Lived experience network – paid consultancy opportunities

The NSPA is planning to further develop its membership of people with lived experience by supporting network of at least 100 people with lived experience of suicide and suicidal behaviour who will inform and influence the development of suicide prevention policy and practice, locally, regionally and nationally, through a large online panel and a smaller group of trained and supported advocates and influencers.

We therefore have two flexible, paid consultancy opportunities from July to October 2020:

Application deadlines are 9am on Monday 29th June – all details in the briefs.

Summaries of all our Covid-19-related online discussions now available

Since lockdown started the NSPA has held over 20 online conversations with more than 300 people working in suicide and self-harm prevention, and bereavement support, enabling people to share the challenges they are facing, and the ideas and plans they have to meet them.

Summaries of these conversations are now on our website here including:

  • Sector-specific conversations for those working in charities, the NHS and public health
  • Reaching and supporting specific populations: children and young people, mental health service users, and older adults
  • Service delivery issues, including staff and volunteer well-being, bereavement support, and moving training online
  • Concerns and plans for the future

All summaries are available here.

Summary of COVID-19 and suicide prevention discussions, 30 April 2020 

Between 14th and 29th April, the NSPA held 7 online discussions with over 140 individuals representing over 130 organisations.  Calls were focussed either on specific subjects (e.g. staff and volunteer well-being, bereavement support, and changes to service delivery) or by sector (charities, the NHS, public health).  Across all the conversations there were some very consistent concerns: 

Staff well-being:  

  • Both for those at the front line, residential staff and those working from home, and for trainees and students working on the front-line 
  • Challenging work and difficult personal circumstances combining
  • People feeling responsible and guilty if they don’t do all they can, so not taking breaks or annual leave 
  • Some organisational cultures can stigmatise poor mental health and discourage help-seeking 
  • Concerns this will have long-term impacts including PTSD 

Service user well-being and changes in demand for services:  

  • Some are seeing increases in demand (including for alcohol services), others seeing decreases; there is a general sense that referral pathways have been disrupted
  • Mixed reports on impact on suicide rates
  • All are seeing increased anxiety and distress in those contacting services 
  • Previous service users are getting back in touch for support 
  • Concern that lots of people are not asking for help as they don’t see themselves as a priority (both for their mental health and physical health), or because they can’t speak freely on the phone 

Service delivery changes and challenges:  

  • Moving support online or over the phone, but some people want to wait until they can be seen face to face again 
  • Training delivery has been moved online by some, but concerns around safeguarding and staff availability to undertake vital training 
  • New services include text lines, additional befriending or well-being offers, digital resources, and increased support for all those bereaved during lock-down  

What the future will hold:

  • Will common mental health problems increase during and following lockdown, increasing the risk of self-harm and suicide? 
  • Lots of unknowns making it hard to plan – how long will this last? Who will be most affected, and how?  
  • Long-term impacts on staff and volunteer well-being, especially for those on the front-line who may be at risk of PTSD 
  • Surge in demand as soon as lockdown ends and people feel able to ask for help, or financial support/rent and eviction freezes etc end 
  • Permanent changes to services – could be positive or negative or both 
  • Possible recession and the impact on budgets, services and service users 
  • Some opportunities to build on new systems, services and attitudes 

We continue to hold online discussions, open to any organisation working in suicide prevention.  If you would like to know more please email info@nspa.org.uk.

Summary of NSPA support discussions on impact of COVID-19, 9th April 2020 

As a cross-sector alliance, with local, regional and national members from a wide range of sectors, we’re keen to provide additional support to our members during these unprecedented times. Following our survey and three support meetings last week, we’ve identified key areas which we’ll be focusing our support to members on in the coming weeks. 

Many members are concerned about the impact of COVID-19 on suicide rates, both during lockdown and afterwards, when the impact of anticipated recession and associated job losses will be felt. Our voluntary sector members are very concerned about their income reducing, with members from across different sectors aware that demand for voluntary sector services is likely to increase. There were also significant concerns that referrals and access to mental health services is reducing. 

Many local multi-agency suicide prevention group meetings have been cancelled as members are moved onto COVID-19-related work and some real time surveillance systems are struggling to get data from police forces  There is concern on the long-term impact of this lack of co-ordination on local suicide prevention and bereavement support work, but also acknowledgement that some members of those groups are now influencing responses to covid-19 and bringing their vital mental health and suicide prevention knowledge.  

The wellbeing and availability of staff and volunteers is a concern for many NSPA membersaccompanied by the need to change how services are delivered.  Worries include how staff manage the emotional impact of working from home, often with children at home, alongside the additional challenges of dealing with suicide prevention content while in their homes, without the usual support of colleagues. Members who deliver services are moving online where possible, and some are seeing an increase in capacity from volunteers now able to offer more time.  However, there are concerns about the safety and efficacy of that work, with many taking the view that something is better than nothing, and putting safeguards in place as best they can.  

There has been an increase in demand for bereavement support, and many members are worried that bereavement in any form will be additionally complex during lockdown, as people may not be able to grieve with family and friends and may be unable to attend funerals.  

A number of NSPA members are providing support to NHS staff, but there was a strong feeling that all key workers should be offered additional support, including supermarket workers, refuse collectors, construction workers, prison officers, funeral directors and postal workers, who may be harder to reach.  Many people were also keen to support positive national and local mental health and suicide prevention messaging, to balance out the negative and difficult COVID-19 news. 

There was a strong sense of support for each other in all the conversations, and acknowledgement that many people feel isolated in their work and were grateful to be connecting with others working in this area.  

We are keen to continue to support our members, and so we intend to: 

  • Provide at least 2 online discussion and support calls per week.  Proposed sessions include: support for staff and volunteers; bereavement support (working with the Support After Suicide Partnership); and changing service delivery. We also intend to offer sector-specific discussions, including: public health, NHS, and the voluntary sector.  If you would like to join one of these discussions, please email info@nspa.org.uk 
  • Share the work of members in specific areas, including: reviews of evidence of the impact on mental health and suicide ratesand delivering effective and appropriate support groups online. 
  • Support other agencies in the development and dissemination of other guidance and communications messaging. 

Peer Support in the Emergency Department – Barnet, Enfield and Haringey Mental Health Trust

In April 2018 Barnet, Enfield and Haringey Mental Health Trust employed seven Peer Support Workers to work a shift system alongside the medical staff in their Mental Health Liaison Service.  Here, one of the peer support workers and one of the psychiatrists reflect on the impact they have had.

Responding to suicidal thoughts in the Emergency Department

A peer support worker’s perspective

Mr Sharif Mussa: As a Peer Worker with lived experience of having suicidal thoughts I can’t help but empathise with patients who present with suicidal ideation. From personal experience I believe that stigma plays a big role in how and when we present. Sometimes it’s the last option. I know I always presented once everything else had failed. All we need at that moment in time is to talk to someone who isn’t going to judge but listen and try to understand. Too often I have seen patients presenting with suicidal thoughts waiting for hours to be seen by a clinician. They’ve had to wait because the team is busy. Too often during this time some patients may abscond and may go unnoticed by the system.

A young woman presented in ED in the morning agitated, confrontational, teary, with very angry facial expressions and was refusing to talk to any of the clinicians. She was brought in by Ambulance with a suspected overdose and there were some concerns about her from everyone in the department. She was discussed in afternoon handover and I was assigned to go in and make first contact. When I met her, initially she didn’t want to talk to me and said she was fine, and just wanted to be alone. I introduced myself as a Peer Worker with lived experience of mental health working in the Mental Health Liaison Team and she immediately asked me if she was going to get sectioned. I told her I play no part in those types of decision, but I was there to make sure that she is heard, and the right type of help can be prescribed. I asked if it was okay to disclose about my history with mental health to see if that would help her trust, to which I could see her body language relax more and become more comfortable with our conversation. She disclosed how difficult it had been for her to get to this point in ED especially after her experience with mental health liaison services in the past. See the patient had presented in the past with the same presentation and ended up on a section order against her will, so her relationship with mental health services had become tarnished.

I went on to explain to her how things worked in our team and how the process should be to protect her and not harm her. I shared with her my negative experiences within the system and how I learnt from them. At this point she said she had something in her bag that she was afraid to share in case she ended up on a section again. I told her she shouldn’t feel bad about thinking that way as it showed that she wasn’t unaware of what’s going on and ideally wanted help just not the wrong kind of help. I advised her of the benefits of opening up against those of closing up and allowing the system to choose what’s best for her, at that point she hugged me and said that she would like for me to support her through the process of seeing the clinician. She decided to share with the clinician a suicide letter that made his decision making clearer and more informed. In light of her opening up, which was a challenge as she openly said to the nurse that she wouldn’t have opened up had she not seen me first, the nurse decided to discharge patient home with Crisis Resolution & Home Treatment Team and further psychological therapy.

During our interaction I also told her about the Wellbeing plan, a wellness tool that I had as a tool to help me cope. She expressed an interest in doing it so we did it together and at the end she said she felt a lot better and was grateful that I had taken time out to do it with her.

Through mutual respect and sharing lived experience I was able to allow someone else to feel like they were being listened to and that they are human, which as a result allowed them to trust and open up about why they were behaving the way they were. I fell in love with my job that day. Not only did it help me do my job but sharing my experience with mental health and my role as a Peer Worker with lived experience of mental health actually made it a better experience for the patient. By sharing and allowing myself to be vulnerable I allowed the patient to trust, feel listened to and understood.

It’s not always easy for clinicians to have that much time to spend with complex patients in a busy ED but my role as a Peer Worker allows me to.

A psychiatrist’s perspective

Dr Susie Lingwood: I work as a Psychiatrist in the Mental Health Liaison Team at the North Middlesex University Hospital. I have worked in this team for 5 years and in mental health services for 16 years. Over time my approach to talking to people presenting in mental health crisis has changed a lot. Several things have influenced my practice over the years, but the past 6 months have been hugely useful in terms of growth. I have been able to access training which has really made me think about the power of truly connecting with people, and I have worked with Peer Support Workers who have helped me do this. The barriers that exist between patients and clinicians can exist for many reasons, but one of these is fear. Fear drives us to become distant; to defend ourselves from the reality that suicidal thoughts could affect us too given the wrong circumstances; and to focus on categorising risk or referrals to other mental health services rather than engaging with hopelessness, staying with difficulties and supporting approaches like Safety Planning. I feel inspired every day I work with Peer Support Workers who share their lived experience and overcome fear to help others. I know that our services for people who self-harm or experience suicidal thoughts are better as a result of the reminder that embracing our own vulnerability helps us to do better work.

The City of London Corporation’s suicide prevention work – Nov 2019 update

The National Suicide Prevention Alliance recognises the importance of promoting good mental health at work, and the vital role this can play in suicide prevention. The City of London Corporation, a member of the NSPA, is raising awareness of workplace well-being in the city, promoting help seeking and providing practical support.  You can read about some of the important work they are doing below. (Find their previous update here.)

Mental Health Street Triage

The City of London Corporation Mental Health Street Triage initiative started in May 2017 as a pilot scheme after the Corporation noticed numerous people in crisis were attracted to the square mile to attempt suicide. It was initially implemented from Thursday to Saturdays, and City of London Police officers were accompanied on their 5pm to 3am rounds by NHS mental health nurses who provided on the spot advice and guidance to officers as well as assessing and triaging vulnerable individuals to a place of safety.

Encouraged by the impact of the pilot, the service was extended from 3 to 7 nights a week and over the 2.5 years existence of this service, has supported 681 people in crisis, many of whom would have been transported to a police station should the Mental Health Street Triage have not been in place. The project was awarded NHS team of the year at the end of 2018.

Find out more here.

Business Healthy

During 2019, Business Healthy has been engaging with the business community in the City and further afield, as well as other key stakeholders on the topic of mental health – particularly where it relates to City workers and working-age adults.

Examples of this work include:

  • Delivery of three Suicide Prevention Awareness sessions to the City’s business community, in partnership with Samaritans and the City of London Police (February, June and October 2019). 55 individuals representing 20 different organisations were trained across the three sessions, including Heads of HR, Security and Facilities, as well as employees with an interest in mental health. Feedback showed that, on average, 97% of attendees who responded felt that the session had helped them to feel more confident in identifying and approaching someone who is at crisis point and who might be considering suicide. The sessions also helped to generate income for Samaritans.
  • Showcasing the City of London Corporation’s work on promoting and improving mental wellbeing among the local worker population and suicide prevention at events including the National Suicide Prevention Alliance’s annual conference and a Revo meeting on suicide awareness and prevention in March 2019 (Revo is a national consortium of shopping centre owners), and in publications such as the St John Ambulance blog (for Mental Health Awareness Week 2019), City Security magazine and the Royal Society for Public Health blog. Business Healthy was also an event partner for the Mad World Summit 2019 – a high-profile event focusing on mental health and the workplace.
  • Business Healthy continues to support wider efforts to tackle mental health-related stigma in the workplace, improve mental health literacy among the UK’s workforce and advocate for mental health as a business priority, by its representation on the Steering Group of the Lord Mayor’s Appeal’s “This is Me in the City” and green ribbon campaigns, and as an Operational Lead for the City Mental Health Alliance.
  • Earlier this year Business Healthy conducted qualitative research into the health and wellbeing needs of City workers, which found that mental health and work-life balance are seen as priority areas for City workers and their employers alike, with regard to wider workforce health and wellbeing.
  • Business Healthy also hosted a free webinar on problem gambling, mental health and the workplace, in partnership with charity GamCare and City law firm Squire Patton Boggs.

Find out more here.

Dragon Café in the City

Following a successful pilot in 2018, Dragon Café in the City secured funding which will allow it to be delivered from April 2019 until at least April 2021.

Dragon Café in the City, which operates from Shoe Lane Library fortnightly on Wednesdays (12-7.30pm), offers a range of free and creative activities aimed at providing City workers and residents with an opportunity to release the pressure from day-to-day life. The vast majority of visitors providing feedback have said that attending has helped to improve their mental health.

Dragon Café in the City has also hosted “special” sessions aimed at engaging specific target audiences within the City’s resident and worker populations, including a speaker session, a “Day of the Dead” session focusing on bereavement and a special session to mark National Carers’ Week.

The City of London Corporation’s Public Health team was invited to share insights and best practice from Dragon Café in the City at the City Health International Conference 2019.

Find out more here.

BarberTalk in the City of London

Set up by inspirational British barber Tom Chapman after losing a friend to suicide in 2015, the Lions Barber Collective is turning barbershops into safe spaces for men, using the opportunity of a regular haircut to start conversations about mental health. This international group of barbers helps raise awareness of mental illness and aims to prevent suicide by creating and delivering a specific training for barbers enabling them to recognise, talk and listen out for symptoms of depression in clients and signpost them to relevant support services. Tom developed Barber Talk with the help of psychiatrists and mental health professionals; it is an adaptation of Safe Talk for barbers.

To support the Lions Barber Collective and promote the great work they achieve in making barbershops safe places for men to talk about potential mental health issues, the City of London Corporation supported a promotional event on 7 October 2019 at the Worshipful Company of Barber-Surgeons’ Livery Hall. Ambassadors and volunteers shared their stories and the mission of the Lions Barber Collective, leading to a celebratory ‘first cut’ in the hall in centuries, under Holbein’s painting of Henry VIII with his Barber-Surgeons and Apothecaries.

The City of London Corporation is hopeful that other local authorities will want to promote and support barbers in their area being trained and helping save lives.

Find out more here.

The Listening Place – A Short History

Since it was established in 2015, The Listening Place’s (TLP) exceptional growth has enabled it to support over 2,800 people who felt life was not worth living.

The charity was set up with the objective of reducing the number of people taking their own lives by giving them ongoing, confidential, face-to-face support. It has received over 4,500 referrals in its short history. Clinical qualitative evaluation of the support given to 1000 visitors showed a highly significant reduction in suicidality and distress after three and six months’ support.

In 2015 TLP was open two days a week. It currently operates seven days a week, 9am-9pm. It has recruited and trained 600 volunteers of all ages, from all walks of life. The common denominator is their commitment to supporting their visitors. They support 900 visitors from London and the Home Counties from two sites in London. A third London site is scheduled to open in early 2020 and more premises are planned.

The volunteers are themselves supported by senior supervising volunteers on each shift, a separate small network of experienced listening volunteers on whom they can call at any time, and a separate network of senior healthcare professionals who hold regular supervision sessions at TLP and to whom listeners and their supervisors can look for support and advice with, for example, visitors who are at particular risk.

Two thirds of TLP’s visitors are referred by the NHS, some by other charities, police, social services, universities and some visitors self-refer.

Each person who is referred has an initial assessment. If it’s agreed that TLP can offer the right kind of support, the visitor will be offered six sessions when they can talk openly, without being judged and in complete confidence. Feedback from visitors shows consistently that it is the confidentiality and non-judgemental nature of their sessions that are of the greatest value. After the first six sessions a review of progress can result in visitors being offered further sessions.

In October 2019 The Listening Place won the Third Sector Volunteer Team of the Year Award and was short listed for the Small Charity of The Year. It won the Foundation for Social Impact, Small Charity Big Impact Award and was highly commended for the Outstanding Volunteer Contribution Award from London’s Westminster Council.

The BBC Radio 4 programme “All In The Mind” is well known for its reporting of mental health issues. It featured The Listening Place in one of its weekly broadcasts, with powerful first-hand testimony from one of its visitors who told the programme: “Structural therapies are trying to solve a problem. The best thing about TLP is that if you have got to a level where you are at risk, you just want someone to listen”.

The Office of National Statistics latest report on suicide showed it to be a continuing, challenging issue for the country.  TLP’s hope is that it can continue to play a significant, and hopefully growing, part in managing this ever-increasing  problem.

Read more at www.listeningplace.org.uk.

First national guidelines for delivering bereavement support groups published

The first national guidelines for delivering bereavement support groups have been published. The guidelines are informed by the national Bereavement Care Service Standards (BSA & Cruse Bereavement Care 2014) for individuals or organisations wishing to set up and deliver a bereavement support group for adults. They are designed as a non-prescriptive guide, to raise awareness, facilitate reflection on the potential challenges of running a support group, and to encourage careful planning. Together, this guide can help to avoid pitfalls and ensure the sustainability and quality of a support group for any kind of bereavement.

The guidelines are suitable for voluntary groups or statutory agencies who would like to deliver a support group for those facing any type of bereavement whether facilitated by volunteers, people with “lived experience” of grief and loss, or professionals, such as counsellors or nurses.  They cover what should be in place to deliver a safe and effective group, different types of groups and other key points to consider, including sections for specific recommendations for different types of bereavement, such as suicide.  There is also a section which addresses legal requirements which apply to all service providers, whether voluntary or statutory, in the UK.

The guidelines were co-edited by Alison Penny of the National Bereavement Alliance, and Anne Embury of the Support After Suicide Partnership (SASP) and Outlook South West’s Suicide Liaison Lead for Cornwall & the Isles of Scilly. They include a foreword written by Julia Samuel, MBE, Founder Patron of Child Bereavement UK and Patron of the SASP until her retirement in 2019. Supported by a grant from the Esmée Fairbairn Foundation, the project was managed by the SASP with input from a number of bereavement organisations who contributed their expertise and experience.

How to access a copy?

To order a hard copy, email info@supportaftersuicide.org.uk

Or download online by visiting the Resources pages at hub.supportaftersuicide.org.uk

NSPA response to Prevention Green Paper, October 2019

The NSPA worked with policy teams from some of our members to inform our response to the Government’s Green Paper: Advancing our health: prevention in the 2020s – consultation document.

Which health and social care policies should be reviewed to improve the health of people living in poorer communities or excluded groups?

Living in poorer communities and being part of excluded groups is not only detrimental to physical and mental health, but as Samaritan’s ‘Dying from inequality’ report acknowledges, “as area-level deprivation increases, so does suicidal behaviour”. The response to this needs to be cross-governmental and is not solely about reviewing policy; the NSPA believes that there is much good policy across government, but there is little funding to implement it. Any funding review should ensure appropriate funding for local authorities, whose staff provide vital support for many people experiencing poor mental health or at risk of suicide. We also support the Centre for Mental Health’s call, in their ‘Briefing on social care funding’, for any new financial settlement to:
• Provide parity of esteem for mental health with other social service functions
• Secure fair funding for people of working age
• Resolve the confusion between health, housing and social care funding for people with ongoing care needs
• Enable local councils to invest for the future in their workforce and their community.

We also recommend a review of implementation of policy, to ensure that those in poorer communities and excluded groups are enabled and supported to access universal and early intervention services, including GPs, IAPT, Health Visitors, and school health teams. Those delivering these universal services must also have a better understanding of mental health and suicide prevention.

There are many factors affecting people’s mental health. How can we support the things that are good for mental health and prevent the things that are bad for mental health, in addition to the mental health actions in the green paper?

Local authorities and local areas are responsible for many of the things that we know make a positive difference to people’s mental health and wellbeing: physical activity, the physical environment, decent housing, employment and the local economy. Additionally, cuts to local services such as drug and alcohol services and domestic abuse services can have terrible impacts on the mental health and suicidal ideation of those that need them. The government should ensure that money for local authorities and local areas is commensurate to their role, particularly following the Samaritans/University of Exeter report into local suicide prevention plans, which found some ambitious and impressive plans, but that support is needed to enable them to be delivered.

Reaching people in the early years of their life will have an impact on their mental health throughout their lives, and health visitors make a crucial difference here. If they are supported with the time (and money) to make the most of the opportunities of being in people’s homes, to understand the challenges that families are facing and support the parents of very young children, that work would reap benefits for decades.

Have you got examples or ideas about using technology to prevent mental ill-health, and promote good mental health and wellbeing?

Various NSPA members are using technology to support mental health and prevent suicide, including:
• Stay Alive app – www.prevent-suicide.org.uk/stay_alive_suicide_prevention_mobile_phone_application.html
• Good Thinking London – www.healthylondon.org/resource/the-good-thinking-journey/
• Shout crisis text service – www.giveusashout.org/
• Isolutions to isolation – www.keep.eu/project/19362/isolutions-to-isolation
• Samaritans’ web chat service
• Using paid Google ads to target people searching for information around self-harm or suicide and directing them to support pages

However, whatever technological opportunities there are to support good mental health, it’s important to implement them in line with best practice and ethics around technology usage, ensuring that those implementing them are trained, and using them as part of blended care.

Have you got examples or ideas for services or advice that could be delivered by community pharmacies to promote health?

Community pharmacies are already alert to some issues around suicide prevention, including the hoarding of potentially dangerous medication. This could be further enhanced by standardised training in mental health awareness and suicide prevention, enabling staff to be more aware of possible signs of deterioration in mental health and what they could do in response to support or refer people. However, this must be based on strong evidence and consistency of approach. Our member Medicspot is already providing online access to GPs via pharmacies, and this kind of intervention could be further developed to include mental health and suicide prevention.

It would also be valuable to consider the co-location of pharmacies alongside GPs and non-clinical services such as debt advice, housing support, addiction services, and community activities. Communication, referral and social prescribing would be facilitated, all of which would have an impact on suicide prevention.

What could the government do to help people live more healthily: in homes and neighbourhoods, when going somewhere, in workplaces, in communities?

When thinking about helping people live ‘more healthily’, the NSPA would encourage government to ensure that their definition includes mental health as well as physical health.

For suicide prevention, loneliness and isolation can be key issues – both for older adults, but also young people, as DCMS’ Community Life Survey 2016-2017 found that young people aged 16 to 24 report feeling lonely more often than older age groups. This can be particularly problematic in rural communities where the lack of public transport, and high cost of what transport there is, contributes to physical isolation. Further support for local community building work, befriending schemes, and improved local transport would be of benefit.

Workplaces have a large role in supporting well-being and preventing suicide. There is good work being done by many of our members to deliver suicide prevention and mental health awareness training to private employers, and we are keen that growing numbers of employers support their staff. The government can continue to encourage businesses to develop this work, but also has a key role in ensuring that public sector staff nationally and locally, are also supported. This is particularly true in the health service, where some staff, particularly female nurses, are at a higher risk of suicide themselves (www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/suicidebyoccupation/england2011to2015).

What is your priority for making England the best country in the world to grow old in, alongside the work of PHE and national partner organisations?

Older adults have a similar risk of dying by suicide to the rest of the population, but there is little research providing evidence of what the factors might be with this age group; possibilities include increasing physical health problems affecting mental health, lack of purpose post-retirement, bereavement, caring responsibilities, isolation, financial worries, or a complex combination of factors. It would be valuable to investigate this issue, to better inform spending nationally and locally on mental health and suicide prevention in older adults, and ensure that work to increase longevity also prioritises quality of life.

We do know that one in five over-65s is affected by depression yet older adults are less likely to use IAPT services (www.england.nhs.uk/mental-health/adults/iapt/older-people/). It is important for GPs and others in touch with older people to understand “symptoms often attributed to ‘old age’ but where a mental health diagnosis and follow-up is more appropriate” as NHS England recommend in their ‘Primer on Mental Health in Older People’ (www.england.nhs.uk/publication/a-practice-primer-on-mental-health-in-older-people/).

What government policies (outside of health and social care) do you think have the biggest impact on people’s mental and physical health? Please describe a top 3.

Suicide prevention needs a cross-government approach as a crisis can arise from a combination of factors, including poor physical or mental health, changes in employment, living conditions, social isolation, educational attainment and more. Our top three areas of concern are welfare reform, housing and employment, however issues as diverse as education, transport and communities/social inclusion will all affect suicide prevention. We are also aware that wider, international issues can also affect people’s mental health, such as climate change and Brexit, which could have wide-ranging negative impacts on issues connected to suicide prevention, including people’s livelihoods, families, communities and mental health.

Whenever government policies are revised to consider physical and mental health, thought needs to be given to how to measure the impact, and including key indicators in policy to enable that measurement. The idea of a Composite Health Index to track the nation’s health alongside GDP could be of benefit, but careful thought must be given to how it will be implemented and how it will then influence cross-government decisions.

How can we make better use of existing assets – across both the public and private sectors – to promote the prevention agenda?

The public sector workforce is a valuable existing asset, and the Making Every Contact Count campaign has potential to reach large numbers of people and promote the prevention agenda. It is vital, however, that mental health and suicide prevention is part of that, enabling any member of the public sector workforce to be able to have conversations around mental health, self-harm and suicide with anyone they are in contact with.

There is also potential if local and national government shifted towards more progressive use of their land and property; for example, by co-locating clinical services with non-clinical services such as debt advice, housing support, addiction services, as well as community activities. This would facilitate better communication, referral and social prescribing, all of which would have an impact on suicide prevention.

More progress could also be made by effectively implementing existing government policy – for example the Children and Young People’s Green Paper. The plans for school mental health teams could have a very strong impact on suicide prevention, particularly if the staff recruited have a strong understanding of self-harm and bereavement support. The impact would be even greater if the proposals become a universal offer, not just for a small proportion of schools.

What more can we do to help local authorities and NHS bodies work well together?

The Samaritans and University of Exeter report on the progress of local suicide prevention plans shows that local areas are trying to do more with fewer resources, and local authorities also have an important role in reaching the two thirds of people who take their lives but are not in touch with mental health services. They must therefore be given the financial support to do this.

The government could also promote the requirement for the NHS to work together with local areas, for example ensuring that NHS suicide prevention plans are co-produced, that any new NHS structural reform or strategy integrates mental health and suicide prevention, and NHS or government expectations of suicide prevention or bereavement support activity are appropriately funded to enable delivery.

The experience of the NSPA and our members is that health, mental health and suicide prevention are not just the work of local authorities and the NHS, but also benefit from the involvement of police, coroners, the voluntary and private sectors, including rail services. Government communication and funding should encourage and support partnership and co-operation between these diverse groups.

What other areas (in addition to those set out in this green paper) would you like future government policy on prevention to cover?

Suicide is a serious, and preventable, public health issue, and as such the NSPA and our members were disappointed it did not feature more prominently in the green paper. This process presents an opportunity to ensure suicide prevention receives more sustainable public health funding.

As suicide is a cross-government issue decisions made by Departments as diverse as the Treasury, Department for Education and the Ministry of Justice could all impact people’s well-being, however much of the thinking in this green paper seems to take a siloed approach. All new government policy should have tests in place to consider what impact they will have on health and mental health. The effective implementation of the Composite Health Index that is considered across all government departments as policy is made could help with this.

Data collection, including real-time suicide surveillance, can impact the speed and effectiveness of local suicide prevention responses and support for those bereaved and affected, who can be at higher risk of taking their own lives. Additional funding and support, and the exploration of a national data capture system, could allow local areas to further improve their suicide prevention work.

NSPA Members’ Survey 2019: what we learned

76 organisational members completed the survey this summer, which is nearly half of our membership – thank you very much to those that took the time, it has been very helpful.

Our key findings include:

When asked about their top 3 achievements in 2018-19:

  • 43% of members mentioned delivering suicide prevention training in their communities and for other organisations, while 14% provided training to their own staff and volunteers
  • 32% of members were involved in campaigning and awareness-raising activities
  • 31% provided bereavement support or postvention advice
  • 23% made improvements to their organisational strategies or policies
  • 23% developed and delivered new services while 18% grew existing services
  • 19% worked in new partnerships and collaborations and
  • 4% believe they achieved changes in policy through their influencing and lobbying work

“Delivering suicide prevention training to 400+ people across [our area].    Providing 1:1 intensive mental health support for 1000+ beneficiaries … through our … service.   Delivering training to workplaces.”

“Produced an … intervention pack and resources to give guidance and support to senior managers, HR, line managers following a sudden death or suicide.  Suicide awareness and suicide awareness plus training.  Free mental health workshops for our supply chain where suicide stats and prevention is covered.  Run World suicide prevention day campaign annually.”

“Reviewing our local suicide action plan in line with the National and [local] Suicide Prevention Strategy.  Launched the Bereaved by Suicide support service.   Worked with all our key local partners to identify possible [high frequency location]. Starting work with workplaces to reduce stress and [improve] mental health.”

When asked about their priorities for 2019-20:

  • 55% of members plan to grow and improve the services they deliver
  • 37% will engage in campaigning and awareness-raising
  • 32% will be providing bereavement support services
  • 27% of members plan to deliver training outside their organisation, and 13% will train their own staff and volunteers
  • 15% will work on improving the data they have on local deaths by suicide and the impact that will have on improving and better focussing their services, many of these mentioned implementing or continuing real-time surveillance

“1. Maintain [our] campaign for everyone in our community in collaboration with [volunteers], partners and our local community. 2. Reach at-risk groups through targeted campaigns focusing on men and particularly Eastern European men in [our area]. 3. Continue to equip local people and professionals with suicide prevention skills for free through training.”

“Continue to increase public awareness of (and willingness to call) our 24-hour support line. Train over 1500 additional people in suicide prevention. Make long term and sustainable changes to strategic policies and clinical pathways.”

We also asked about the challenges they are facing in 2019-20:

  • 55% identified financial pressures as an issue for them, which may well be linked to the 53% who are facing an increase in demand for their services and the 37% who mentioned staffing issues
  • 20% were concerned about the external environment, including Brexit, and how that would impact them

“We are a small team. It has been a challenge continuing to run the service whilst making significant changes in our service delivery to meet funders requirements for areas such as reporting.”

“[Our area] has one of the highest levels of social deprivation in Northern Europe and has relied heavily on EU funding which will not be replaced by Westminster.  This is having an indirect impact on social programmes, housing and community initiatives to promote wellbeing.  There is no hard evidence that the current political situation and Brexit is having a detrimental impact, but it is probably having an indirect impact on the increased number of suicides in [our area] across all age groups.”

We asked members what they found valuable about being members of our alliance:

  • 63% mentioned how much they value that we keep them informed of news and research, provide useful resources, and enable them to learn
  • 45% value the opportunities to network and collaborate that we provide, with 13% specifically mentioning our conference and members’ meetings
  • 34% appreciate that we share good practice from others, with 13% also valuing the opportunity to share their own good practice via the NSPA
  • 16% talked about how lonely the work can be, and how much they value the support from the NSPA team
  • 13% appreciate our ability to influence at a national level

“It is so important to feel connected with other people working in the same field, so that we can learn from one another, share our experience and knowledge, and grow stronger together in our aims and mission to prevent suicide. Being a member of such an important body, also raises our status as an organisation and we feel welcomed and supported.”

“Being part of a wider family, all of whom are trying to achieve the same goals. Sharing of best practice and the evidence base. Relationships. Simply not being alone when one needs to reach out.  Contacts.”

“Ability to share practice and learn from other. Also working purely in the field of Suicide Prevention is very isolating and long term – hence difficult to keep up motivation. The support from the NSPA either in events or personal has been so positive and supportive it keeps you focused.”

When we asked how else the NSPA could help members in their work or if they had any other comments nearly 50% said thank you and that we were doing good work.  However, there were various suggestions that we will reflect on, including holding more events outside London, using online discussions or webinars more, and how we can support the work our members do even more.

Thank you again to everyone who took the time to complete the survey, your feedback is invaluable. If you would like any further information on our findings, please email us at info@nspa.org.uk.

NSPA Annual Members Meeting 2019

“Thank you for one of the best events of the year”

Our Annual Members Meeting took place on 11th June at NCVO, London. A wide range of organisational members attended from across the public, private and voluntary sectors alongside individual members.

A selection of NSPA members presented about their work on the day, alongside updates on real-time surveillance and the review of local authority suicide prevention plans.  All attendees also spent time discussing topics such as local plans and local multi-agency groups, workplace suicide prevention, and suicide prevention in children and young people, and sharing ideas of good practice and working with people with lived experience of suicide.

Feedback from the event has been overwhelmingly positive, with many attendees commenting on the value of sharing ideas, challenges and hopes in such a diverse group who all care so much about suicide prevention and bereavement support. Thank you to those members who came along and made it such a fantastic day.

Below is information on each of the presentations from the day, please click on the title to view the slide sets.

Update from the NSPA

Penny Fosten (NSPA Executive Lead) updated members on some of our work in 2018-19, including the launch of our Resources Hub, the growth of our national conference, our World Suicide Prevention Day activities, and the increase in our social media presence. She also outlined plans for the coming year including how best to share information and support cross-sector collaboration whilst continuing to enhance connections and communication with and between members and represent our members nationally.

Institute of Mental Health at the University of Birmingham – Working alongside young people to develop and deliver mental health-related research

Maria Michail (Senior Birmingham Fellow), Niyah Campbell (Youth Participation Lead) and Layne Boyden (Member of the Youth Advisory Group) spoke about their work to establish a Youth Advisory Group as part of the Institute, which can contribute to their aim to create a transformational change in our understanding, conceptualisation and response to self-harm and suicide prevention in research, clinical practice, policy-making and community practices.

Rural Community Council (Leicestershire & Rutland) – The RCC’s role in suicide awareness

Mike Wilbur (Delivery Manager Community Wellbeing) presented on the community-based work of the RCC in suicide awareness raising and tackling taboo. He spoke about the Start a Conversation initiative which aims to encourage people to be more open about their worries and show them where to seek help and to break the stigma around suicide.

Merseyside Fire and Rescue – Effective emergency service employee health and wellbeing support

Kelly Patterson (Senior Occupational Health Officer & Psychological Therapist) and Mark Thomas (Group Manager) talked us through the ground-breaking implementation of Mental Health First Aid and Critical Incident Stress Management undertaken by their fire service and the positive impact it has had on staff and the service as a whole.

Mental Health Foundation

(no slides used)

David Crepaz-Keay (Head of Empowerment and Social Inclusion) spoke about the about the progress made in attitudes and approaches to mental health in the 70 years since the Mental Health Foundation began its work.  He also stressed the vital importance of “less focus on illness and broken individuals, more focus on communities and relationships”.

Jonathan’s Voice – Workplace engagement – working with the legal sector

Graham McCartney (Trustee) talked about their road to becoming a charity and what drives the work of Jonathan’s Voice. He also spoke about outreach and raising awareness through their networks in the legal sector.

Real-time suicide surveillance – review of current practice and recommendations for future development

Jonathan Ling (Professor of Public Health, University of Sunderland) gave an overview of the findings of the Public Health England-funded research exploring 2 questions:

  • Whether a police and/or coroner led RTSSS could lead to earlier more effective monitoring and improved support for people bereaved by suicide and
  • What action is required to implement a RTSSS across the UK effectively?

Samaritans – Local suicide prevention planning in England – research findings

Jacqui Morrissey (Co-Chair, NSPA and Assistant Director of Research and Influencing, Samaritans) gave a preview of research findings from the Samaritans joint report with the University of Exeter which provides the first ever nation-wide view of the breadth and depth of suicide prevention planning within local authorities in England. You can access the full report here.

 

NSPA response to NICE suicide prevention quality standards consultation

Last week we submitted our response to NICE’s (National Institute for Health and Care Excellence) consultation on suicide prevention quality standards.  We were very pleased to see that NICE have taken on board the comments from ourselves and our members in drafting the quality standards, particularly in relation to: the inclusion of people with lived experience on local multi-agency groups; more use of real-time surveillance; supporting professionals to ask about involving family or carers when someone is feeling suicidal; and better support for those bereaved by suicide.

The key areas we believe could be improved in the draft quality statements are:

  • More focus on a diversity of people with lived experience participating in local multi-agency suicide prevention groups
  • More effective support of those with lived experience who are involved in local multi-agency suicide prevention groups
  • Stronger reference to professionals acting upon permission to inform the family or carers of someone with suicidal thoughts, not just asking about it
  • Ensuring that support for those bereaved and affected by a suspected suicide is timely – within 72 hours

You can read our full response here.

Many thanks to the NSPA members who helped us with our response.