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choose life: A National Strategy and Action Plan to Prevent Suicide in Scotland

APPENDIX 4 THE DEVELOPMENT OF THE NATIONAL STRATEGY AND ACTION PLAN

1. THE DRAFT FRAMEWORK

Following the publication of the report of the conference, The Sorrows Of Young Men, held by the University of Edinburgh in 1999, the Scottish Executive embarked on a process to consult and develop ideas on what actions could be taken to address the rising rate of suicide in Scotland.

Two national consultative seminars were held in November 2000 and May 2001. These involved over 200 people from a wide range of backgrounds including health and social care professionals, service providers from both statutory and voluntary agencies, people who use mental health and other services, family members and those who have been directly affected by suicide, and others who have an interest in the prevention of suicide.

The result was overwhelming support for the development of a national strategic approach to suicide prevention that addressed not only suicide and its prevention as an important objective in its own right but which also took a more universal and combined approach to addressing a range of issues that affect people's mental health and well-being.

Following the first national consultative seminar, a National Planning Group was established to advise on the development of the draft framework. Members were drawn from statutory services, local authority, voluntary and user representative groups.

The members of the National Planning Group were:

The ideas put forward at the two seminars informed the development of a Draft Framework for the Prevention of Suicide and Deliberate Self-harm which was issued widely for formal consultation from October 2001 to January 2002.

2. COMMISSIONED WORK

In addition to the formal consultation process, the Scottish Executive commissioned further work from the Scottish Development Centre for Mental Health (SDC), namely:

• 'Exploring Experience': a series of discussions with the media, and with groups and services directly affected by suicide and self harm.

• 'Laying the Foundations: Identifying Practice Examples': a compilation of a range of practice examples using a variety of different approaches and client groups.

3. ANALYSING THE RESPONSES TO THE DRAFT FRAMEWORK

A detailed analysis was also carried out on the 140 written responses the formal consultation and a report produced by Scottish Health Feedback on behalf of the Scottish Executive. This report, together with reports of the work commissioned from SDC, which were published in July 2002, form a valuable resource and are available from the Public Health Division of the Scottish Executive and the Scottish Health on the Web (SHOW) web-site - www.show.scot.nhs.uk/sehd/mentalwellbeing

Key Points

From the main consultation exercise, the following key points emerged:

• The overall emphasis and approach advocated in the Framework was generally welcomed as a 'timely' and constructive way forward.

• There was enthusiasm for the notion of a shared responsibility and a multi-layered approach to prevention within the context of the promotion of health and well-being.

• A number of organisations offered their support to implement the framework.

• Respondents predicted problems with achieving the level of joint working required locally to implement the Framework.

• Tensions were highlighted concerning the degree of central direction versus local control and how commitment might be achieved across all agencies.

• It was felt that further consideration should be given to the role of voluntary and community providers, with additional consultation involving these bodies.

• There was a perceived neglect of the complex issue of deliberate self-harm (DSH) within the framework and respondents identified the need to distinguish more clearly between suicide and DSH.

• To overcome the challenges of collecting and sharing data on suicides and DSH and with measuring outcomes, the need for large-scale and long-term studies was stressed.

• Respondents acknowledged the resource implications arising from the proposed approach, given competing priorities and finite resources, as well as 'over-stretched' mental health services.

• The limitations of tackling the structural and organisational issues, rather than 'deeper alienation' and disaffection within society, were highlighted.

• To implement the Framework, respondents identified the need for 'dedicated resources' for: training and awareness-raising among staff; systems for dissemination of information and good practice; central co-ordination; and investment in developing joint information systems.

The extensive discussions, debates and research material accumulated throughout the process of developing this National Strategy have been invaluable in helping to shape the work. Thanks are due to all those agencies and individuals who have participated so willingly in the development process.

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