The Prevention of Suicide and Self Harm Task Group

1. The Prevention of Suicide and Self Harm Task Group Reference Group Meeting Thursday 8th December 2005

2. Bernie McNally Director of Children’s Services and Mental Health, North & West Belfast Health & Social Services Trust; Chairperson, Prevention of Suicide and Self Harm Task Group,

3. Growing public/community concern Evidence of high prevalence in N&W Belfast The need to work together to Raise awareness Lobby for resources Achieve “joined up thinking” Context

4. Suicide and Self Harm gets on DHSSPS agenda The Regional Suicide Strategy Group is set up Minister Shaun Woodward holds conference Local Initiatives through the 5 Working Groups of the Task Group Sharing Best Practice across Community / Voluntary / Statutory Sectors Developments

5. Ongoing ActionMargaret WoodsMental Health Promotion ManagerNorth & West Belfast Health & Social Services Trust

6. New Initiatives • Continuation of programmes/groups already started • Projects which work across organisations/agencies and promote joined up working

7. ASIST (Applied Suicide Intervention Skills Training) • emergency services, community groups, statutory staff • Change of Mind- Mental Health Promotion Group • Primary school art competition • Attendance at health fairs etc • Turn it around – All schools in N&W – evaluation • Young persons health conference- West Belfast • Suicide Awareness Support Group • “Reaching Out” booklet

8. S.A.F.E. (Safe Alternatives For Self harm) • Service Improvement Project (N&W and Mater Trusts) • The North & West Belfast Trauma centre • Support and services for those adversely affected by the troubles • Heads Away campaign - positive evaluation • Home treatment – emergency response • moving towards extending hours • Celebration of Life • (World Suicide Prevention day)

9. Forthcoming events • Memory Tree of Lights • Carlisle Circus 18th December 2005 • Self harm conference • March 2005

10. House in Duncairn Gardens • family groups benefiting from Art therapy • Employment of a senior admin worker to help co-ordinate work of PIPS and ASIST • Family support groups continue to develop across North & West locality • IFH monies • To establish neighbourhood response teams - North • To train more people as trainers in ASIST in West and Shankill areas, to enable neighbourhood response teams to be set up in these areas.

11. Developing an Integrated Approach Mary Black, HAZ Leader

12. Process of Developing a co-ordinated and integrated approach HAZ Council Task Group Working Group 1 Working Group 2 Working Group 3 Working Group 4 Working Group 5 Reference Group Timeframe: April 05 - March 06

13. Primary aim of the Task Group is to develop a co-ordinated and integrated approach to the prevention of suicide and self-harm in North and West Belfast (against an agreed timeframe) through: A Review of the evidence of effective intervention on an international, regional and local basis. An analysis of information in order to assess levels of need in North and West Belfast. Mapping existing practice and local initiatives currently underway/planned within North and West Belfast. Terms of Reference Task Group

14. Providing an opportunity to share information across agenciesand sectors, including the views of communities, families and young people in pursuit of a shared strategy and to drive forward change within those same sectors. The development of a local co-ordinated and integrated plan with reference to known effective interventions within an agreed timeframe to address key areas of need. Informing and influencing the development of a regional strategy for suicide and self-harm prevention. Terms of Reference Task Group

15. Ensure communication within the various strands of the strategy's development and ensure linkage with other relevant areas of development, including mental health service development, draft strategy for children and young people in Northern Ireland, Neighbourhood Renewal Strategy, victims and survivors of trauma and so on Contributing to the creation of a supportive climate for dealing with mental health needs and the issues of suicide prevention and self- harm. Provide a report to HAZ Council and the wider community on agreed Action Plan. Members of the Task Group will be committed to providing advice and support to staff working to co-ordinate an effective integrated response. 1st meeting May 24th 2005 Terms of Reference Task Group

16. Step 1. Progress Report to Reference Group (8 December) • Record of process • Research-quantitative and qualitative • Emerging recommendations from working groups • Action proposed for Local and Regional level

17. Step 2. Links to Regional Development • Input directly to Task Force and drafting of report • Commitment to prioritise families’ views (in particular families in North & West Belfast) • Presentation to Regional Task Force on: emerging recommendations (at local and regional level); proposed action from N&W HAZ • November

18. Step 3. Moving the process forward locally • Working Group reports complete by December 2005 • Briefing for politicians • Presentation to HAZ Council December 2005 • Draft Report for consideration by Task Group January 2006 (including actions required at region and North & West Belfast) • Submissions made to planning processes DHSSPS, EH&SSB, DE, BELB, DSD, NRS etc.

19. Step 4. Final Report March 2006 • Final Report agreed by Task Group and presented to Reference Group • 2.00-4.00pm 24 March 2006 • Next Steps Identified • Clear implementation plan - local and regional actions required • Agreed implementation process • Monitoring and Evaluation framework

20. In Conclusion: Significant progress Concerted effort for next period - timing is important Final report from working groups by end December 2005 Information flow Recommendations for action need to be Specific, Realistic and Achievable What actions are required at region and what actions can be taken locally?

21. Karl Tooher Self Harm Working Group

22. Membership Process of Working Evidence Reviewed Proposals for Action Resource Implications Conclusions Self Harm Working Group

23. Mapping Exercise Establish Pathways Leaflet / Literature Training and information resources Recommendations

24. Joe Barnes Family Support Working Group

25. Working Group activity Participation in Research Learning from existing practice elsewhere Call for a regional strategy Shift from medical model to social process Family Support Working Group

26. Joe McGinnity Schools Working Group

27. Background Schools Questionnaire Recommendations Staff development and support Services and Support for Pupils Schools Working Group

28. Moira Doherty Vulnerable Young People Working group

29. Evidence reviewed Community programmes Community/Statutory Partnership Voice of Vulnerable Young People Research / Survey Vulnerable Young People

31. Margaret Mulholland Communications Working Group

32. “The members of the Communications Sub Group of HAZ Suicide Task Group are aware of the immense responsibility in how we respond and discuss the issues of suicide in public. This becomes even more acute when addressing the community through the media, whether this is local newspapers, radio or television. We must constantly be aware of the balance between educating our community, raising the awareness of suicide and carrying this out in a way that will not influence anyone in taking their own life. Therefore, we work with all identified target audiences including the media in relation to suicide, it will be with the express intention of educating and informing and never to sensationalise or play a role in increasing the chances that a vulnerable individual may attempt or commit suicide”. (Developed by the Community Response Team) PRINCIPAL

33. Inform all target groups of the work of the HAZ Suicide Task Group Inform and influence the development of a Regional Strategy for suicide and self harm Contribute to the creation of a supportive climate for dealing with mental health needs Develop a Communications Strategy to support the Action Plan OBJECTIVES

34. HAZ Suicide Task Group Sub Group Members Staff from all Groups/Organisations on the Suicide Task Group LOCAL COMMUNITIES North; West; Shankill Young people 12 – 18 year olds Young people 18 – 30 year olds The 30+ age group are young gay men and women Bereaved families General public – in North and West and beyond KEY INFLUENCERS MLA’s/Councillors x area Health Spokesperson x party Advisors x party Minister for Health, Social Services and Public Safety Permanent Secretary; Department of Health, Social Services and Public Safety TARGET AUDIENCE

35. VOLUNTARY ORGANISATIONS SCHOOLS STATUTORY ORGANISATIONS TARGET AUDIENCE

36. TACTICS

37. The Needs of Families Bereaved by Suicide Margery Magee Research Consultant

38. Background Methodology Participants Bereavement history Research – families bereaved by suicide

39. Life events Educational aspirations Substance misuse Access to services Primary care Secondary care Adolescent services Counselling Family support Impact on family Stigma Parenting Awareness At time of death Emergency services Formalities Issues raised

40. Post bereavement General support Bereaved children Media Need for support and services Issues raised

41. Outline Proposal for Further Research Joanne Jordan Queen’s University Belfast

42. Providing meaningful care: learning from the experiences of suicidal men to inform mental health services

43. Aim: To obtain a comprehensive theoretical understanding of the experiences of suicidal men, aged 16-34, to underpin the provision of accessible, acceptable and appropriate mental health services Research Aim

44. Elicit the experiences of men, aged 16-34, of being suicidal and their understandings of what would constitute meaningful caring Uncover a theory-base that identifies the specific caring processes that might make a ‘difference’ to caring for the suicidal person i.e. that will inform what health care professionals can do day by day, hour by hour, minute by minute Research Objectives

45. Between 1999-2003, approximately 30% of all male deaths in the 20-34 age group were due to suicide Of the 143 deaths recorded as suicide or ‘undetermined intent’ in 2003, almost one-third (43/31%) were of men aged 15-34 A high percentage of people who die by suicide are or have been in contact with mental health services Why this research?

46. Consequently, need to address the issues relevant to this group of men as soon as possible, including in relation to the professional care they (can expect to) receive But, very aware of need for research relevant to other groups Overall aim is to pursue a programme of research focusing on suicide and self-harm Why this research?

47. Majority of research on suicide has focused on issues such as risk factors and causal links Use of quantitative methods Valuable in exploring the epidemiology of suicide but variation in research findings Much less attention paid to generating knowledge to improve the day-to-day, face-to-face care that vulnerable people receive What do we know?

48. Recent consensus acknowledges the need for qualitativeresearch to generate an understanding of: (1) The meaning of suicidal behaviour – the ‘whats’, ‘hows’ and ‘whys’ (and how this relates to) (2) The social processes involved in appropriate care-giving What do we need to know?

49. Two core principles: Shneidman (1997) “our best route to understanding suicide is not through the study of the structure of the brain, or the study of social statistics, or the study of mental diseases, but directly through the study of human emotions described in plain English, in the words of the suicidal person’ Guiding principles of the research

50. (2) There is nothing as useful as good theory… theory encompasses what and why A substantive theory, based on an underlying understanding of the social reality of suicide and its relief, allows practical knowledge to be generated regarding what may or may not be helpful Guiding principles of the research