Meeting of the Parliament

Meeting date: Wednesday, October 26, 2022

Official Report 1158KB pdf

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Suicide Prevention

The next item of business is a statement by Kevin Stewart on the suicide prevention strategy and action plan. The minister will take questions at the end of his statement, so there should be no interventions or interruptions.

17:12  

It is important that I start with a simple truth. Every suicide is a tragedy that has profound and lasting effects on people’s lives. It is imperative that Governments set a clear course to reduce suicide and to ensure that anyone who is affected by suicide is able to get the help that they need.

Today, I am happy to say that, a few weeks ago, we launched a document that I believe does just that—the new 10-year suicide prevention strategy from the Scottish Government and the Convention of Scottish Local Authorities, “Creating Hope Together: Scotland’s Suicide Prevention Strategy 2022-2032”.

The work around time, space and compassion for people in suicidal crisis has emerged over the past few years, and it now forms a key foundation of our new strategy and action plan. We understand that we also need to embed those principles right across our work to build compassionate communities and services.

I must acknowledge that although we launched the strategy and the associated three-year action plan last month, the impact of the national period of mourning on parliamentary business meant that this statement could not be made until today. However, I am pleased that I am now able to make it, because key to the strategy is an ambition for everyone to work together to prevent suicide.

Members across the chamber know the devastating impact that any death by suicide has on families, on friends and on communities. Although the number of people who take their lives has, thankfully, reduced in each of the past two years, we know that there is still much to do to reduce suicide deaths in Scotland.

Our aim is for any child, young person or adult who has thoughts of taking their own life, or who is affected by suicide, to get the help that they need and to feel a sense of hope.

Our approach needs to be rooted in the three principles of time, space and compassion. That must be the case across Government, across party lines and across all sectors and communities. To put it simply, we all must do everything that we can to reduce death by suicide in Scotland.

I would like to thank everyone involved in shaping the strategy, including members in the chamber today, for the way in which they have positively engaged and supported the work.

We have called our new strategy “Creating Hope Together”. That is absolutely what we need to do to deliver our vision of reducing suicide deaths in Scotland. We are backing the strategy by doubling annual funding for suicide prevention to £2.8 million by 2025-26.

We know that if we are to deliver our vision, we must build on our successes to date, particularly the way in which our approaches have been shaped by evidence of what works and the views of those with lived experience, including the national suicide prevention leadership group, which has been recognised for its work by the World Health Organization. I would like to take this opportunity to again thank the lived experience panel and all those involved in the leadership group for their work.

Our new strategy continues to drive forward key actions from “Every Life Matters”, our previous action plan. That includes our vital work to reduce stigma and grow public awareness of suicide and its prevention; to embed time, space and compassion into the responses that people receive when they are suicidal, both within services and within their communities; and to support people bereaved by suicide.

Crucially, though, we also plan to step up our approach. The strategy and action plan set out a number of new approaches—again, guided by insights and evidence. I would like to highlight a few of them.

First, the strategy seeks to support anyone affected by suicide, whatever their age or experience. That could be their own experience of suicidal thoughts, caring for someone close to them, or feeling affected by suicide more generally in our society. We know that we will succeed only by supporting everyone affected by suicide.

Secondly, we are taking a whole-of-Government-and-society approach to tackling the inequalities that contribute to suicide. Statistics tell us only too clearly that certain groups are at higher risk of suicide. Deprivation can be a key factor, so it is important that we seek to tackle the social determinants of suicide through policies such as reducing child poverty, tackling homelessness and funding debt advice. That is all the more important at a time when the cost of living crisis is impacting significantly on so many lives.

The third theme in the strategy is a strong focus on reaching and supporting people who are at higher risk of suicide as early as we can. In this Parliament, we have recently reflected on the value of initiatives such as men’s sheds in promoting good mental health and reducing suicide risk. The strategy highlights our aim of taking a proactive approach to supporting other groups who may have a higher risk, such as people who are LGBTI or neurodivergent. We will work with people with lived and professional experience to understand more about how we can connect and support more marginalised groups. That includes how we can remove barriers and ensure that the responses that people receive are embodied by the principles of time, space and compassion and are culturally appropriate.

We also wish to focus on the different needs of population groups. For example, older adults and children and young people may have different needs and different types of responses that are suited to them.

We are taking a focused approach right across our work so that we have maximum effect in our overall aim to reduce suicide. The strategy prioritises settings such as prisons and locations of concern, particular communities and parts of the workforce where we feel our efforts can make the biggest difference.

We have a very solid baseline of understanding through our work in Scotland over the past two decades and our first-class academic research. Both have been fundamental in shaping the contents of the new strategy and the action plan. That research also reminds us of the importance of sensitive media reporting of suicide, and so that is another priority for action.

Evidence also tells us that it is crucial that people who are suicidal get the support that they need from services. We know that many people who die by suicide have had contact with statutory services—often health and social care services—leading up to their death. Through the strategy, we want to make sure that, whenever someone contacts services, they will be met with compassion and given the support that they need. That support should promote their wellbeing, protect against suicide and have a primary focus on recovery. Our work encompasses primary care, mental health and unscheduled care settings.

The final area that I will highlight is peer support. One of the strongest messages that we heard in developing the strategy was the value of people talking to others who have shared their experience of suicide. I have been fortunate to hear first-hand accounts of the value of peer support, both at the launch of the strategy and in the countless discussions that I have had with those with lived experience. Peer support clearly gives people a deep connection, which not only offers them personal support but can help create a path to recovery. We will seek to embed peer support and recovery models for suicide prevention, working with key partners such as the Scottish Recovery Network.

In developing the strategy, we have both deepened existing relationships and created new ones. We must continue to nurture those relationships so that we can truly create hope together in our mission to prevent suicide. The strategy and action plan set out the plans of the Scottish Government and the Convention of Scottish Local Authorities to realise our vision, working across sectors and bringing our local and national work together in a meaningful way.

I once again thank everyone who contributed to the development of the strategy and action plan across all our partners and stakeholders as well as members of all parties, including members who are in the chamber today. I thank you all for your efforts.

We all have our part to play in preventing suicide. I very much look forward to seeing the progress that we will make together as we create hope together and make a profound and lasting difference to people’s lives.

The minister will now take questions on the issues raised in his statement. I intend to allow around 20 minutes for questions, after which we will move to the next item of business. I would be grateful if all members who wish to ask a question would press their request-to-speak button now.

I thank the minister for advance sight of the statement. I am sure that everyone in the chamber will be deeply concerned that Scotland has the highest suicide rate in the United Kingdom. Last year, 753 Scots took their own lives; that is 753 people who were not given the support that they needed.

I welcome the new suicide prevention strategy and action plan and, like the minister, thank every organisation, family and individual that contributed to its development. Every suicide is preventable, and we owe it to those who have lost their lives, and to their families, to make sure that Scotland’s suicide prevention plan is the very best that it can be.

Although I welcome the doubling of annual funding for suicide prevention to £2.8 million by 2025-26, it does not matter how much money we spend on developing effective suicide prevention interventions when, ultimately, we know that the most significant barrier to improving mental health nationwide is the lack of well-trained clinicians. We may have mental health interventions that work—but we lack the workforce or infrastructure to deliver them.

A strong suicide prevention strategy requires us to intervene early. Samaritans Scotland said that the bar is still far too high for accessing support when facing a crisis. More sustainable investment in crisis support is required to promote and deliver 24-hour, open access, crisis support for those in distress and crisis. Does the minister agree that the prevention strategy needs to ensure that people are supported before they face such a crisis?

First, I put on the record my thanks to Ms Webber for engaging with me and with the Government on the issue and helping us to create the strategy and action plan.

I agree that we need to do more to ensure that people do not reach crisis point. I disagree with Ms Webber on some of her points about the workforce, because we have the largest mental health workforce in these islands. However, we still need to do better—I do not disagree with that point.

We would all agree that some of the interventions that we need to make are not at the clinical or acute stage—they are in communities. That is why the Scottish Government is investing in our children’s and adults’ communities mental health and wellbeing funds, which are making a difference in communities across the country.

We also need not to rely only on clinical interventions. We must all do better in helping people when they are at crisis point. I know that there is an ambition, from all the parties that I have spoken to, that we get that right. I will continue to listen to the views of members from across the chamber so that we get those interventions right and, most important, I will continue to listen to the voices of people with lived and living experience, and I know that members across the chamber will do that, too.

In my area of East Ayrshire, which has been highlighted as one of the places most affected by the issue, the key to successful intervention is to work with people early and have properly funded training, so that we can embed the concept of suicide prevention throughout every stage of care and treatment. Many professionals in primary care require further training to recognise those signs, and in doing so, they would bring down the backlog of people who are waiting for treatment, which is, of course, concerningly high. Given that it does not match previous investment in suicide strategies, I will ask the minister directly whether he really thinks that the annual funding of £2.8 million and a rebranding exercise will cover the training requirements and the work that we need to put in to make the strategy successful.

The £2.8 million for suicide prevention is not the only money that we are spending on training and ensuring that we get this right. For example, the trauma training that is being delivered across the country is absolutely beneficial in getting all this right for people. I praise the trauma training champions in South Ayrshire who I met recently. They are making a huge impact, and the impact that some of the champions are making is changing how local authorities create and advance policy. That is important as we move forward.

We all need to get the issue right. We are not spending only that £2.8 million; there are other investments, including, as I said in answer to Ms Webber, the £15 million for the children’s communities mental health and wellbeing fund and the £15 million for the adults’ communities mental health and wellbeing fund. We must ensure that we do all that we can with the available resource.

I wrote to the minister on the day that the strategy was published to raise concerns about the collection of geographic information system mapping data for suicides. Many mental health organisations warn against publishing how and where suicides are completed, because it acts as a how-to on what the most successful route is to complete suicide, which is dangerous for anyone who is considering it. Can the minister reassure me and others that, if that data is collected, it will not be published or, for example, made available through a freedom of information request, to protect the public?

I know the interest that Emma Roddick has in the topic, and I will respond in more depth in writing on some of those issues. We will continue to approach our work on locations of concern with the utmost care. I give the assurance that our work will always be designed to safeguard and support individuals who are at risk and wider communities.

Any new data collection or intelligence on locations of concern is sensitive, and therefore the sharing of such data will be very limited to key partners and will not be put in the public domain. We will also take action to support responsible media reporting as we are very conscious of the risks that are associated with reporting on suicide.

Early prevention is key to a robust strategy of suicide prevention. As a practising general practitioner, I refer people to mental health services all the time, but patients face a very long wait; many of them wait more than 18 weeks for treatment, which is in part due to staff vacancies. What steps will the minister take to increase staffing levels in mental health services?

As I said in my response to Sue Webber, we have more staff in mental health services in Scotland than in other parts of the UK and we have invested heavily in mental health staffing during our time in office, but we will go further.

At the moment, we are looking at our mental health workforce strategy for the future, which will form an essential part of the mental health and wellbeing strategy that will be published in the spring of next year. However, it is not only about investment in clinical services, although we have to get that right too; we also need to look at more preventative spend. The Government is spending money on community services so that we can reach people at an early stage, before they hit crisis point. I am willing to share information with members on some of the impacts that that investment is making, and I encourage members to go and visit some of the projects that have benefited from community funds, because they are having an impact and are preventing people from reaching crisis point.

The minister is well aware of the on-going and long-term crisis in mental health services in NHS Tayside, which has led to two reports by Dr David Strang—the findings of the second one were described to me as the “worst in Scottish public life.” The conclusions of those reports led to ministers forming the independent oversight and assurance group on Tayside’s mental health services. When will the Parliament see the final report of that group, and can the minister assure us that there will be a full debate, in Government time, on the content of that report to ensure that more lives are not needlessly lost to suicide in Tayside?

I am well aware of the situation in Tayside. I have spent more time visiting Tayside than any other health board area, so that I can see for myself some of the difficulties that have been faced. I put the oversight group in place because I was not happy with some of the responses that we received from the Tayside partnership. The oversight group is due to report to me very soon, and after it does I am quite happy to have conversations with members about the findings. Mr Marra will probably ask for such a meeting anyway. Maybe we can provide a briefing for interested members after the report is published.

I assure the chamber that I recognise, without doubt, the seriousness of the Tayside situation and the fact that many patients and families feel that they have been failed. We will do better.

First, I would like to express my sincerest condolences to any family that has lost a loved one to suicide.

Some great work is being undertaken in my constituency by organisations such as Chris’s House and local football teams such as Bonnyrigg Rose that seek to address mental health issues and suicide prevention. Unfortunately, suicide rates in Midlothian—particularly for males—remain high, which is a great worry. What targeted help will be available for areas such as Midlothian? Will the minister join me in visiting those fantastic organisations in my constituency to see their work?

I am always happy to visit organisations that are doing well for their areas and I am more than happy to visit Bonnyrigg Rose with Mr Beattie.

A key element in all this is the peer support element, which I mentioned in my statement. Such folk are often immense in providing that support. I think that men in particular feel more comfortable in certain environments, and football is doing extremely well in helping with these issues. For example, the changing room—extra time project, which is run by football clubs and the Scottish Association for Mental Health, is doing wonders, and I am sure that the same thing is happening at Bonnyrigg Rose.

I was absolutely delighted to attend a day of suicide prevention work at St Mirren last year. The club has been at the forefront of some of this work, and it has been immense to hear how well the work that it has been doing has been received by people.

Also on a football-related theme, the FC United to Prevent Suicide campaign is absolutely top-notch and I urge members to have a look at the work that FC United is doing.

I am keen that we manage to include all members who have requested to ask a question, so I would appreciate short and concise responses and questions.

I very much welcome the strategy, as does my party. I draw members’ attention to the last line of the vision that is outlined in the strategy, which references children and young people. That is important, because last month devastating statistics from Public Health Scotland revealed that one in four deaths of five to 24-year-olds was as a direct result of suicide. That is compared to just 1.2 per cent of those aged over 25. Even more shockingly, the report acknowledged that five to 24-year-olds were significantly less likely to have had contact with the healthcare service in the period before their death than people older than them. How will the additional funding in the strategy outlined today specifically give much needed help to our young people?

I think that I outlined in my statement that there will be much more focus on certain areas, including much more focus on young people. We must get better at being able to discuss these issues and we must take cognisance of what young people can tell us. One of the reasons why we have established a young people with lived experience group is to guide not only the Government but others on where we are getting it right and where we are getting it wrong. Those young people will help us to shape what we need to do in order to change our responses and to change services. I am sure that, like me, members in the chamber will want to express their gratitude to those young people for coming forward and helping us with this work.

The Scottish mental illness stigma study commissioned by See Me Scotland found that stigma around mental illness remains pervasive in daily life. Stigma has been identified as a significant factor in suicide. With that in mind, how will the Scottish Government place greater emphasis on the impact of stigma in relation to mental health as part of its new suicide prevention strategy?

The Scottish Government is providing £1 million of annual funding until 2026 for See Me Scotland’s national campaign to stop mental health stigma and discrimination. We have given See Me Scotland the comfort of that year-on-year funding so that it can continue to build on the good work that it has already done. See Me Scotland carries out a huge amount of work, including work with employers on mentally healthy workplaces as well as FeelsFM, which is an app to help young people express themselves, and face-to-face work in communities right across Scotland.

Tomorrow, I will be attending See Me’s 20th birthday celebrations in Glasgow and I take this opportunity to publicly thank the organisation for its hard work over the past two decades.

How suicide is reported can make a huge difference to those left behind—not only grieving family members but others who might be impacted—and, on occasion, it can lead to suicide clusters. Does the minister agree that it is important that, when reported in the media, deaths from suicide are reported in a sensitive way without sensationalism? What discussions has the Scottish Government had with the National Union of Journalists and newspaper proprietors regarding their approach to reporting on suicide?

I absolutely agree with Mr Gibson. We need sensitive reporting of suicide by the media in the printed press and across social media. Sensitive reporting is vital to protect bereaved families from further traumatisation and to avoid the increased risk of suicide in the wider community. Our action plan sets out our plans to work with the national and local media sectors to support responsible media coverage, and we will start to engage with everyone in the sector shortly on that important issue.

I am pleased to say that, in Scotland, the Samaritans are already working hard to support responsible media reporting of suicide and to publish guidelines for the sector. We look forward to building on that valuable work.

Will the minister outline what will be put in place as a result of the strategy for those people who have made multiple attempts to take their lives, many of whom have complex trauma? How can we ensure that each of those crisis periods is taken seriously and treated without stigma?

That is a really important question. In those circumstances, what we need to do for the most vulnerable people is ensure that we listen and then tailor services to meet their needs. When I talk about services, I am not just talking about mental health and wellbeing services. We need to take a completely different approach across services to get it right for individuals. That is the single most important thing that we need to do. It is one of the most complex things, but, by working together in that holistic way and creating a greater understanding of people’s needs, we can do it.

Although the strategy makes a passing reference to rural issues, will Mr Stewart commit to a specific suicide prevention plan for farmers and gamekeepers? Will he support the British Association for Shooting and Conservation’s proposal for a gamekeepers’ task force to better understand the significant mental health challenges that that group of people face?

As I explained earlier, we will look at different sectors. We recognise the fact that suicide is more prevalent in certain work groups, and a fair amount of work has been done on those issues by the likes of Support in Mind Scotland. My mind is not closed to any suggestion on those issues. I say to Mr Hoy and other colleagues that we do not want to fragment our approach too much. At the same time, I am more than willing to look at anything that we need to do to create better protections and safeguards for sectors, whatever they might be. I am happy to speak to Mr Hoy further on that issue, if he wants.

I recently met pupils from a school in Stirling who raised concerns about mental health provision for young people. Can the minister advise how the suicide prevention strategy and action plan will be rolled out to ensure that young people in my constituency are supported?

The new strategy will go further in supporting children and young people affected by suicide. We know that that group needs different approaches. As I said in my answer to Mr Cole-Hamilton, that is why we have established the youth advisory group—to help us to understand their needs in greater detail, so that we can develop effective responses, building on our existing work, such as the better tomorrow social media campaign, which ran earlier this year. The action plan sets out a range of specific work to support new approaches to prevent suicidal behaviour in children and young people. That work will focus on key settings, such as education, health and social care and youth work. We will work with partners to develop existing and new age-appropriate resources for inclusion in the school curriculum, which will build on the understanding of mental health, self-harm and suicide prevention. All that will be evidence informed.

Thank you. That concludes the ministerial statement.