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choose life: A National Strategy and Action Plan to Prevent Suicide in Scotland
3. Action Plan
3.1 INTRODUCTION
National Actions
The Scottish Executive will establish a new National Action Plan Implementation Steering Group and a new National Implementation Support Team. These will give leadership, co-ordination, focus and drive to the implementation and monitoring of national actions and provision of support to local areas in developing and implementing their local plans.
Key aspects of the National Implementation Support Team's role will be to:
establish and support a national
Support and Learning Network involving local agencies;
collect and disseminate information on practice, evidence and research findings and training programmes;
support the development of a national data set of indicators, figures and trends on suicidal behaviour and completed suicide;
support the commissioning of additional research work on suicidal behaviour; and
commission a detailed independent evaluation of the national strategy and action plan to report by March 2006.
Over the next three years (2003-2006), the Scottish Executive is committing 3 million to support and complement national actions.
Local Area Actions
Each local authority area will be expected to produce a detailed local suicide prevention action plan by the end of 2003 which should take into account the seven key objectives and the priority groups identified in this strategy and action plan (and any other additional priorities determined by local circumstances). This local plan should form part of the local joint Health Improvement plans and be part of the local community planning process. These local action plans should be completed by December 2003.
Included in these local action plans should be investments to support local actions and implementation, including the investments and supports to local voluntary and community- based organisations and local training programmes.
To help support the development and implementation of local action plans and improved local co-ordination, the Scottish Executive will allocate 6 million over the next three years across the 32 developing community planning partnerships. Further guidance on these monies, which will be for local links and co-ordination, will be provided shortly.
To support and encourage the development of more innovative local voluntary, community- based and self-help initiatives that address suicide reduction and prevention in local communities, and to support the development of local training programmes, the Scottish Executive is making available 3 million over the next three years in a Local Innovation and Training Support Fund. Further guidance will be issued shortly on this fund.
3.2 THE SEVEN OBJECTIVES
OBJECTIVE 1: EARLY PREVENTION AND INTERVENTION
Providing earlier intervention and support to prevent problems and reduce the risks that might lead to suicidal behaviour by:
Nationally:
Locally:
developing local awareness raising work and supporting local links to the National Programme and NIST
improving earlier identification of people at risk of suicidal behaviour through local work by agencies and organisations (including local training programmes on early identification)
developing accessible local responses that provide support and care to people with mental health problems and, in particular, developing improved capacity to identify and respond to potential suicidal behaviour in primary care (by health, social care and voluntary organisations)
ensuring that early identification and early effective interventions are identified and appropriate actions initiated for all 'at risk' groups, for example, young people, looked after children, young offenders
encouraging effective support to people who experience significant emotional and psychological distress and mental health problems, for example, depression and anxiety
These will require local action to:
continue the emphasis on integrated working between health and social care professionals (both mental health and general health services) including an increased ability to liaise and work with people from a range of other agencies in particular, education, police, prisons and community and youth workers
train staff in local agencies in early identification, assessment of risk factors, risk assessment and management, awareness raising and promotion
ensure effective and integrated working between health professionals, social care, education and youth workers in identifying and responding effectively to young people's mental health and psychological needs
provide additional support to, and investment in, the efforts of local community groups, local voluntary sector agencies, self-help groups and others.
OBJECTIVE 2: RESPONDING TO IMMEDIATE CRISIS
Providing support and services to people at risk and people in crisis, to provide an immediate crisis response and to help reduce the severity of any immediate problems by:
ensuring continued action to provide good local crisis services and enhanced awareness of appropriate services and points of contact at times of crises
ensuring quick and easy access to help and support when required, particularly in times of crisis, through contact points such as phone lines, helplines and 24-hour crisis services
ensuring provision of sensitive, sympathetic and appropriate responses from those who deal with suicidal behaviour in crisis situations, for example, ambulance staff, police, prison staff, health and social care professionals and others, and the effective liaison between agencies and professionals in responding to crisis situations
enabling early identification and assessment of those at risk, with immediate onward referral to appropriate services and supports
providing knowledge, information and understanding to those people who are feeling suicidal and to those who care for them, thereby providing more effective response and crisis management interventions
ensuring that the physical environment of health and social care facilities (particularly mental health services facilities) and amenities minimise the risk of suicide
ensuring effective implementation of recommendations from inquiries and Critical Incident Reviews.
OBJECTIVE 3: LONGER-TERM WORK TO PROVIDE HOPE AND SUPPORT RECOVERY
Providing on-going support and services to enable people to recover and deal with the issues that may be contributing to their suicidal behaviour by:
Nationally:
Locally:
ensuring the provision of appropriate support, counselling and psychological services from trained professionals
ensuring appropriate and effective follow-up arrangements are in place to maintain contact and support in the community for people discharged from psychiatric in-patient care, those released from prison and others
ensuring the delivery of effective local services and supports and effective liaison between services, for example, between general hospitals and local psychiatric and mental health care services, local social work and voluntary agencies, primary care services and substance misuse agencies and services and links with criminal justice agencies (particularly prisons)
developing effective interventions to support people who are affected by suicidal behaviour and completed suicide in both the short and medium term
continuing development support groups for those affected by suicidal behaviour and completed suicide.
OBJECTIVE 4: COPING WITH SUICIDAL BEHAVIOUR AND COMPLETED SUICIDE
Providing effective support to those who are affected by suicidal behaviour or a completed suicide by:
providing appropriate support, counselling and services from trained professionals for families and others affected by suicidal behaviour or a completed suicide
developing effective interventions by services to support people (friends, families, colleagues, people providing services and others) who are affected by a suicide in the short and medium term
developing local support groups and self-help groups for those who have suffered the loss of someone through a completed suicide
identifying, within local plans, the role of local agencies in ensuring an effective and integrated response to support organisations and institutions, such as schools, in the event of a completed suicide by, for example, a school pupil. This will require proactive planning by health, social work and education authorities and others.
OBJECTIVE 5: PROMOTING GREATER PUBLIC AWARENESS AND ENCOURAGING PEOPLE TO SEEK HELP EARLY
Ensuring greater public awareness of positive mental health and well-being, suicidal behaviour, potential problems and risks amongst all age groups, and encouraging people to seek help early by:
continuing to promote greater awareness of mental health issues both nationally and locally. At a national level this will be achieved through the National Programme to Improve the Mental Health and Well-Being and other linked programmes, initiatives and efforts. Locally, this will be achieved through local awareness-raising work
developing and implementing action to encourage people with mental health problems to seek help and support particularly those amongst priority groups
continuing the development and roll-out of the 'see me' national anti-stigma and anti-discrimination campaign at a national level and providing support to the development of local anti-stigma and anti-discrimination work
supporting the work of local agencies and groups in tackling stigma and discrimination associated with emotional and mental health problems in a range of settings including schools, workplaces and community settings.
OBJECTIVE 6: SUPPORTING THE MEDIA
Ensuring that any depiction or reporting by any section of the media of a completed suicide or suicidal behaviour is undertaken sensitively and appropriately and with due respect for confidentiality by:
Nationally:
developing and promoting guidelines, based on national and international evidence, for a 'code of conduct' on the depiction and reporting of suicide by local and national media to encourage informed and sensitive reporting of suicide
continuing to develop appropriate training and awareness raising initiatives for those working in, or with, the media
Locally:
OBJECTIVE 7: KNOWING WHAT WORKS
Improving the quality, collection and availability of information on issues relating to suicide and suicidal behaviour and on effective interventions to ensure the better design and implementation of responses and services and use of resources by:
Nationally:
establishing and maintaining the Public Mental Health Resource Service as an authoritative source of information and guidance on effective interventions in suicide prevention and supporting people who self-harm
establishing national and local indicators on suicidal behaviour, the incidence of completed suicides, self-harm and other 'at risk' factors to enable monitoring of national and local trends and progress, and identifying areas for improved action and support
continuing the development of an effective national database on mental health information through support for the on-going work of the Information Systems Division of the Commons Services Agency and the Office for National Statistics
commissioning research to improve understanding of the risk factors for suicide and suicidal behaviour, through secondary analyses of existing data, and undertaking systematic reviews and large-scale analysis of the effectiveness of interventions to prevent suicide, both at population level and among high-risk groups; supporting new research to determine whether those interventions identified as promising from existing research literature can be successfully implemented in Scotland
establishing links with research programmes on suicide prevention in other parts of the UK, Europe and Internationally and producing regular research bulletins and updates on findings.
National Leadership, Co-ordination and Support for Local Action The Scottish Executive will: establish a new National Action Plan Implementation Steering Group comprised of representatives from all Scottish Executive departments responsible for ensuring effective links between Scottish Executive policy initiatives that will contribute directly and indirectly to suicide prevention, as well as overseeing the national implementation of the strategy establish a new National Implementation Support Team (NIST) responsible for driving forward the strategy and action plan nationally and for supporting local work.
The NIST will: develop and maintain a pro-active support network for local alliances to ensure the effective sharing of information and experience on local work, effective interventions, good practice and successful local initiatives hold an annual cross-Ministerial Summit for all interested practitioners from statutory and voluntary agencies and alliances, family and support groups, to provide national focus and attention on progress being made towards the implementation of the National Strategy and Action Plan appoint a Clinical Advisor to support local services in complying with, and implementing, good practice guidance in services work with colleagues across the Scottish Executive and associated agencies such as NHS Quality Improvement Scotland, Mental Welfare Commission for Scotland, the Scottish Commission for the Regulation of Care, and other interested monitoring and inspection bodies to ensure that the actions which services take, in identifying and minimising risk among their client groups, are identified and effective interventions identified and promoted be responsible for the implementation of objective seven of this National Strategy and Action Plan put in place arrangements through the Performance Assessment Framework (PAF) for NHS Boards and other current monitoring arrangements to ensure effective performance management of the National Strategy and Action Plan * evaluate the National Strategy and Action Plan at regular intervals by measuring its impact in assisting to develop and promote effective responses, in addition to monitoring trends in suicide and self-harm. An initial detailed evaluation report on the first three years of the strategy will be prepared by March 2006 to guide future work.
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