Strategy is working but more still needs to be done, writes Frances Simpson
When Sarah was found by her family attempting to take her own life they were alarmed and afraid and phoned the police. Sarah was taken into custody where she was detained until she could be taken to hospital so that her mental state could be assessed.
However, Sarah was too intoxicated to go through this assessment, leaving the police with a highly vulnerable young woman who could not be admitted to hospital but whom they believed they had to keep safe. Their only option was to return her to a police cell where she was held overnight before being returned to A&E where her assessment resulted in her being detained for treatment due to her mental illness.
Sarah’s story is not unusual and none of the emergency personnel involved believe in any way that this is an acceptable way to respond to someone in a highly distressed state. But when faced with a situation that demands an immediate response to manage risk, the over-riding objective is to keep someone safe.
Responding to distress has been a high priority in Scottish Government policy since 2002 when the national programme for mental health and wellbeing introduced a national suicide prevention strategy, Choose Life, with a target for reducing suicide in Scotland by 20 per cent by 2013, a target almost met with an overall 18 per cent reduction achieved. However, 672 people took their own lives in 2015: 672 personal tragedies that leave families tormented by the question: “why?”, and professionals desperately questioning what could or should have been done differently.
Suicide Prevention Day 2016 (10 September) presents another precious opportunity to lift the lid on this most taboo of topics, and reach out to those in distress to encourage them to seek help and hold on to hope, no matter how bleak the future seems.
This overall reduction in the number of people dying by suicide is encouraging, and supported by a proactive approach by the Scottish Government and partner organisations, such as Samaritans, with a refreshed 2016 Suicide Prevention Strategy about to be published, we can be cautiously optimistic that we are finally tackling this issue.
However, there are some statistics that reveals a worrying weakness that we can’t ignore: one in four people who died by suicide in 2014 attended A&E in the three months before they died, and 9 per cent of people attended A&E multiple times within the same window.
While we cannot prevent every single death, and the reasons why someone chooses to end their life are complex and often completely unknown or unexpected, we cannot escape the reality that there is something in our system that is failing people when they are at their most vulnerable.
The Scottish Government has recognised these critical gaps, and is working with partners to further understand and address this problem with a new pilot called Distress Brief Interventions (DBI) that will attract £4.2m additional investment over four years. This pilot is designed to take an early intervention approach to identifying those in distress who are vulnerable at the time of crisis, and providing swift person-centred follow up and support through a multi-agency partnership that will work to address the causes of distress, signpost people for help and ultimately help to prevent future crises arising.
Support in Mind Scotland is pleased to be one of the partners who will help to develop and deliver this pilot. Our organisation produced a short report in 2014 which captured the experiences of people who, like Sarah, found themselves in a police cell because they were too distressed to cope with life.
One participant said: “I really think there should be a ‘drop what you’re doing– this person is in crisis’ approach from professionals.” We believe that the DBI is a very positive response that allows us to do that and help to save lives.
• Frances Simpson, CEO Support in Mind Scotland. For support in a crisis, phone Samaritans on Freephone 116123. Or Breathing Space 0800 838587