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| Individual representatives, Sarah Dale & John Lilley |
by Lucy Taylor, PAVO Startwell Officer
On 30th June Powys Teaching Health Board launched the county’s new Suicide and Self Harm Forum at the Metropole Hotel in Llandrindod Wells. Led by Jan Roberts, Suicide and Self Harm Prevention Co-ordinator, practitioners from across the sectors gathered to discuss these important topics.
Hayley Thomas, Director of Planning & Performance at Powys Teaching Health Board, opened the day saying that suicide was everyone’s business. It should be treated like other big killers, and collective action is needed to shape a plan going forward. The new forum would consider prevention, tackle the stigma, identify the signs, early help and 24-hour support, the unique factors in Powys and ensure the equity of services across the county. Hayley also stressed the importance of listening to those with lived experience such as the speakers that followed.
Attendees heard from two contributors who had personal experience of the effects on family of suicide. They spoke of the support they received, or did not, and what they hoped Powys would offer going forward. Information for the families on what support is available to them, both immediately and in the months following a suicide, was high on their list of requirements. They said that it was crucial for all relevant organisations and services to have this information to enable them to be as supportive as possible of families at this time.
The personal experiences inspired those in the room to work on taking important next steps. Firstly, to make sure that if families should experience the suicide of a loved one then they would have the best possible support as soon as the suicide was discovered, and secondly, to take a reflective look at their own services and how they currently respond to such situations.
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| Angela Samata on being bereaved by suicide |
Strategy and guidance
Also contributing on the day were Clare Cotter - National Co-ordinator for Suicide & Self Harm Prevention with the NHS, and Laura Tranter - the Regional Co-ordinator, Mid & West Wales for Suicide & Self Harm.
It is hoped that an NHS executive for Wales will be set up by October 2022. The National Institute for Health & Care (NICE) guidance has been refreshed and Welsh Government’s strategic direction is that suicide is everybody’s business. The Talk to Me Suicide and Self Harm prevention strategy for Wales was originally published in 2008, and in 2015 Talk to Me 2 refreshed. This has 31 recommendations. The 6 objectives set out in 2015 are detailed below.
The strategy covers: prevention, the compassion needed, promoting anti-stigma and non-discrimination in communities, enabling help-seeking behaviour, and increasing confidence and skills in the workforce.
There was a listening exercise across Wales in 2021 about which the respondents spoke, highlighting:
The particular nature of bereavement by suicide and the need to have someone come alongside the bereaved as soon as possible to help with the practical challenges and emotional support.
- Support required for the inquest.
- Options for support and different needs.
- Help is at Hand (published in 2016) is a handbook for those who are bereaved by suicide or working with someone who has been.
In Powys there will be three workstreams to follow up this work – Suicide, Self Harm and Postvention. The aim of the self harm workstream will be to understand self harm in Powys. Currently the Minor Injury Units do not have a set pathway to manage self harm. In the last year 230 people from Powys attended 17 different hospitals, 50% of which were in England. 19 – 24 year olds said they were most likely to go to a GP. In September a survey on “Self Harm in Rural Areas” is planned for those 16 + to give feedback on their experiences of services.
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| Jan Roberts, Powys Suicide & Self Harm Prevention Co-ordinator |
Jan Roberts first wrote about her work of intelligence gathering and research into suicide in the county in a blog post last summer. Since then she has been analysing suicide data gained from 83 deaths by suicide between 2015 - 2019 in Powys. She discovered that an average of 33% of those who died were open to secondary mental health services in the 12 months prior to their death. The all Wales average is 23%.
The Postvention work (activities to support those bereaved by suicide to help with their recovery) will be done by the newly-established Powys Suicide Bereavement Project. Work started in 2021 with Postvention Assisting those Bereaved by Suicide training. The aim is to make the offer of support to people bereaved by suicide when they are notified about the death. That support will be provided, if required, within three working days of the suspected suicide. An open offer of support would remain available for up to three years, and repeated at regular intervals.
The new model will be reviewed regularly by partners and those with lived experience.
In the 2020 From Grief to Hope report from the Support after Suicide Partnership 23% of respondents were friends of the deceased and they and family reported that by the second anniversary everyone else had moved on.
Next steps
The next steps will be to gather data, on suicide, mental health and The Wales Applied Risk Research Network - a formulation-based technique for the assessment and management of serious risk (for example, violence to others and suicide) for users of mental health services. It has been gradually adopted as the risk evaluation and safety-planning technique for all seven health boards in Wales.
Other next steps include:
- Forming an immediate response group.
- To offer a police pack on available support.
- The assessment of resources.
- To further the Arts Strategy pilot project.
- To work with the third sector to create effective and sustainable provision across Powys.
- To establish clear interfaces with third sector provision across Wales, for example, the Jac Lewis Foundation.
The forum then mapped the current provision in Powys against the Welsh Government report – Talk to me 2 which was the basis of the Suicide and Self Harm Prevention Strategy for Wales 2015 - 20 that is being refreshed.
- Further improve awareness, knowledge and understanding of suicide and self-harm amongst the public, individuals who frequently come in to contact with people at risk of suicide and self-harm and professionals.
- To deliver appropriate responses to personal crises, early intervention and management of suicide and self–harm.
- Information and support for those bereaved or affected by suicide and self-harm.
- Support the media in responsible reporting and portrayal of suicide and suicidal behaviour.
- Reduce access to means of suicide.
- Continue to promote and support learning, information and monitoring systems and research to improve our understanding of suicide and self-harm in Wales and guide action.
The forum went on to comment on different aspects of the plan and contribute their ideas and experience to the conversations.
The meeting was pulled together with promises that participants would take the work forward and share information. PAVO promised to facilitate a meeting of the third sector to discuss the support the sector offered and the strategic plans.
Watch this space for further updates.
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| Kirsty Williams, Vice Chair - Powys Teaching Health Board, makes the closing remarks |
Meanwhile, you can read “Safety Advice for Parents & Carers in relation to Self Harm & Suicide”, as recently published by the Child & Adolescent Mental Health Services’ team at Powys Teaching Health Board, in English and Welsh.
And Bereaved by Suicide Support on the Powys Teaching Health Board website.
Thank you to Powys Teaching Health Board for use of some photographs of the day.
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