Suicide Hotspots guidance implementation - Preliminary Research findings

1. Suicide Hotspots guidance implementation - Preliminary Research findings  David Hess Research & Development Consultant

2. Qualitative Study Aims to discover: How the guidance has been received in the UK since publication in 2006, How it is being translated into practice, What are its perceived strengths and limitations

3. The aims of the workshop Share preliminary findings. Opportunity for participants to share their experiences of working with the audit tool and hotspots guidance

4. Study design Pragmatic qualitative study using a combination of telephone and face-to-face interviews and electronic survey methods.

5. Method Given that the guidance was developed under the auspices of CSIP/NIMHE, and is being actively promoted by this body, the study will initially focus on the English CSIP regions and will seek to build up a detailed picture of what activity is going in each region in relation to identification and management of suicide hotspots.

6. Method CSIP has 8 regional Development Centres, each of which has a Suicide Prevention Lead: North East, Yorkshire & Humberside West Midlands Eastern South East South West East Midlands North West London

7. Method Relevant contacts may include: Mental Health Trust Standard 7 Leads Directors of Public Health chairs of LITs (Local Implementation Teams) local councils Samaritans branches Police (e.g. North East Region, reported activity, p.14 Annual Report 2007) Railway authorities (e.g. North East Region, reported activity, p.14 Annual Report 2007) Highways Agency (e.g. North West Region, reported activity, p.26 Annual Report 2007)

8. Method 8 regional case studies, within which will be mini-studies of activity around particular hotspots. It will be particularly important to explore as fully as possible those regions in which there appears to be little or no activity in relation to the hotspots guidance, and to understand the reasons for this Interviews (both telephone and face-to-face) will be audio-recorded.

9. Method It will then be a case of following up leads and ‘snowballing’ until we feel we have all the information available from each region (including documentary data, photographs of hotspots and/or interventions and any other available material).

10. East Midlands Many areas have looked at hot spots and generally have struggled in identifying local hot spots. In Derbyshire they have been looking at trying to extend the working definition of a hot spot, to include those places which have a common link or a commonality to them. For example, in Derby, we have a number of high rise car parks and currently not one would meet the definition of a hot spot. However, collectively they would. The other discussions they are having is identifying hotspots not purely as a result of events that have occurred that have resulted in death, but events that may frequently be viewed as near misses at various locations. Recent contact with police negotiators has highlighted this and acknowledges that there may be data available in various sources i.e. ambulance, EMAS, police call out records, fire service records etc. that may help us to identify those risk places where people may be going to, even if they do not necessarily carry through their final act

11. London Surprising little activity No coordinated London wide approach. Not seen as a priority by many of the 31 London authorities due to small numbers Only 8 of 31 had suicide audits in place

12. North West Greater Manchester – quite a lot going on – Director of Public Health Network – mainly to work with 10 directors of public health - 10 PCTs work together PHN identified series of priorities -one was suicide prevention – established Greater Manchester suicide prevention partnership Identified hotspot at Barton Bridge M60 ring road and bridges across ship canal near Salford and Trafford Worked with Samaritans and Highways - constructed signs not visible from carriageway but if you walk up to top of bridge one suicide since –Vitally important to evaluate effects – very small numbers 3 or 4 a year – early days

13. North East County Durham – identified hotspots within suicide prevention strategy but don’t have sub group which focuses on that Doing work with local councils and transport providers. Sub regional level - largely signs Regional – work with railway providers just got go ahead with network rail to set up time limited group looking at piloting evidence based measures at some stations – hoping to have something in place March this year.

14. North East Guidance crystallised things for them Main hotspots tend to be familiar landmarks – Tyne bridge, coastal area south of Tyne. Tyne bridge – took long time to get signage up, working with local council etc – the police have identified major reduction in call outs due to signs on bridge – that sub group are now looking at other bridges on Tyne.

17. North West North West Public Health Observatory “It is interesting to note that the number of hotspots and suicides do not correlate with the overall suicide rate for each local authority. For example, although Stockport has a comparatively low suicide rate (5.93 per 100,000 population), this local authority has a large number of hotspots (five). Conversely, where the suicide rate is high (e.g. Rossendale and Burnley at 8.45 and 7.51 per 100,000 population respectively) no hotspots are identified. These results suggest that all local authorities need to be aware of suicide hotspots and take action to prevent suicide, even if their rates are low. A total of 48 hotspots were identified across the North West.”

18. South West WEST COUNTRY SUICIDE & FATALITY MANAGEMENT MEETING British Transport Police South West Samaritans CSIP First Great Western Network Rail

19. WEST COUNTRY SUICIDE & FATALITY MANAGEMENT MEETING Reviews Railway statistics & updates on current initiatives - 6 monthly Suicide continues to be relatively low on West Country railways. Few trends can be noted from the stats. FP Crossing in Exeter is now a hot spot area. Network Rail are discussing the possibility of closure of footpath. Training, Signage, Barriers

20. Your experiences