Call to Action for Suicide Prevention in England - Samaritans

Call to Actionfor Suicide Preventionin EnglandEvery life lost to suicide is a tragedy.If we work together, suicide can be prevented.Call to Action for Suicide Prevention in England1

The Call to Action brings together over 50 nationalorganisations. This is the first time we have allcommitted to work together and deliver real actionto reduce the risk of suicide.2 Call to Action for Suicide Prevention in England

Call to Action for Suicide Prevention in EnglandContentspageForeword by Catherine JohnstoneSamaritans CEO, Chair of the Call to Action steering group 4Call to Action overview 5Collective commitmentsStatement of principles 9Partner organisations 10Shared aims 12Individual commitments from Call to Action members 13Testimonials 22Call to Action for Suicide Prevention in England3

Foreword:Catherine JohnstoneCEO SamaritansMore lives are lost to suicidein England than to road trafficaccidents each year with over4,200 suicidal deaths recordedin 2010. 1 The effects of thesesuicides are often felt in the widercommunity and in particular, bythose who have had their livesshattered by the loss of a lovedone. Each and every suicide isa tragedy, and one that has adevastating effect on friendsand families.Samaritans works hard to supportpeople who are struggling to copeand experiencing feelings whichmay lead to suicide. Accordingto research evidence, the risk ofsuicide in the whole populationincreases when we collectivelyexperience times of financialdifficulty, so it is vital that activityto support suicide prevention ismaintained as a priority over thenext few years.The risk factors that contributeto suicide are wide-ranging andcomplex, so the task of preventingsuicide requires action from all partsof society and across organisationsfrom the public, private andvoluntary sectors. It is a task we allhave a duty to address.The Call to Action brings togetherover 50 national organisations.This is the first time we haveall committed to work togetherand deliver real action to reducethe risk of suicide. Among thetangible and credible objectiveswe have set are: to improveaccess to services, by makingsure local and national informationis easily available; to developstrategies to encourage helpseekingbehaviours amongstboth ‘high-risk’ groups and thewhole population; and to createmechanisms to make sure thatpeople in distress have increasedoptions for support and aregiven information in a clear andconsistent way.Thank you all for taking part.Suicide is usually the resultof a complex set of issues insomeone’s life. It is crucial thatwe continue to work together anddeliver on our shared objectivesremembering that most peoplewho attempt suicide do not wantto die; they want to end the painthey are suffering.Together we can make adifference.Yours sincerely,Catherine JohnstoneChair of the Call to ActionSteering Group...the task ofpreventing suiciderequires action fromall parts of society andacross organisationsfrom the public, privateand voluntary sectors.1. Office for NationalStatistics (2012),Suicide rates in theUnited Kingdom,2006 to 2010.4 Call to Action for Suicide Prevention in England

Key messagesPurpose of the Call to ActionIn England, a person dies every two hours by suicide.There are over 4,200 deaths by suicide each year. Morelives are lost to suicide than to road traffic accidents. 2The Call to Action has been shaped by what stakeholdersbelieve is important. The achievements of the Call to Actionare strongly dependent on the will and commitment ofstakeholders to take action and to work together.The Call to Action:• Engages national organisations so that together eachorganisation or agency plays their individual role inreducing suicide.• Seeks to achieve real change by prioritising a few of themost important issues to focus our joint energies on.• Recognises the good work already underway and helpsstakeholders share and coordinate activity.• Makes us all more accountable for what we havepromised to do because we have publicly stated ourcommitment.2. Office for NationalStatistics (2012),Suicide rates in theUnited Kingdom,2006 to 2010.Call to Action for Suicide Prevention in England5

Key messagesWhat is the Call to Action forsuicide prevention?Who is involved?The Call to Action consists of nationalorganisations from across the public, private andvoluntary sectors in England taking action so thatfewer lives are lost to suicide and people bereavedor affected by a suicide receive the right support.Suicide prevention requires action by manystakeholders from across all sectors, becausesuicidal behaviour is related to so manyvaried factors.In Preventing suicide in England: A cross-governmentoutcomes strategy to save lives, the Governmenthas set out its overall objectives to reduce suicideand improve support for those bereaved or affectedby suicide. The strategy sets out the Government’scommitments to take specific actions to supportdelivery of those objectives. The Department of Health,as the cross-government lead on suicide preventionand a signatory to the Call to Action, will overseeimplementation of the strategy. However, achieving theobjectives will depend on a wide range of organisationstaking co-ordinated action, nationally and locally.The Call to Action complements this new strategyand brings together national organisations with theoverarching aim of successfully supporting those at riskof suicide, reduce suicide and support people affectedby a suicide.The Call to Action includes over 50 nationalorganisations. Suicide is usually the result of acomplex set of issues in someone’s life. The riskfactors are wide-ranging and complex, so the taskof reducing suicide requires action from all parts ofsociety and across organisations from the public,private and voluntary sectors.A Call to Action steering group has been createdfrom interested stakeholders. This group bringstogether the work of all five working groups and willhelp to meet the intention of delivering against theagreed aims. If you haven’t been involved in the Callto Action thus far and would like to work togetherwith other organisations to reduce the risk of suicide,please contact the Call to Action coordinating team oncalltoaction@samaritans.org.6 Call to Action for Suicide Prevention in England

What are the continuingaims of the Call to Actionfor suicide prevention inEngland?• To raise awareness of the issue ofsuicide amongst national and localorganisations and agencies who mayinteract with people in distress or whohave a role to play in reducing suicide.• For national organisations to publicallyshow their commitment to suicideprevention by playing an active andongoing role in Call to Action activities.• To enable stakeholders to map theaction they are currently undertakingto reduce suicide or support thoseaffected by suicide, to be recognisedfor this work, to understand the workof others and to consider how wecollectively may wish to coordinatefuture action.• To review the priorities that Call toAction stakeholders believe will make areal difference to reducing suicide andsupporting people affected by suicide;and to continue to mobilise action toaddress these priorities.How does this link to the deliveryof shared aims within the Call toAction?The shared aims have been developed bystakeholders working together. Since the firstworkshop held in November 2011, a total ofthirty-three areas have been identified where itwas felt action was needed. Working groups werethen established around five themes (referralsand signposting, campaigns, data and research,training and the online environment). These groupsare comprised of stakeholders with an interest in aparticular area(s) and the capacity to dedicate timeand resource to progressing them.Shared aims across the five areas have been shapedby what Call to Action stakeholders consider to bemost important in reducing the risk of suicide andimproving support to those bereaved by suicide. Theworking groups will continue working as far as possibleto deliver the aims in their area, and will keep allstakeholders updated on progress.Call to Action for Suicide Prevention in England7

Key messagesHow will progress within the Callto Action for suicide prevention inEngland be tracked and monitored?Participating in the Call to Action for SuicidePrevention in England is an on-goingcommitment. The five working groups – referralsand signposting; training; data and research;campaigns and the online environment, togetherwith the Call to Action steering group, will meetbi-annually to formally discuss progress on theshared aims. In the interim, smaller working partieswill continue to meet in person and/ or virtually inorder to deliver progress in particular areas.Suicide prevention requires action by manystakeholders because suicidal behaviour is related toso many variable factors. The Call to Action workinggroups are a real, working network that seek to deliveragainst the agreed aims. This long-lasting activity isnecessary to achieve real progress. The steering groupwill pull together the work of all stakeholders and offersupport and guidance to progress our shared aims.The regular review of our shared aims and the progressmade against them will ensure that stakeholderscan assess how well we are working together. Thecommitment to our shared principles will ensure that inaddressing our collective priorities, we are able to usethe most effective approaches in order to make a realdifference to reducing suicide in England.What is the ongoing benefit ofbeing involved in the Call to Action?Suicide is about people’s lives. Death by suicidemeans lost life, lost talent, a lost mother orfather, brother or sister, son or daughter, partner,friend or colleague. This is a wound that doesnot easily heal in families and communities. Inorder to help vulnerable people at risk of suicideand people affected by a death by suicide, weneed collaboration, coordination and action fromstakeholders across all sectors.The Call to Action has involved partner organisationsbeing able to:• Be at the centre of the action to reduce suicide• Showcase and be recognised for the good workcurrently underway• Build relationships with other organisations• Potentially take part in new initiatives going forward• Draw attention to the challenges and barriersexperienced• Influence other organisations to take action• Be part of making a difference.8 Call to Action for Suicide Prevention in England

Partner organisations10 Call to Action for Suicide Prevention in England

OpenMindsCall to Action for Suicide Prevention in England11

Shared aimsCall to Action for Suicide Prevention in EnglandWe are working towards thefollowing shared aimsHow these aims may be deliveredPeople in distress have increased optionsfor support and are given information in aconsistent way.Increased sharing of best practice, learningand partnership working between all agencieswith an interest in suicide reduction activitiesor that play a role in reducing vulnerability tosuicide.Better access to and take up of suicideprevention training.Better, more accessible data relating tosuicide prevention.Improving access to appropriate services thatprovide effective interventions by ensuringeasily available local and national information.Improved help-seeking behaviours amongst‘high-risk’ groups and the whole population.Learning lessons from the response to asuicide to reduce the number of futuresuicides and better support bereaved families.• Shared best practice document on signposting.• Record signposting agreements.• Detailing effective pathways of possible ‘follow-up’care for presenting people.• National suicide prevention forum.• Local suicide prevention forums.• National annual suicide prevention conference.• Mapping and evaluation of available training.• Call to Action stakeholder-endorsed list of trainingproviders/ programmes.• Shared engagement plans for the Office of NationalStatistics and the Office of the Chief Coroner/Coroners.• Review of suicide websites/ forums to betterunderstand the online landscape.• Online portal resource.• A shared suicide prevention communicationcampaign.• Joined-up outreach activities targeting ‘high-risk’groups.• More education on emotional well-being and goodmental health as an early intervention.• Engaging people with lived experience ofbereavement by suicide.• Structured formal support provided to familiesbereaved by suicide.• Applying the lessons learned at local and nationallevels.12 Call to Action for Suicide Prevention in England

Individual commitmentsfrom Call to Action membersThe Call to Action placesthe person at its centre.Suicidal feelings andbehaviour usually result frommultiple issues in someone’slife, and can be relatedto many different factorsincluding demographics,social issues, settings ortimes of crisis in a person’slife. There are manypossible points of contactwith someone at risk, anda vulnerable person mayneed help and support fromseveral different sources.The Call to Action has given national stakeholdersacross all sectors the opportunity to identify andprioritise action to support those at risk of suicide,reduce the number of deaths by suicide andsupport those affected by suicide.To inform the Call to Action, a number of nationalstakeholders shared information on their currentactivities, the types of challenges they have faced,and what their priorities for action are within thecontext of limited resources.The British Association Of SocialWorkers (BASW)What we do:• Support social workers working in mental healthsettings, when supporting those facing distress andwho may be at risk of suicide.What we aim to do:• Support our members when they are confronted byissues around suicide.• Work with our members to promote goodpractice and respond to any government or otherconsultations. Continue to attend the all-partyparliamentary group (APPG) on suicide prevention.• Pressure employers so that social workers canpractise offering emotional support effectively.How we would like to work with others:• Promote good practice among everybody workingwith people who are at risk.• Draw attention to the effects of recession and thesuicide rate by targeting policy formers and thosewho influence and fund the work of all organisationsin this field.• Publicise the good work that is taking place via ajoint campaign and raise questions as to why this isnot the case all over the UK.Call to Action for Suicide Prevention in England13

ChildLine/NSPCCFamily LivesWhat we do:• We offer 24-hour support via helpline, live online chator email to children and young people presentingas suicidal or with issues of loss or bereavement.Young people can also support each other on ourmessage boards.• We train our staff and volunteers in suicideintervention.What we aim to do:• Increase telephone helplines and online services.• Engage in partnerships with related services,promote our services and set up processes fortransferring calls between services.• Commission programmes aimed at improvingaccess to services for vulnerable children and youngpeople.• Maintain statistics on contacts from children andyoung people with suicidal ideation. Continueinternal and external research to keep practicesevidence-based and up-to-date.How we would like to work with others:• Train all professionals working with vulnerable youngpeople in suicide intervention (such as ASIST) andgive professionals and parents general informationabout how to recognise signs and support children.• More immediate access to mental health/supportservices for children and young people showingsigns of depression.• A consistent approach to recording child suicidesacross the UK.• Share more research into the effectiveness ofdifferent intervention models.What we do:• We listen to individuals in families in the short-termor long-term via helpline, email and online chatto identify what help they feel they need and tosignpost them to other sources of help.What we aim to do:• Build awareness of the challenges of family life,encourage people to seek help and promote FamilyLives as the confidential service, which can supportevery family problem, however big or small.• Work with individuals and communities to providesupport and advice.• Become the first point of contact and reducestatutory service requirements.• Strengthen our partnerships with otherorganisations.• Signpost to organisations and receive signposting.How we would like to work with others:• Easy access to support services.• Ensure best practise across the sector.• Lobby national and local government for adequatefunding for services.16 Call to Action for Suicide Prevention in England

Farm Crisis NetworkFriends, Families and TravellersWhat we do:• We provide a telephone helpline and face-to-facebefriending service for stressed farmers, farmworkers and their families in difficult times andthrough bereavement.• Our volunteers work with those experiencingsuicidal feelings and look at the risks and discoverprotective factors. We also raise awareness moregenerally in the population about the issues facingfarmers, farm workers and their families.• We work with two other farming help organisations(RABI and the Addington Fund) to provide possiblesolutions to the issues which affect farmers andaccept third-party referrals from other agencies.What we aim to do:• Raise awareness about the stress involved infarming.• Raise awareness of suicide risk and the measuresvolunteers can take to mitigate it.• A confidentiality policy enables volunteers to call forassistance for those who are at risk of suicide.How we would like to work with others:• Raise awareness of the specific needs ofoccupational groups such as farmers.• Establish ‘suicide` first aiders’ in organisations.• Roll out the SATS education programme being usedin the Eastern region.What we do:• We work towards a more equitable society whereeveryone has the right to travel and to stop withoutconstant fear of persecution because of theirlifestyle.• We respond to the needs of the community as awhole, support Gypsies and Travellers to accessmainstream mental health services and make surethe services are culturally appropriate throughbespoke training, informal consultations and writtenmaterials for practitioners.• We also provide wellbeing materials onbereavement.What we aim to do:• Emphasis on housing, health and the outcomes foryoung people.• Not to underestimate the mental impact ofconstantly being on the receiving end of racism.How we would like to work with others:• Address the social determinants that cause suicide.• Address the emotional impact of racism.• Target men’s mental health.Call to Action for Suicide Prevention in England17

Judi Meadows Memorial FundJames Wentworth-StanleyMemorial FundWhat we do:• We help save lives threatened by suicide throughresearch that builds awareness and improves policyand practice. We collaborate with existing mentalhealth charities, academics and campaigningindividuals.What we aim to do:• Provide £150,000 in funding for two researchprojects, reporting back in Dec 2012:– Dr Ann Adams, University of Warwick –Implementing the GRiST clinical decision supportsystem within primary care and the community, toimprove detection and management of suicide riskamongst depressed patients.– Professor Keith Hawton, University of Oxford –Systematic review of risk factors for suicide in peoplewith depression.• Determine how we can actively address issues ofdata collection, coroners and families bereaved bysuicide. Collaborating with other charities towardspositive change in policy and practice.How we would like to work with others:• Health professionals training.• Productive use of data collection, including the fullcircumstances surrounding a person’s death.• Genuine collaboration, without duplication of effort.What we do:• We raise awareness of anxiety, depression andsuicide amongst young people and raise moneyfor research, training, and prevention in the area ofdepression and suicide.• We are currently collaborating with other charitiesand trusts/funds to significantly reduce the numberof deaths, particularly in young men.What we aim to do:• Fund research with SANE to help identify individualsmost at risk of suicide.• Fund training workshops for Counsellors andPsychotherapists in Primary Care (CPC) to helpspread the latest, most effective methods of suicideprevention and risk assessment.• Work with CALM to help expand its campaigntargeted primarily towards young men.How we would like to work with others:• Encourage mandatory training for NHS staff incontact with self-harming or suicidal patients.• Raise awareness of suicide as a major health issue,particularly in young men, and reduce stigma.• Improve facilities for high-risk groups within our localcommunities.18 Call to Action for Suicide Prevention in England

SamaritansYoungmindsWhat we do:• Samaritans is a confidential emotional supportservice for anyone in the UK and Ireland.• The service is available 24 hours a day for peoplewho are experiencing feelings of distress or despair,including those which may lead to suicide.• Volunteers offer support by responding tophone calls, emails, text-messaging and letters.Alternatively people can drop in to a branch to havea face-to-face meeting.What we aim to do:• To alleviate emotional distress and reduce theincidence of suicide feelings and suicidal behaviour.• Being available 24 hours a day to provide emotionalsupport for people who are experiencing feelings ofemotional distress or despair, including those whichmay lead to suicide.• Reaching out to high risk groups and communitiesto reduce the risk of suicide.• Working in partnership with other organisations,agencies and experts.• Influencing public policy and raising awareness ofthe challenges of reducing suicide.How we would like to work with others:• Working in partnership to explore means of bettersupporting vulnerable people within an onlinecontext.• Working in partnership to provide a wider rangeof services to better support those bereaved bysuicide.• Continuing to explore opportunities for working inpartnership with national stakeholders e.g. NetworkRail and ChildLine.• Continuing to provide secretariat services for the Callto Action membership and All-Party ParliamentaryGroup for Suicide Prevention and Self-harm.What we do:• We support people at risk of suicide and reducedeath by suicide through various services andactivities that improve mental health services, raiseawareness about the importance of mental healthamong children and young people, and improveoutcomes for children and young people. Weactively campaign and influence policy, producepublications and are involved in research.What we aim to do:• Work with schools to improve outcomes forchildren and young people with social, emotional orbehavioural difficulties.• Feed into government consultations, and monitorthem.• Continue the Very Important Kids project nationallyand regionally.• Expand our Parents Helpline, and provide moreonline support.• Campaign on the effect of funding cuts on child andadolescent mental health services, on the provisionof mental health support for under 18s in the justicesystem, and on implementing the Mental HealthStrategy.• Research the relationship between mental healthservices and whether lack of provision exacerbatesoffending behaviour in young people in contact withthe justice system.How we would like to work with others:• Promote mental health and emotional wellbeing ofall children and young people.• Reduce stigma.• Provide effective, easily accessible and acceptablemental health services for children and youngpeople.Call to Action for Suicide Prevention in England21

TestimonialsMental health problems are common, and if left untreated, canbe a serious threat to a person’s life. We need joined up, evidencebased treatment (interventions) for these illnesses, just like we have forphysical diseases like cancer, heart disease and diabetes.People who experience anxiety and depression often use alcoholor drugs to relieve their symptoms. We need to have a much betterunderstanding about the reasons for this and not let substance misusebe a barrier to accessing mental health services.It’s important that parents and teachers emphasise theimportance of good emotional health and that our children areencouraged to talk about their feelings. This is especially importantfor boys because our society still seems to foster the idea that it is‘unmanly’ for men to show (talk about) their emotions. Young menespecially need to understand that emotional feelings have to have asafe outlet and to know that it is OK to cry.Pamela White, bereaved motherResearch shows that people bereaved through suicide are more likelyto develop mental health problems and are at an increased risk ofsuicide. It is therefore vital that they are well supported.Research has also shown that for every suicidal death 6 – 8 people areintimately affected.Mental health promotion in general should be a key priority in tacklingbereavement issues. There is a need for much more work to teachmen and boys coping strategies for dealing with life’s difficultiesand emotional problems and ensure that they have the knowledge, skillsand confidence to access support services when needed.Mike Bush, bereaved son and mental health consultant22 Call to Action for Suicide Prevention in England

Samaritans Registered OfficeThe Upper Mill, Kingston Road, Ewell, Surrey KT17 2AFT 020 8394 8300, F 020 8394 8301www.samaritans.orgPatron: HRH The Prince of Wales. Founded in 1953 by the late PrebendaryDr Chad Varah CH CBE. A charity registered in England and Wales no.219432, in Scotland no. SC040604 and no. SC009843, and in Ireland no.CHY11880. Incorporated in England and Wales in 1963 as a company limitedby guarantee no. 757372, and in Ireland no. 450 409.Call to Action for Suicide Prevention in England23

The Call to Action has beencoordinated by Samaritans onbehalf of partners from acrossthe public, private and voluntaryand community sectors.Every suicide is a tragedy.Together we can make a difference.For more information on the Call to Action for SuicidePrevention in England and details for partner organisationsplease contact calltoaction@samaritans.orgCoordinated byIn collaboration withpartner organisations24 Call to Action for Suicide Prevention in England