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Listen
Preventing Suicide and Deliberate Self Harm
Laying the Foundations: Identifying Practice Examples
Project Report
14. Big River Project, Turning Point Scotland, The Scottish Borders
Target Group
The Big River Project is a free, specialist service for people whose lives are affected by drugs, managed by Turning Point Scotland, and funded by both the Borders NHS Board and the Scottish Borders Council. The project operates in several areas across the Scottish Borders, including the major areas of population.
Issues
Many issues affect the lives of people who use the service - their drug use (or the drug use of a family member), and many other issues such as their health, housing situation, abuse, bereavement, relationships or financial situation amongst others. Mental health issues underpin them all.
Many people who use the project attempt suicide or self-harm. Drug use itself can sometimes be seen as a form of self-harm. People who use the project also sometimes undertake more 'traditional' forms of self-harm such as cutting themselves.
Services/approach
The project offers counselling, support, drop-in and work around harm reduction.
One-to-one support is provided by appointment. The service aims to be flexible - people can use the service as often as is needed at that particular time in their lives. The counselling is at the individual's own pace and is person-centred, working around what the individual feels would be useful, as well as forward looking. This way of working can help people develop a sense of hope.
At the drop-in service people can chat, have a cup of tea, and receive support and advice from one of the workers. Ear acupuncture is also available. The drop-in service works particularly well for people who find specific appointment times difficult to manage.
In terms of helping to prevent people from attempting suicide, the project can provide somewhere for people to turn to, and a supportive relationship. The project can help a person look at what makes them feel better and explore the reasons for feeling suicidal.
The project aims to have good working relationships with other workers who are involved in supporting people who use the project - this can be very necessary when people are feeling seriously suicidal. The project also helps people by acting as advocates, helping them to link in with health, psychiatric and other services before they hit a crisis.
It is also important that there is good communication within the team. Also, that more than one worker is involved with each client, so that when the worker is away for whatever reason, then the client will still receive a service. This is very important for the times when someone is in a crisis and possibly at risk of attempting suicide. The project also ensures that staff can follow the procedures that should be used if someone is in a crisis.
The project tries to involve people as much as possible. For example, people who use the project chose the paint for the premises at Eyemouth. And, when the project has to liase with other agencies, they will let the project user see the information that is being passed on, and give them a say in writing the letter. The project also asks people what they think about the project. If people are being listened to, then this can have a positive effect on their confidence levels.
Taking people seriously also helps the situation when someone either self-harms or is feeling suicidal. For example, not using phrases such as 'a cry for help'. When supporting someone who harms themselves, the project may help the person explore the issues that prompt them to cut as well as work around other areas in their life which may be affecting them.
The project undertakes a lot of work around drug use and harm reduction, such as how to avoid accidental overdose. When people are withdrawing from drugs, project workers can provide one-to-one support for this - helping people keep themselves going, and an opportunity to talk through ways of coping with the withdrawal.
The way that people feel about themselves is very important, and the project can have an effect on this. If someone feels valued, they are far more likely to value themselves. The project can give a person positive feedback. If the project can see that a person is making progress, then this can be pointed out to them - this can help people feel better about themselves. The project also has a policy of not requiring that people go back on the waiting list if they haven't been in touch with the project for a while, or if they miss an appointment. Also, the project will send an informal note out to someone if they haven't had contact for a while.
The project makes acupuncture available. This is good, not just as a treatment in itself, and the relaxing effect that it has on people, but also because it allows people to engage without having to talk. It is easier to come into the project for acupuncture, and then get speaking to project staff than it is to say 'I want to talk to someone about my drug problem'.
Key features
Continuity of support
Harm reduction focus
For further information, contact:
Kirsteen Bristo, Project Leader
Big River Project
9 Bank Street
Galashiels, TD1 1EN
Tel 01896 759740
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