Time Space Compassion - supporting people experiencing suicidal crisis: stories in practice - volume 1

6. Glasgow Complex Needs Service

Making the link between compassion and trauma informed practice by building relationship, being clear and consistent, and making connections

The Glasgow City Health & Social Care Partnership's Complex Needs Service provides specialist, highly personalised support for people with multiple and complex health and social care needs, which mainstream services are at times unable to meet.

"…through a focus on building relationships, people have the opportunity to feel supported enough to begin to trust that perhaps there is a different future available to them than the one they once accepted for themselves"

6.1 Our challenge

For some people we support, suicidal crisis can be chronic, lasting days, weeks and sometimes months at a time. The possibility of completing suicide can be both protracted and acute. For some, the ongoing factors that contribute to their experience of suicidal crisis, alongside the impact of previous suicide attempts, can compound their levels of distress. Before COVID, we offered support out of our clinic at Hunter Street. We'd allocate appointments and invite people to attend for review, addiction care and treatment. The pandemic meant we needed a safe and sustainable way to work that and, most importantly, met the needs of the most vulnerable people we supported. This led to a major shift in our approach and ways of working.

6.2 Our response

We implemented an assertive outreach approach, increased the amount of face to face contact time, and introduced new ways of assessing and responding to the level of risk people experience. Removing the barriers to staying in contact with people, has been a key move – distributing mobile phones to help us stay in touch between face to face sessions and support follow up. Increasing the number of people in the teams with social care expertise helped us take a more holistic and person centred approach, and enabled skills sharing between the nursing, keyworker, clinical and social care staff in the team. Providing training on suicide prevention, mental health awareness and targeted support to our key partners has helped us build stronger working relationships and employing a clinical psychologist to support our team has had a big impact on our practice and team wellbeing.

6.3 Learning from practice

Building relationship – trauma early in life can teach people it's not safe to share difficult emotions or trust those in a position of power. We work hard to respond to this through the support we provide, taking time to build relationships that show care, support safety, and build trust. We've found this is only possible through collaboration, empowerment and choice. Trauma informed practice is a core approach in our team. Being clear & consistent – by consistently offering and role modelling this kind of care, we can help people feel safe enough to share more of what they are experiencing and open up to alternative ideas of what their future might be like. To help people build confidence in us and what we're doing together, we regularly work through outreach – going to the places they feel safe and comfortable. Making connections – by listening without judgement, offering validation, sticking with people as they change their mind and experience setbacks, we aim to help the person get a clearer sense of their needs. When the time is right, we use this assessment to identify and introduce key workers, who will stay with them while they use the service and eventually, help connect them to a wider network of support.

6.4 Impact

We have seen a sustained increased in the uptake of the health interventions we offer, better outcomes and a reduction in critical incidents. Working this way has increased people's engagement with the support and treatment available through the team. Find out more and contact the team through their website