cyber bullying and misuse. The need to monitor and evaluation online resources was also highlighted.

14. Respondents gave further comments about developing online and social media resources for suicide prevention. These included: unifying current online resources; increasing the use of multimedia resources; ensuring user interfaces are user-friendly; involving young people and those with lived experience in the design of online resources; and co-producing resources with the third sector, academia, private sector and experts.