Case study summary
A real time surveillance system (RTS) that tracks the number of suspected deaths by suicide, underpinned by the ‘Orange Button Community Scheme’, are the two key elements of a suicide prevention system that is saving lives in Lancashire and South Cumbria.
Note: Some sections of this case study refer to clinical commissioning groups (CCGS). On 1st July 2022, integrated care systems (ICSs) took over statutory commissioning responsibilities in England, and CCGs were closed down.
NHS Lancashire and South Cumbria Integrated Care System (ICS).
What was the aim?
The aim is to prevent suicide by providing teams with up-to-date information and the ability to target messages at high-risk groups such as middle-aged men in high-risk locations such as motorway bridges, providing a data-led approach to suicide prevention not seen before.
What was the solution?
The RTS is a police-led system producing a sudden death report within 24 hours of any suspected suicides and drug related deaths across the Integrated Care System. Prior to this the system relied on ONS data, which can be up to 18 months behind.
Recognising that no single organisation can tackle the issue on its own, people from health, police, fire, local authority, the voluntary sector, local communities and people with lived experience are working together as part of Lancashire and South Cumbria ICS, to shape the approach to suicide prevention.
Acting in real time, the system enables preventative action to kick in immediately. If it is a young person, support is given to schools, family and friends, identifying anyone at risk and delivering wrap around support, including putting training in place if needed.
With adults, bereavement support services can be placed into the workplace. The system can identify if a person is known to drug and alcohol services, mental health services, or social care, and also identify if there is any history of domestic abuse. This helps to build up a profile of what is happening across the ICS and support real time work to save lives.
A vital part of the suicide prevention system is the Orange Button Community Scheme.
People who are having thoughts of suicide, or who are worried about a friend or family member, can now push the button when they see someone wearing a distinctive orange badge, and ask them for information and support.
What were the challenges?
The challenge was having the most up to date intelligence needed to support effective communication campaigns, enabling targeted messages to be flooded into high-risk locations and high-risk demographics.
What were the results?
Winning a Health Service Journal ‘Connecting Service and Information’ Award, the driving principle is that suicide prevention is ‘Everyone’s Business’.
Louise Thomas, Mental Health Clinical Network programme manager for Lancashire and South Cumbria ICS said: “The CCGs, police, mental health trusts, fire service, bereavement services, voluntary sector, drug and alcohol services, local authorities, public health, social care, and prison and probation services meet monthly in a real time surveillance panel to look at data and take action and we firmly believe this is saving lives.
“This is strengthened by the ‘Orange Button Scheme’ where an orange button is worn by people who have undergone suicide prevention training, and while they are not able to counsel people, they can provide comprehensive signposting to relevant services”.
The scheme has already trained over 4,000 people with 10,000 information packs ready for distribution to businesses such as cafes, shops and pubs with an orange button to place in a prominent window, alerting people to trained staff available to help.
The scheme has created a community of people trained in suicide awareness that have gained skills, including active listening, from quality assured training. There is a network of organisations now that have orange button wearers in place that can listen and signpost, ensuring all communities are aware of the Orange Button, what it signifies and how people can get involved.
What were the learning points?
Neil Smith, Mental Health Multi-Agency Strategic Lead for Lancashire and South Cumbria ICS, added: “The suicide prevention training is delivered for free by Lancashire Mind to anyone who lives or works in Lancashire or South Cumbria. Following our first quarter evaluation, we know that people who have had the training have felt empowered to intervene and ask someone if they feel suicidal.
It is important that we have connectors in our community wearing the orange button giving out a simple message, come and say the word to me and I won’t think any less of you”.