Preventing Suicide and Deliberate Self Harm - Laying Foundations: Identifying Practice Examples - Summary of Project Report

DescriptionProvides practice examples which contribute to prevention of suicide & DSH, and improvement of mental well-being. Complements SE consultation on Framework for Prevention of Suicide and DSH
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Official Print Publication Date
Website Publication DateJuly 31, 2002

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    Preventing Suicide and Deliberate Self Harm
    Laying the Foundations: Identifying Practice Examples
    Summary of Project Report
    July 2002

    Prepared for the Scottish Executive by Scottish Development Centre for Mental Health

    This document is also available in pdf format (244k)

    NATIONAL FRAMEWORK FOR THE PREVENTION OF SUICIDE AND DELIBERATE SELF-HARM

    SUMMARY OF REPORT BY SCOTTISH DEVELOPMENT CENTRE - "LAYING THE FOUNDATIONS: IDENTIFYING PRACTICE EXAMPLES"

    Identifying practice examples

    In launching the National Framework for Suicide Prevention and Deliberate Self-harm Reduction, one of the key challenges will be to secure the interest, engagement and commitment of the wide range of sectors and agencies who have a role to play in this important area of social policy implementation.

    This project set out to gather examples of practice and work on the ground that contribute in a variety of ways to the prevention of suicide and deliberate self-harm, as well as to the improvement of mental health and well-being. It was considered important to ensure that further policy development was founded on recognition of the diversity and richness of existing activity in this area, which may not necessarily be explicitly identified as falling within the ambit of the Framework.

    The aims of the project were to:

    • complement the formal consultation on the Draft Framework

    • inform the further development of policy and its implementation

    • illustrate that the implementation of the Framework will build on a great deal of work already in place

    • indicate the part that a variety of agencies might have to play in this area of social policy implementation.

    The project focused on two areas of Scotland - the Scottish Borders and Edinburgh. Information was gathered on a selected range of projects and initiatives working with groups identified as potential high-risk groups in the draft Framework. The aim of the exercise was to provide an illustration of the range of work being undertaken rather than to provide a comprehensive data set.

    This extract presents a summary of the material gathered from the research. The services provided, and approaches taken, by each project are summarised in Tables 1 & 2 below, as are the target groups and issues facing project users. The key features of each project are also highlighted.

    Table 1: Edinburgh projects

    Project

    Target group

    Issues

    Services / approach

    Key features

    1. Be Well
    Craigmillar Health Project

    Local people

    Stress
    Anxiety
    Depression

    Counselling
    Group work, including men's group
    Drop-in
    Complementary therapies

    Community development
    Mutual support and volunteering
    Developing skills and self-confidence

    2. Time for Talking
    SAMH

    SAMH employees

    Personal and work related issues: e.g. stress, relationships, bereavement

    Short term free counselling (5 sessions)
    Longer term requires self funding

    Confidential
    Independent of employer

    3. Men in Mind

    Black and ethnic minority men with mental health problems

    Isolation
    Racism
    Cultural identity
    Risk of suicide

    support
    Group work
    Drop-in and user Forum

    Activities and interests to stimulate discussion and reduce isolation (drama, IT)
    'Mental health by stealth'

    4. Ward 1A, Edinburgh Royal Infirmary

    Toxicology inpatient care, patients referred (fast track) from A&E or the Royal Edinburgh
    Ages 16-65

    DSH, especially overdose
    Abuse
    Bereavement
    Relationships

    Full assessment
    Treatment
    Follow up support in community
    Training for staff in Community and A&E

    Opportunity to assess
    Time out for people, including to sober up in safe place
    Database of local resources for onward referral
    Good liaison with GPs
    Procedures in place to deal with regular attenders

    5. Wester Hailes Youth Agency

    Young people aged 8-25, living in W Hailes
    Vulnerable young people: 'low achievers'

    Lack of confidence
    Bullying, violence
    Coping with independence

    Adventure play
    Educational work in and outside school
    Prep for school leavers and college students
    Detached street work

    Mix of formal, structured and informal, ad hoc work
    Building communication skills and confidence
    Help with choices and transitions

    6. SACRO

    Ex offenders, more recently incl. Women

    Mental health
    Drugs and alcohol
    Anger and aggression
    Women esp vulnerable - abuse, DSH and depression
    Most young offenders have been in care

    Supported accommodation
    Hostel for young offenders
    Linking people in training and work opportunities
    Behavioural programmes, group and individual work

    Working holistically with an individual
    Get people settled, stabilised and work with them to build skills and self esteem

    7. Grass roots community work
    Church of Scotland

    Clubbers

    Hopelessness
    Loss of connections and community
    Disillusionment with club scene

    Building networks or resourceful friends and healthy structures

    Working within the club culture
    Helping build connections

    8. Stonewall

    Lesbian, gay, bisexual and transsexual young people

    Isolation and rejection
    Family relationships
    Identity
    Practical problems with housing etc

    support by phone and
    email
    Groups
    Drop-in
    Pen pals
    Practical social and emotional support

    Focus on issues of self acceptance in relation to gender and sexual orientation
    Hard to reach groups e.g. people with a disability are a priority

    9. Barnardos 16 plus

    Young people 15 1/ 2 to 21

    Self harm
    Drugs
    Abuse

    Practical and emotional support
    Drop-in

    Consistency - establish long term supportive relationships
    Develop problem solving skills

    10. Student Counselling Service, University of Edinburgh

    Students

    Anxiety and depression
    Smaller numbers with severe mental health problems
    Increasing number of students are self harming

    Assessment and brief counselling intervention
    Train other University staff and volunteers on Nightline

    Proactive campaign to promote awareness of service
    Ease of access, encourage early use
    Training for Wardens and Directors of Studies to identify problems at an early stage

    11. Nari Kallyan Shangho

    South Asian women and children

    Isolation
    Relationships
    Poverty
    Adapting to culture in UK

    Groups
    Support networks
    1-1 support

    Dedicated youth worker
    Training for health agencies
    Mutual support

    12. Lothian PCT Suicide Review Committee

    Review of suicide incidents among patients

    To identify learning points and improve quality of care

    Examination of cases - situation reviewed, meet with care team

    Reports to Clinical Governance: quality enhancement not blaming.

    13. Streetwork

    Young people and rough sleepers at risk on the streets
    People with 'too many needs' for most services

    Mental health
    Suicide and self harm
    Drugs and alcohol
    Homelessness

    Assertive outreach to make contact
    Detached work, on the issues that people want to address
    Small goal-directed steps, starting with basic needs
    Practical and emotional support

    Fluidity around structure
    Active engagement of people who other services do not reach
    Acceptance and tolerance
    Providing a sense of belonging

    Table 2: Borders projects

    Project

    Target group

    Issues

    Services / approach

    Key features

    14. Big River
    Turning Point Scotland

    People whose lives are affected by drugs

    Drugs
    Mental health
    Relationships
    Housing
    Many people have experience of suicide attempts or DSH

    counselling
    Drop-in
    Advocacy support and liaison with other services

    Continuity of support
    Harm reduction focus

    15. Health promotion
    NHS Borders

    Age groups and local communities

    Improving confidence and well being

    Work in schools
    Community health development in disadvantaged local area
    Health and exercise class for older people
    GP exercise referral

    Range of initiatives using community development and health promotion approaches

    16. Burnfoot Community School

    Pupils, families and community

    Peer relationships
    Self esteem
    Bullying
    Bereavement

    Drop-in for pupils
    Family work and home visits by school nurse
    Activity based groups

    Use of activity as basis for discussion of health and social issues
    Drop-in provides accessible information and advice

    17. Royal Scottish Agricultural Benevolent Institution

    People in rural occupations

    Isolation
    Loss of confidence
    Depression
    Relationship stresses
    Financial anxieties

    Helpline operated by volunteers (due to end) in response to Foot and Mouth crisis

    Loss of traditional community supports
    Impact of initial financial worries and increasing social isolation now being manifested as mental health problems

    18. Penumbra Youth Project

    Young people with mental health problems

    Social isolation
    Abuse
    Family relationships
    Self harm

    Drop-in several towns
    1-1 support on
    harm reduction
    Developing coping strategies
    Practical support with housing, training etc

    Self harm regarded as a choice people make
    Work with the whole person not just the self harming behaviour
    Allow time and space for person to talk about deeper issues when ready

      Page updated: Friday, June 24, 2005