Welsh Government's Draft Guidance on responding to people affected by suicide

Samaritans Cymru exists to reduce the number of people who die by suicide. The causes of suicide are complex. Suicide can be the result of the interaction between many different factors and should not be attributed to one single cause. Suicide is a major public health and inequality issue, and it is everybody’s business.

Death by suicide brings a unique grief for those left behind. It can cause intense grief and emotional distress to those closest to the person who has died such as parents, siblings, partners and friends, but often also having an impact on the wider community. National governments and statutory services can act to improve the support and information that is available for people who have been directly affected by suicide and a wide range of support services is also provided by the voluntary sector.

Samaritans Cymru have lobbied extensively to improve services for those bereaved by suicide and as such, we are wholly supportive of the guidance and welcome it as a very positive milestone in improving outcomes for survivors who are dealing with such a devastating loss. We were pleased to be part of the National task and finish group to shape this guidance.

Having reviewed the guidance, we believe it to be a very comprehensive draft and as such our comments focus on a few key opportunities for improvement. We are really pleased to see such a strong focus on compassion, system-wide approaches and trauma-informed care.

We are also encouraged to see the inclusion of our research on the link between suicide and socioeconomic disadvantage. Suicide is a major inequality issue and we believe there needs to be broader understanding and engagement with this from providers and services across Wales.

1) Suicide risk for those bereaved by suicide

The emotions experienced after bereavement by suicide can differ considerably from other types of death and that the shock can be especially acute and complex. There is evidence that people who have been bereaved by suicide can themselves be at a higher risk of suicide. A 2016 UCL research study found that people bereaved by the sudden death of a friend or family member are 65% more likely to attempt suicide if the deceased person died by suicide than if they died by natural causes.

This is also a risk factor for suicidal behaviour and ideation. We believe it is crucial to include this evidence in the guidance so that providers and workplaces are given a solid understanding of how crucial the support they provide is with regards to mitigating future risk. This evidential context can be a key motivator for change.

2) Postvention support for schools

We would like to highlight our Step by Step service for inclusion in the guidance as we want to make sure it is utilised as broadly as possible in Wales for any school community going through a suicide. Step by Step is a Samaritans service that provides practical support to help schools prepare for and recover from a suspected or attempted suicide. Samaritans has offered the Step by Step service across the UK since 2010 and the team aims to:

• Provide information and support to help the school community come to terms with what has happened and prevent stigma and isolation in the school community;
• Support school communities to reduce the risk of further suicide.
• Reach out to high-risk people and communities to reduce the risk of further suicide.

The bilingual guidance and signposting information can be found at www.samaritans.org/stepbystep

3) Developing compassionate approaches in workplaces

In 2018, we launched a free bilingual toolkit, titled Working with Compassion. We developed this guide to help people in Wales develop compassionate approaches at work and improve interactions between staff, customers, clients or service users. We believe compassion can change and save lives. The toolkit was specifically designed as non-clinical, accessible guide for anyone who may come into contact with someone experiencing distress in their workplace. As such, the guide has been very positively received and is now used in a very broad range of different sectors and services across Wales, such as foodbanks, call centres, the police service and the construction industry.

This toolkit may be useful for workplaces seeking to strengthen the support they are able to provide and is available at www.samaritans.org/workingwithcompassion

4) Strengthening compassionate approaches for education staff

As a follow-up resource to Working with Compassion, we also launched another free bilingual toolkit titled Compassion in Education. It was designed to provide teaching staff with facts and information, alongside real tips and actions which can be used in daily working life. This toolkit can assist staff when talking to or helping pupils, students or staff who are experiencing emotional distress. It also promotes a preventative approach to poor mental health in pupils, students and staff, which is a core focus of Samaritans work.

This resource is suitable for use in schools, youth settings, colleges and universities. It includes a guide on how to respond to questions about suicide and links to our wider teaching resources for pupils.

We believe this may be of use in the guidance too and can be found at www.samaritans.org/compassionineducation