The Scottish and Welsh Government suicide prevention strategies highlight the need to change the behaviour of the public and all the agencies that are responsible for positively engaging with the public. They highlight the need to raise awareness of suicide and self harm; to deliver training to all agencies that engage with the public, and improve the immediate response by caregivers to individuals in distress at the point at which that distress is recognised.
Early intervention means services responding to individuals in need at the point at which they request help. This early response helps to reduce the isolation of the person at risk, relieves their distress and improves the chances of services working together effectively to support the individual. While a referral to mental health services will often be an integral part of this response, individuals with thoughts of suicide will usually need a range of interventions, including help with issues relating to housing, debt, use of alcohol & drugs and support from family, friends and community groups. The service where the individual has ﬁrst asked for help is usually best-placed to help them access this range of help and support.
Barriers such as stigma, fear and pessimism can prevent people accessing help, leading to suicide being seen as something only a specialist mental health professional can deal with, and can result in inertia in front-line services and the general public. As long as suicide is seen as the preserve of specialist mental health services, opportunities for early intervention will be missed. While only 25% of those who die by suicide are known to specialist mental health services, the majority of the remaining 75% will be in contact with other front-line services of some other type, in the months leading up to their death.
“Can I help this person to stay safe?”
There is evidence that even people with intensely suicidal thoughts are ambivalent about dying, but are so distressed that they cannot think of an alternative to dying; by giving a person the opportunity to talk, distress can be reduced, often enough for them to want to keep themselves safe and increase their ability to engage with available support. The chances of someone who is thinking about suicide ﬁnding someone to talk to, and relieving the distress they are experiencing, increases if there are trained people in the community who are ready, willing and able to intervene.