Best practice checklist for suicide prevention at local

level

Stephen Platt University of Edinburgh

Police Scotland/HIS Strengthening Partnership Working to Support People at Risk of Suicide, Police

Scotland College, Tulliallan, 3 October 2016

Background

Key feature of Scotland’s approach to implementation of its suicide prevention: clear demarcation of responsibilities between national and local agencies

At national level NHS Health Scotland leads implementation of key aspects of the suicide prevention in partnership with a wide range of stakeholders (local and national)

At local level a nominated contact in each LA area has a key role in supporting the implementation of the local suicide prevention action plan

Towards a best practice checklist (1)

Substantial investment in producing evidence of interventions which are effective in reducing risk of suicidal behaviour

But little consideration of:

– which agencies in the suicide prevention ‘system’ should take the necessary action

– how agencies at different levels might monitor their contribution to the overall national suicide prevention effort

Given importance of local planning/delivery of services in Scotland, I have developed a ‘best practice’ checklist for self-evaluation of suicide prevention policy and practice at the local level

Towards a best practice checklist (2)

Tool based on international research evidence and practical experience

Intended to help local coordinators and members of the local community planning partnership assess: – whether key elements of suicide prevention planning, strategy and

action are in place in the LG area

– to what extent these conform to best practice and/or incorporate a commitment to evaluate effectiveness.

At present the tool consists of 18 questions, each of which is rated on a simple (but variable) three-point scale

Rating scale: interpretation

Mostly 2s Key elements of suicide prevention planning, strategy and action in place in the local area;

conform to best practice and/or incorporate commitment to evaluate effectiveness

Mostly 1s Key elements of suicide prevention planning, strategy and action in place in the local area,

but may not be evidence-based or subjected to evaluation of effectiveness

Mostly 0s Key elements of effective local suicide

prevention planning, strategy and action not in place

Checklist items

Items Areas

1-4 Strategic/planning issues

5-10 Actions/activities

11-13 Monitoring and review

14-18 Awareness and training

Completing the checklist

Checklist should be completed by person(s) with responsibility for coordinating/leading suicide prevention planning and action in local area

Coordinator may need to gather information from other team members or colleagues in partner organisations

Rating for each item should be supported by evidence

Validation and review of checklist findings

Coordinator should produce draft version of completed checklist to relevant colleagues for comment

Final version of checklist should represent an agreed collective understanding among members of local suicide prevention community

Final version should be used as learning tool

– To support critical reflection on achievements/challenges

– To plan future remedial action, where appropriate

Process should be repeated on annual basis

Checklist items: strategy/planning

1 Is there a strategic approach to suicide prevention in the local area?

2 Does the local area have a multi-agency suicide prevention group which plans and coordinates activity?

3 Are the financial resources available in the local area sufficient to support delivery of effective local suicide prevention action?

4 Are the human resources available in the local area sufficient to support delivery of effective local suicide prevention action?

Checklist items: action 5. Is there effective action to reduce the risk of suicidal

behaviour in known high risk groups (e.g. persons with mental illness, persons who have self-harmed, victims of violence/abuse) in the local area?

6. Is effective treatment and aftercare provided in primary care for persons who have self-harmed in the local area?

7. Is effective treatment and aftercare provided in secondary care for persons who have self-harmed in the local area?

8. Is there effective action to reduce harmful use of alcohol in the local area?

9. Is there effective support available to those bereaved or affected by suicidal behaviour (postvention) in the local area?

10. Is there effective action to reduce access to means of suicide, e.g. through ‘suicide proofing’ local areas of concern, in the local area?

Checklist items: monitoring/review

11.Is there a process for reviewing suicide deaths unknown to mental health services in the local area?

12.Is there monitoring of the characteristics and determinants of suicidal behaviour in the LG area?

13.Are monitoring data used to inform the development of suicide prevention strategy and action in the local area?

Checklist items: awareness/training

14 Is there effective action to raise awareness about suicide and self-harm, including risk factors and prevention, in the local area?

15 Is there a suicide prevention training programme targeted at gatekeepers in the local area?

16 Is there a suicide prevention training programme targeted at the general public in the local area?

17 Is there effective action to reduce public stigma relating to mental (ill-) health and suicidal behaviour in the local area?

18 Is there effective action to ensure that media in the local area report sensitively and responsibly on suicidal behaviour and avoid intrusion on those bereaved by suicide?

Table discussion

What’s your local suicide prevention infrastructure?

Consider a best practice evaluation checklist for suicide prevention in your local area