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Suicide prevention and reduction
The Five Year Forward View for Mental Health set out clear recommendations on suicide prevention and reduction, and made a commitment to reduce suicides by 10% nationally by 2020/21. Alongside this, Secretary of State Jeremy Hunt announced a zero suicide ambition for mental health inpatients in January of this year.
In 18/19, local communities that are worst affected by suicide are being given additional funding to develop suicide prevention and reduction schemes. The investment marks the start of a three year programme worth £25 million that will reach the whole country by 2021.
The funding, which has been allocated to eight Sustainability and Transformation Partnerships (STPs) this year with a high level of need, will help to ensure people know high quality confidential help is available within their community.
Alongside local plans, all STPs will be working with the National Confidential Inquiry into Suicide and the National Collaborating Centre for Mental Health to improve quality and safety within their mental health services. This includes implementing evidence from their 20 years of reviews, such as ‘Ten Ways to Improve Safety’.
Details on plans from each STP are set out below.
Durham, Darlington, Teesside, Hambleton, Richmondshire & Whitby
Durham, Darlington, Teesside, Hambleton, Richmondshire & Whitby STP area plan to target men by reaching out to them through their passion for football to promote emotional wellbeing and help seeking behaviour by providing a contribution to the funding of the ‘Team Talk – suicide prevention through football’ project. There are also plans to facilitate a small grant allocation process across the area to community groups specifically engaged with building resilience and targeting vulnerable population groups. This involves expanding the reach of existing arrangements and better linkage between primary care and mental health for early intervention. In addition, the area aim to have a shared public mental health and suicide prevention training hub, to promote mental health awareness, resilience and targeted suicide prevention training. They will also be undertaking a piece of development work to understand the pathways, coding requirements and training needs for self-harm pathways for those accessing A&E departments and hope to work in collaboration with the North West in the piloting of a primary care data base algorithm to provide an earlier identification of risk and opportunities for intervention in GP practices.
Lancashire and South Cumbria
Lancashire and South Cumbria aims to reduce suicide rate across their population, covering a range of high risk groups identified in the national suicide prevention strategy. These include inpatient and community mental health settings, children, young people and adults who self-harm and those who have been bereaved. They will also work on cross cutting infrastructure improvements such as workforce, data and intelligence. One element of this focuses on local workplace settings, such as within the healthcare, local authorities, schools, voluntary, community and faith settings, among maternity and perinatal teams, and other major organisations. The STP will also appoint a self-harm quality improvement lead to ensure evidence-based self-harm services are available across the geography, working closely with primary care.
South Yorkshire and Bassetlaw (shadow Integrated Care System ‘ICS’)
South Yorkshire and Bassetlaw plan to look at three key areas: support to primary care, prevention work targeting middle-aged men and improvement in self-harm support. These plans include providing self-harm and suicide awareness training for all staff in primary care and running both a large scale prevention campaign working with local organisations, and events that are accessible and relevant amongst males such as sport, leisure facilities and service industries. Part of the funding will be used to improve pathways and support for patients (including children and young people and people with personality disorder) presenting with self-harm, including in acute hospitals and mental health services. Finally, the ICS will consider consistent and cost-effective bereavement support pathways across the ICS, including enhancing data sharing agreements across organisations and improving real time surveillance.
Coventry and Warwickshire
Coventry and Warwickshire will be targeting men in their local population tackling stigma and isolation, improving support around employment and housing, and ensuring there are safe drop in places available for men in their community. Their work will include developing their existing suicide prevention campaign ‘It Takes Balls to Talk’, and expanding to reach additional community assets such as barbers and workplaces. They will work closely with the third sector to develop a social prescribing offer for men who are socially isolated or experiencing difficult life events. The STP also plan to deliver new evidence based mental health awareness and suicide prevention training aimed at non-mental health professionals including social care, primary care, A&E, Job Centre and Citizens Advice Bureau staff. This will run alongside developing a network of champions and train the trainers within healthcare settings and in specialist mental health services to promote awareness, develop a compassionate culture within services and to drive an ambition towards zero suicide.
Norfolk and Waveney
Norfolk and Waveney will focus on children and young people and men, through their acute services and prevention through educational and occupational strategies. Their plans include working alongside voluntary and community sector (VCS) to provide enhanced support to acute hospitals in Norfolk particularly for those with self-harm, and a project in primary care to improve the recording, assessment and level of support and action for those with suicide behaviour and risk factors. In additional, part of the funding will be used to extend and enhance the innovative “12th Man Barbers Shop” project, extending Suicide Prevention Training (based on the ASIST model) and mental health training to pubs, bars and social clubs alongside barber’s shops. Further support will be given to promote self-harm and suicide prevention and emotional wellbeing training in education settings, using school PHSE sessions. The STP is also looking to strengthen their use of data through developing a data hub to better understand suicide and self-harm locally and allow for improvements in suicide prevention and postvention.
Kent and Medway
Kent and Medway have identified the following aims for this year: more support for key high risk groups (particularly middle-aged men); at least 1000 individuals will be trained in suicide warning signs and how to respond. The STP will develop a greater system wide understanding of the reasons that lead to people committing suicide. The STP will strengthen support and improve quality at high risk points within adult secondary care services. The focus here will be on people who are discharged from inpatient settings as well as those discharged from community mental health teams. The STP intends to improve the way people who have attended a hospital emergency department because of serious self-harm are followed up. Additional projects include a social marketing campaign ‘Release the Pressure’ to encourage men to call a 24/7 support line. There will also be a digital app to allow individuals to create their own safety plan and access support when they need it.
Cornwall and Isles of Scilly
Cornwall and Isles of Scilly will look to improve access to help for men of all ages, refining pathways to be more accessible and building on local pilots. The STP intends to improve self-harm care, focussing on better support after self-harm based on better recording and evaluation to identify recurrent self-harm, increase availability of psychological support after self-harm and introducing peer or volunteer input in crisis cafes. They also plan to expand the “Fit for Life” project, which reaches men, those in the care of services, people with a history of self-harm and those with substance misuse. In addition, the STP will run a tailored GP training package (piloted as part of the South West Zero Suicide Collaborative) to combine with a referral care pathway, including social prescribing, the local ‘Fit for Life’ campaign, and linking with existing Care Navigators.
Bristol, North Somerset and South Gloucestershire
Bristol, North Somerset and South Gloucestershire’s local suicide prevention strategies cover major groups identified in the national strategy, with the additional funds planned to support the delivery of some of these. This includes both an immediate system wide focus, working closely with universities to increase the capacity of support to provide a broader range of help and access to advice and counselling for students, internal and external to the university, as well as building on longer term plans and approaches. Funds will be also used to focus on men, as a local high risk group, in two ways. The first is through a new service offering a psychosocial intervention addressing the acute distress created by debt, financial, employment or welfare difficulties, via the expansion of their HOPE project (a service piloted by the CCG, the university and the Voluntary and Community Sector last year). Secondly they have planned a targeted strategy to raise mental health awareness and wellbeing for males in their community. The STP will work closely with the local Public Health and the voluntary sector to target suicide prevention training in industries including construction, and promote events aimed at men, such as “Movember”, and a Time to Change football tournament.