In September 2019, the National Institute for Health and Care Excellence (NICE) published new guidance for Suicide Prevention (Quality Standard 189).
This quality standard covers ways to reduce suicide and help people bereaved or affected by suicide. It describes high-quality care in priority areas for improvement by the outlining of 5 quality statements:
Statement 1 Multi-agency suicide prevention partnerships have a strategic suicide prevention group and clear governance and accountability structures.
Such a structure could be in the form of Safer Custody Teams made comprising all disciplines within each establishment that simply goes beyond representation from residential functions and mental health teams.
Quality measures would be evidenced through clear terms of reference and accurate minutes from meetings with the specific focus on planned actions and accountability.
Expected outcomes would be reductions in the rates of incidents of suicide and self-harm.
Statement 2 Multi-agency suicide prevention partnerships reduce access to methods of suicide based on local information.
- Identify emerging trends in suicide methods and locations
- Understand local characteristics that may influence the methods used
- Determine when to take action to reduce access to the methods of suicide.
Reducing access to common methods of suicide and to places where suicide may be more likely to occur can be an effective way of preventing suicide, along with consideration of any measures that can be used to interrupt prisoner’s plans, enough to give them time to stop and think, or making it more difficult for them to put themselves in danger.
It’s not inconceivable that one of the positives of allowing smoking in prisons in England and Wales was the act of rolling a cigarette, that then allowed such an opportunity to stop and think. In the Smoke Free estate, it is doubtful that any e-cigarette or vape can fill the void of such a process. This isn’t the only example, but certainly one of the more obvious that springs to mind.
Statement 3 Multi-agency suicide prevention partnerships have a local media plan that identifies how they will encourage journalists and editors to follow best practice when reporting on suicide and suicidal behaviour.
Best practice when reporting on suicide and suicidal behaviour includes:
- Using sensitive language that is not stigmatising or in any other way distressing to people who have been affected
- Reducing speculative reporting (that often serves no other purpose than to attract more online “clicks” perhaps?)
- Avoiding presenting detail on methods providing stories of hope and recovery including signposting to support.
Statement 4 Adults presenting with suicidal thoughts or plans discuss whether they would like their family, carers or friends to be involved in their care and are made aware of the limits of confidentiality.
The judgement may be that it is right to share critical information, which is what the Assessment, Care in Custody and Teamwork (ACCT) process permits. After all, families and friends would prefer to be involved, and be a part fo the support process rather than after the event when being informed that their loved one has completed suicide.
Statement 5 People bereaved or affected by a suspected suicide are given information and offered tailored support.
Support that is focused on the person’s individual needs. As well as professional support, it could include:
- Support from trained peers who have been bereaved or affected by a suicide or suspected suicide,
- Adjustments to working patterns or the regime in residential custodial and detention settings,
- Other support identified in Public Health England’s Support after a suicide: a guide to providing local services and the National Suicide Prevention Alliance’s Support after a suicide: developing and delivering local bereavement support services.
The quality standard is expected to contribute to improvements in the following outcomes:
- Quality of life for people bereaved or affected by suicide
- Rate of self-harm
- Hospital attendances and admissions for self-harm
- Suicide rate.
Support After Suicide – Help Is At Hand