Response to The Equalities, Human Rights and Civil Justice Committee inquiry into the Scottish Government and COSLA’s Suicide Prevention Strategy 2022-2032

Response to The Equalities Human Rights and Civil Justice Committee inquiry into the Scottish Government and COSLA’s Suicide Prevention Strategy 2022-2032

1 In your view, what factors contribute to the rates of suicide in Scotland?

Several psychological risk factors have been found by research to influence suicide rates in Scotland, these factors often revolve around the individual’s connections to their loved ones and community, mental health, work issues, sense of overwhelm and inability to cope with life issues. Additionally, factors like the cost-of-living crisis, deprivation, limited access to care, and the aftermath of the COVID-19 pandemic exacerbate the situation. Unhealthy coping mechanisms such as gambling, drug and alcohol misuse also play a role.

2 What actions could we take as a society to reduce suicide rates in Scotland?

To reduce suicide rates in Scotland, we can take several actions at different levels.

More research into the role of some mental health medication in suicide prevention can provide valuable insights and link to a deprescribing strategy.

Incentivizing primary care to adopt the “make every contact count” proactive approach. Patients prescribed mental health medication or those who are at suicide risk should be offered further support by making referral to a social prescribing link worker as part of their care plan.

3 To what extent do you believe that the Scottish Government and COSLA’s Suicide Prevention Strategy 2022 to 2032 and delivery plan will achieve its vision of reducing the number of suicide deaths in Scotland?

While the Suicide Prevention Strategy 2022 to 2032 sets a commendable vision, its success hinges on comprehensive prevention efforts across all levels of care. Primary care, plays a pivotal role in suicide prevention, with over 40% of mental health contacts occurring in general practice and this is where patients are discharged to for continuity of care. Therefore, integrating social prescribing link workers into primary care teams is crucial- the evidence is consistent in the role of social factors in suicide prevention. Proactive approaches, such as offering follow-ups at GP practices as highlighted in 2 above, will enable needs to be addressed holistically.

4 To what extent do you believe the Suicide Prevention Strategy 2022 to 2032 and delivery plan will reduce inequalities which contribute to differing suicide rates between groups?

The success of the Suicide Prevention Strategy 2022 to 2032 in reducing inequalities contributing to varying suicide rates among groups may be influenced by several confounding factors. These include changing population dynamics, geopolitical conflicts, climate change, and economic conditions, all of which can complicate cause-and-effect relationships. To effectively address these inequalities, we advocate for an expanded and adaptable set of success criteria that align with the diverse needs and priorities of affected communities.

Given the complexity of inequalities, interventions must be multifaceted and tailored to specific cohorts. Proactive deployment of thematic link workers through social prescribing initiatives can play a crucial role in providing targeted support to vulnerable groups, thereby contributing to the reduction of inequalities in suicide rates.

5 Do you think that sufficient funding is available to implement and support the Strategy and delivery plan?

The evidence overwhelmingly indicates that social factors significantly contribute to suicide rates. Social prescribing services, including link workers and third-sector community support, offer practical solutions to address these social determinants of mental health. However, inadequate funding for these services impedes their effectiveness. Moreover, funding uncertainty hampers service expansion and limits the capability building of the third sector.

Awareness campaigns and sustainable funding mechanisms are necessary to rectify this issue.

6 To what degree have the voices of people with lived experience of suicide been meaningfully considered within the development of the Strategy and its implementation?

The voices of people with lived experience of suicide have not been adequately incorporated into the development and implementation of the Suicide Prevention Strategy. Organisations like the National Association of Link Workers, with extensive experience in both primary care and community settings practical delivery, have not been consulted despite our valuable insights.

Our members are direct patient care workers who work closely with patients experiencing contributory social factors to suicide and they advocate for their needs, making their perspectives crucial for effective suicide prevention strategies. Our inclusion would ensure a more comprehensive and empathetic approach to suicide prevention. Coproduction is not only listening to the usual suspects, diverse voices with crucial experience on the ground should be included to reduce implementation bias.

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