Funding >> Additional Funding Allocation

Additional monies for suicide prevention in 2011

Suicide prevention remains a significant public health issue. After a period when suicide numbers and rates fell between 2003 and 2007, the impact of the economic downturn has led to a sharp rise in deaths since 2008. Against this background an additional €1m has been made available to us in 2011.

Earlier this year we sought bids for this funding from many organisations working in suicide prevention. We received 81 bids and assessed them against agreed criteria. As a result 25 programmes have been agreed and funding is being provided either as a once off payment or recurring into 2012 and 2013.

Set out below is a brief description of the successful organisations and programmes which will receive funding. Further details can be obtained from Paula Forrest at

National Youth Health Programme (NYCI)

The NYCI has received funding to deliver a National Skills Based Training Programme to Youth Workers and those working in other out of schools or non formal education settings. The training will be based on the MindOut Programme and Good Habits of the Mind. Combining the two programmes will equip youth workers with the skills and information to deliver a 12 session programme to young people in multiple settings; both formal and informal e.g.

The programme will also benefit youth workers; youth reach tutors and youth justice workers as well as promote the concept of implementing Good Practice Guidelines around Mental Health Promotion Programmes

Tackling youth suicide is a priority action for the National Office for Suicide Prevention and this project will promote the establishment of a national youth training programme on mental health for the out of school setting.

Crosscare National Traveller Suicide Awareness Project

This project's vision is to develop and implement a community development approach to address the issue of suicide within the traveller community with a specific focus on traveller men. The rate of suicide within the male traveller community is significantly higher than the national average and as such this project will work in a targeted way to address the inequalities within the traveler community. The project will employ a traveller man and another part time worker to devise and facilitate suicide and mental health awareness programmes for young traveller men at a local, regional and national level. The project intends to target and include those not in receipt of prevention, intervention and post-vention initiatives and who may be at risk of suicide. The project will combine culturally specific activities and counseling services initially to engage traveller men with a view to strategically developing appropriate partnership supports and identifying service gaps. The next step will be meeting the needs / gaps identified and developing traveller specific materials to develop and deliver training in mental health and suicide prevention and to deliver leadership programmes that can be rolled out by those participating in the course.

Dodder Valley / Suicide Action West

This pilot project intends to create a model of inter agency support, to be disseminated nationally, for newly unemployed men aged between 30-50 years. Recent data on suicide has shown the impact of the economic downturn on suicide mortality, particularly within this population cohort. This will include improved access to local counseling / support services; specialized training for practitioners; appropriate training / workshops for vulnerable men to promote positive mental health; improved links to GPs; improved links to community organisations and outreach supports. The project will also develop and promote pathways to appropriate volunteering opportunities. The part time coordinator will be based in the Local Employment Service enabling the development of a multiagency network and an integrated approach to support unemployed men and those in financial distress. The programme will be evaluated over a three year period with a plan to share learning nationally with the National Office for Suicide Prevention; local Suicide Resource Officers; National Mental Health Organisations; Citizen's Information etc.

DBT Training / Evaluation

HSE North Dublin Mental Health Service
Cavan Monaghan Adult Mental Health Service
Ardee Adult Mental Health Service (HSE)
Endeavour Programme, North Lee Adult mental health service
Westport Ballinrobe Adult Mental Health service

Several applications were submitted requesting funding for mental health teams in the evidence based Dialectical Behaviour Therapy (DBT). The therapy is specifically aimed at those with a diagnosis of Borderline Personality Disorder, a condition that is characterized by affect instability, impulsivity, intense inappropriate anger, suicidal and self mutilating behaviours such as cutting, overdosing, substance misuse, burning, binge eating and food restriction. Such individuals, due to the complexity of their presentations, are often resource intensive in acute and primary care settings; they do not respond to treatment and /or are difficult to engage in services. Persons with a diagnosis are also at high risk of suicide.

DBT helps reduce self harm and self destructive behaviours, using a combination of group skills training, individual therapy and phone coaching. It promotes a more coordinated response for those with severe para-suicidal and suicidal behaviours and with the funding of members from six mental health teams, covering a significant geographic region, and an Irish based evaluation on an existing programme (Endeavour Programme) it is hoped to promote broader interest and practice as well as a blueprint for how services can best be developed in line with Mental Health Policy nationally.

SCAN Projects

Similarly to the DBT training the funding of the projects below will successfully cover part of each HSE region following on from SCAN pilot projects in SE Dublin and Wexford. With significant aspects of evaluation integral to these projects the findings potentially can influence and direct future response from primary / secondary and community agencies to service users self-harming or in suicidal crisis.

St. Ita's, Portrane, HSE DNE

Service users who often present repeatedly are moved between GPs, the emergency department and community mental health teams. St. Ita's have highlighted the under utilisation of community resources in the management of self harm. As such they will allocate their funding to the creation of a pilot Suicide Liaison Officer from within existing resources, to work within the St. Ita's catchment area. The SLO would primarily develop stronger links and improved collaboration between community based resources; develop referral practice protocols; serve as a link between service providers to promote accurate and timely information around clients; inform and educate the broader community and to support and advocate for service users to navigate existing services and ensure access to service and continuum of care.

The SLO role should help perpetuate a targeted early intervention approach for service users who may be contemplating suicide so that the need for intervention at crisis level (e.g. hospital admissions) may reduce.

Laois / Offaly DML

Laois / Offaly will identify an existing member of staff to establish the position of a Specialist Mental Health Nurse whose responsibility will be to provide a "fast track" priority assessment service for persons at risk from self - harm / suicide as identified by General Practitioners. The nurse will implement a "Stay Safe" care plan that is individualized and tailored to meet the specific needs of the individual. The nurse will also deliver appropriate awareness raising / education at primary care and community levels.

It is anticipated with the development and implementation of this specialised role that access to services will be improved; decrease in referrals to mental health services; improved confidence and diagnostic skill levels within Primary Care staff; improved collaboration between primary and secondary services and increased mental health knowledge and awareness of the community. The project will also be fully evaluated and will complement data from the Wexford SCAN thus providing a broader base for findings, outcomes and action plan.

HSE West Galway West

Galway mental Health Service will identify an existing member of staff to establish the position of a Specialist Mental Health Nurse. The role will be very similar to the above and as stipulated will build on the knowledge and experience of existing SCAN (Suicide Crisis Assessment Nurse) Projects.

Health Promotion, Sligo

This is a research based initiative designed to identify best practice, evidence - based programmes to promote the mental health of the population and that identify and support those individuals with early signs of mental distress. The project will be established as a national project, involving key stakeholders. The anticipated outcome is to support / enhance the capacity of Primary Care Services when responding to people presenting with mental health difficulties, including suicidal behaviour that may not require an immediate clinical intervention after an initial assessment. With referrals to Primary Care Mental Health Teams increasing this research will examine existing evidence based pathways that could reduce the pressure on these services and offer "de-stigmatising" early intervention approaches e.g. social prescribing, creative arts etc. It is intended that the research outcomes will promote increased capacity for primary care teams to respond appropriately and effectively to persons presenting with mental health concerns; development of a best practice model in primary care mental health at local and national level; a stigma reduction campaign and greater awareness of other treatment options in line with mental health recovery reduction and demands on specialist mental health services.

Pieta House

Repeated self harm has been evidenced as a significant predicated risk factor in the suicide mortality data.

As a unique service provider in the area Pieta House crisis suicide and self harm intervention and prevention service provides assistance and support for people who feel isolated; who are experiencing challenging life events and who may be at an increased risk of suicide and self harm throughout Dublin, Limerick and beyond. Pieta House has a specific treatment model for people who engage in self harming behaviours. Their service is provided free of charge and alleviates some of the pressures on statutory mental health service providers. In 2010 referrals from mental health centres, Accident & Emergency Departments, General Practitioners and schools equated to 40% of overall referrals. Pieta House works in conjunction with a range of local and national statutory and voluntary agencies. A recent service user evaluation clearly established the role Pieta House played in their recovery, with 74% of clients identifying the service as the key aspect. The funding allocated will enable Pieta House to expand and increase the number of outreach counselling hours as the number of referrals continues to increase.

Curam Clainne (Family Life Services)

This project involves two separate but overlapping initiatives. Two part time staff will be recruited:

Staff A will work on a piloting model of "social prescribing" in County Mayo as a way of reducing the risk of suicide. This will include skills based training programmes in suicide prevention for those most vulnerable in the community and developing the capacity of primary care to respond to those presenting with suicide.

Staff B will have two specific duties. As an accredited counsellor that person will provide specialist family support in the immediate aftermath of a suicide bereavement, liaising with the family and coordinating support and services to meet the family's identified need. The counsellor will also prioritise individuals least likely to engage in social prescribing providing therapeutic intervention to develop coping skills and promoting mental wellbeing and will augment existing services to individuals in crisis due to the impact of suicide or experiencing thoughts of suicide.

There will be a formal evaluation of the social prescribing model where there is an existing resource and financial commitment from the HSE West; Erris Primary Care Team, MABS etc. The findings of the evaluation will be disseminated at a local, regional and national level.

This programme will be interlinked with Sligo Health Promotion's research.

NOSP would consider that the approach of this community based suicide prevention project will provide shared learning, evaluation, research and a template for other communities throughout the country.

Shine - Supporting People Affected by Mental ill health

Shine propose to roll out the one day workshop "Taking Control" nationally. It has already been delivered in the Midlands region with HSE funding support, where an initial evaluation on the programme feedback has been positively delivered. The promoting positive mental health and suicide prevention programme is directed at people recently unemployed and facing financial and / or other personal challenges.

The workshop is designed to build resilience, enhance coping skills and build self-esteem / confidence. Participants are supported to identify positive factors in their lives; recognize stressors and to safeguard against these: they are also informed on opportunities available to them and professional supports accessible by them. Shine will also design, deliver and evaluate a Training for Trainers to increase the capacity for the programme's delivery nationwide.

The programme in the Midlands to date has undergone a robust monitoring and evaluation system which all subsequent workshops will undergo as well as an external evaluation that will be tendered at a later date.

Western Region of Family Resource Centres c/o Clann Resource Centre

The Family Resource Centres are part of the National Programme of the Family and Community Resource Services Programme. The centres act as frontline support for individuals, families and communities experiencing stress, anxiety, depression and isolation. The intention of the nominated project is to improve the collective response of the Family Resource Centres and local Primary Health Care Teams by developing community skills based approaches to suicide prevention.

The project worker across all the 13 Family Resource Centres in Galway / Mayo will:

The Code of Practice will be shared with 107 Family Resource Centres nationwide supporting the delivery of action area 1- the Family, in Reach Out, the national Strategy for Action on Suicide Prevention

Senior Helpline

Senior Helpline has fifteen centres throughout Ireland operated by its 325 volunteers. The Helpline operates a peer to peer helpline service every day of the year, providing support to isolated and vulnerable older people in the community. The funding awarded will help:

Update and up skill Senior Helpline Volunteer staff in Mental Health / Suicide Awareness and their role in crisis intervention by composing and delivering an updated training module incorporating specific helpline skills for dealing with calls of a suicide nature.

To identify / train 1 or 2 volunteers from each centre to the extent they can provide support / debriefing, further training and collation and updating of information for all volunteers in their centres.

Older people have been identified as an at risk group for mental health problems / suicide. Due to the profile and national aspect of Senior Helpline and the improved response to crisis calls that the training should create, an awareness and knowledge and support is made widely accessible to older people at risk of suicide.

GROW / HSE Joint

This project will be delivered in three stages with the aim of empowering local communities to develop area specific suicide prevention strategies. The expected outcome will be the development of an assessment and planning tool kit for suicide prevention within Longford / Westmeath and Laois / Offaly communities but that can be applied nationally.

Phase1 - Pre-Assessment: Research and Information on Suicide and Suicide Prevention - Understanding Suicide and Suicidal Behaviour among Youth:

Phase 11 - Community Assessment -
Collate relevant community information to complete a comprehensive community profile

Phase 111 - Developing a Community Plan
Utilise the information in Phase 11 and apply to a specific planning process By identifying and developing the community's interagency or committee and completing the community assessment, the community's strengths and risk factors have been identified and then applied to a specific planning process

The programme will be evaluated and learning will be shared locally / nationally across statutory / voluntary / community services. The toolkit will support the implementation of a multifaceted approach to suicide prevention in a rural setting.

This programme will be interlinked with the SCAN project in HSE DML and the Dodder Valley project.

Irish College of General Practitioners (ICGP)

Skills based Training of General Practitioners in Suicide Prevention has been shown internationally to be an effective strategy in reducing suicidal behaviour. The ICGP have the responsibility for the continuing professional development for GPs in Ireland.

The ICGP project is to develop and deliver a suicide prevention course for General Practitioners, Practice staff and Primary Care Teams using workshop / home study / on-line discussion and access to on-line services. The course intends to deliver an evidence based education programme developing competencies in knowledge, skills and attitudes around suicide prevention.

The training will be preceded by an educational needs assessment consisting of qualitative interviews with key stakeholders and utilizing the Delphi process to identify the content and method of delivery.

General Practice has been identified as often the first point of contact for people with suicidal thoughts to seek help and support. This project will ensure the skills of GPs and Primary Care staff are current and because of the IT aspect of the training it is conceivable that all HSE Primary Care Teams could benefit.

BelongTo

Using Reach Out and Supporting LGBT Lives, as a framework document, BelongTo will develop the skills of youth workers, volunteers, steering groups and young people engaged in BelongTo nationwide. BelongTo will link in with NYCI due to the commonalities of their projects. As a national organisation BelongTo represent and advocate for a minority group who have been deemed to be more at risk of mental health difficulties.

Prior to the training BelongTo will roll out an in-depth and locally based needs assessment. This will be carried out with LGBT young people and youth workers to establish an accurate picture of needs.

A programme of skills based mental health promotion will be designed, delivered and evaluated with all groups in the national network with a Training for Trainers package offered to youth workers and volunteers.

Finally BelongTo will also operate an advocacy and outreach campaign targeting media used by LGBT young people to promote the mental health of LGBT young people and target LGBT young people not currently engaged in services.

Samaritans

The Samaritans want to establish and provide a converged Caller Contact System (CONNECT) to improve the experience of each call connecting with Samaritans and other partner Helplines while increasing the support options available to callers via Samaritan volunteers. Due to the technology solution required to implement CONNECT the costs extend beyond what funding is being allocated so Samaritans will contribute significantly to this process.

The funding allocation will be utilized primarily to recruit an Operation and Relationship Manager with responsibility to:

Samaritans Ireland will work closely with UK counterparts where the process is more advanced.

Samaritans hope to have full implementation of the CONNECT system by 2013 and a possible move to Free call.

Suicide or Survive

Suicide or Survive has applied for funding that would permit them to increase their capacity to deliver their Wellness Workshops. The genesis of the Wellness Workshop derived from their experience in delivering the Eden Programme which has educational and therapeutic aspects. Using Cognitive Behavioural Therapy principles the Wellness Workshop explores the relationship between thoughts, feelings, actions and physiology and the interventions that can lead to improved mental health and wellbeing. It focuses on goal setting, self appraisal and self awareness around triggers that effect mental health and strategies to manage these.

Around 700 participants representing service providers, service users, families and community representatives have availed of the Wellness workshop which has been favorably received and reviewed by those who attended however the programme has not received an external or independent evaluation on the impact on its participants. Anecdotal evidence and internal monitoring would suggest that the training does have a positive impact on participants' wellbeing and recovery and as such the National Office for Suicide Prevention has committed to providing funding for the purpose of an evaluation.

NSRF & Cork Liaison Psychiatry Service

This is a collaborative project related to the assessment of deliberate self harm patients presenting to HSE South hospital emergency departments and training of HSE staff who come into contact with DSH patients. It derives from the amalgamation of two separate funding application from the above two agencies and is designed to deliver a whole hospital approach to the treatment of self harm. The result is the following proposal:

Objectives:

1. Training:
Suitable training will be provided to HSE staff that comes into contact with deliberate self harm patients in the hospital emergency department (ED) setting. There is a general cohort of staff primarily made up of the nurses working in the EDs who have initial contact with self harm patients and a second cohort of staff who are responsible for providing mental health/psychosocial assessments to self harm patients. A more limited training course will be provided to at least 80% of the general cohort of ED staff. This will be adapted from the training materials developed by the EU-funded OSPI Study (Optimising Suicide Prevention Programmes and their Implementation in Europe). At least 90% of the more specialised cohort of staff will receive a more intensive and in-depth training course which will be provided by the STORM training group in Manchester.

2. Assessment:
The current procedures relating to the assessment of deliberate self harm patients were discussed and the current form used for guiding and recording the information from the assessment was examined. It was agreed that an electronic system of recording a subset of the information from the assessment would need to be installed on desktop computers rather than on portable devices. The system would need to be easy to use, it would need to record the information in a database format but it would also need to facilitate the work of the staff carrying out the assessment and not lead to significant duplication of effort. Specifically, there was a need for the system to produce a completed printable form which could be signed and could potentially replace the existing discharge summary and/or act as the communication to the patient's GP.

Procedures will need to be established to enable the database stored by the system to be extracted and subsequently linked to the routine data collected on self harm presentations to hospital by the registry of deliberate self harm.

The impact and cost-effectiveness of the training and optimised assessment procedures will be investigated in terms of outcomes such as changes in levels of repeated self harm and the percentage of patients leaving early/before assessment.

If the programme is successful it has the potential to be adapted / utilised throughout the acute sector.