Suicide Mitigation: Compassion and governance

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1 Liaison Faculty, Royal College of Psychiatrists Annual Conference 2017 Suicide Mitigation: Compassion and governance Dr Alys Cole-King MB, BCh, DGM, MSc, FRCPsych Consultant Liaison Psychiatrist BCU HB/Clinical Director Connecting with People Dr Monika Ferguson PhD, GradCertSuicidePrevSt, BPsych(Hons) Research Associate, University of South Australia/Connecting with @DrMonikaF

2 I ve got one of yours here. Which one?

3 Identification of suicide risk People identified as high risk People identified as low risk

4 Strategic suicide prevention

6 SAFETool Triage Expert Reference Group Prof Ella Arensman President International Association for Suicide Prevention Jonny Benjamin Expert by expertise Dr Nadine Dougall Assoc Prof Edinburgh Napier University Sheila Hardy Member of RCGP MH Training Advisory Group Dr Peter Ilves GP, Big White Wall Ltd and Connecting with People Associate Director Dr Kirsten Lawson Consultant Liaison Psychiatrist, RCPsych Liaison Faculty Executive Prof Margaret Maxwell University of Stirling Prof Rory O Connor President IASR, University of Glasgow Prof Siobhan O Neil University of Ulster Professor Stephen Platt 2nd Vice Pres International Associate for Suicide Prevention Prof Ellen Townsend Associate Professor University of Nottingham Keith Waters Clinical Advisor Suicide Prevention EMHSN Sharron Scotson Connecting with People Associate Trainer Dr Judy Shakespeare RCGP Lead on Perinatal mental Health

8 Student mental wellbeing in higher education

9 @StuartGuy25

10 Connecting with People in South Australia Note: Map of Australia image removed from this slide - Commissioned by SA Health Chief Psychiatrist - 4x local health networks - 25x CwP trainers Vision = to train 3,000 public health service staff between

11 Current Progress in South Australia Trained >300 mental health staff ED, inpatient, outpatient and community General adult, youth and older persons Multidisciplinary Psychiatrists (incl. registrars), mental health nurses, social workers, occupational therapists, psychologists, peer support workers, etc.

12 Connecting with People Building Hope Note: Images of hope boxes and hope board removed from this slide, as specific permission was granted to share the images at the conference but not to share online.

Connecting with People Education Resource Note: Once final editing has been completed, the video shown at the conference will be freely available here:

13 Connecting with People Education Resource Note: Once final editing has been completed, the video shown at the conference will be freely available here: Research/Research/Mental-Health-and-Substance-Use/latest-news-andinitiatives/#VideoResources.

14 South Australian Evaluation Data Suicide Response Part 1 (22 courses; n = 337) Evaluation items % agreement I m able to overcome the barriers to patient disclosure during a suicide risk assessment 88% I am able to understand the value and limitations of risk factor identification and the importance of red flag warning signs I am able to co-produce an immediate safety plan with a patient 89% I am able to ask about suicidal thoughts and how to use the Classification as part of a suicide risk assessment I am able to use the Continuum as part of a suicide risk assessment and prioritise referrals to mental health colleagues *Agreement = agree and strongly agree combined 88% 93% 90% 90%

South Australian Evaluation Data Suicide Response Part 2 (20 courses; n = 298) Evaluation items % agreement I am able to understand how patient, practitioner and organisational factors contribute to

15 South Australian Evaluation Data Suicide Response Part 2 (20 courses; n = 298) Evaluation items % agreement I am able to understand how patient, practitioner and organisational factors contribute to risk assessment process 88% I am able to use the Bank of Hope, Triple Whammy and Mitigation Framework as part of long term mitigation strategy I understand how the CwP clinical tools can help to mitigate against Human Factors Errors I am able to co-create a long term mitigation plan which includes social support mapping and a contingency plan I understand the importance of supervision and self-care 95% *Agreement = agree and strongly agree combined 92% 89% 88% 84%

16 South Australian Evaluation Data Sample quotes from clinicians: A compassionate approach to understanding suicidal risk. It is reassuring that staff are encouraged to focus on detail and context and plan for safety not just a check list Boosted my confidence The workshop was very informative and specifically tailored to our team Real examples linking back to current practice and looking towards best practice Shift in thinking about assessments More time needed to go into in more depth

17 Future Directions for South Australia: Research Priorities Mixed methods Attitudes Confidence Competence Clinical tools in practice Clinician experiences Consumer/carer experiences

18 References - Chapters Cole-King A. (2017) Suicide Mitigation a compassionate approach to suicide prevention in Henden J. Preventing suicide: the solution focused approach (second Ed.) John Wiley. Cole-King A, O Neill S. (2017) Suicide prevention for physicians: identification, intervention and mitigation of risk in mental Health In Primary Care Mental Health Gask L, Peveler R, Royal College of Psychiatrists Second Edition (in submission) Waters K, Cole-King A. (2017) Assessing risk of suicide and self-harm in Psychiatric and Mental Health Nursing: The craft of caring (Third Ed.) Chambers Cole-King A, Platt S (2017) Suicide prevention for physicians: identification, intervention and mitigation of risk. Medicine. DOI /j.mpmed Cole-King A Compassionate suicide prevention in Charlton, R. Compassion, Continuity and Caring in the NHS. 224pages, Published , Royal College of General Practitioners Publishing. ISBN:

19 References - Peer reviewed publications Cole-King A, Garett V, Williams H, Hines K, Platt S (2013) Suicide mitigation embedding compassion in clinical care. Advances in Psychiatric Treatment. 19: Cole-King A, Green G, Gask L, Platt S (2013) Suicide Prevention are we doing enough? Advances in Psychiatric Treatment. 19: Hines K, Cole-King A (2013) Hey Kid are you OK..a story of a suicide attempt Advances in Psychiatric Treatment. 19: Cole-King A, Lepping, P Suicide mitigation: time for a more realistic approach BJGP 3-4 Cole-King A, Lepping P (2010) Personal view: Will the new Government change our approach to risk? British Medical Journal, July. 341: c3890. Cole-King A, Green G, Peake-Jones G, Gask L (2011) The Assessment and Management of Patients with Suicidal Thoughts in Primary Care: An introduction to the concept and practicalities of suicide mitigation. Innovaite Vol 4: issue 5, Cole-King A, Green G, Wadman S, Peake-Jones G, Gask L (2011)Therapeutic assessment of patients following self harm in primary care. Innovaite Vol 4: issue 5, p Cole-King A (2010) Suicide Awareness in Primary Care: How making the right connections can save lives. RCGP News p RCPsych peer reviewed poster presentations of all clinical tools

Responding safely and compassionately to someone after self-harm

Responding safely and compassionately to someone after self-harm Dr Alys Cole-King MB, BCh, DGM, MSc, FRCPsych Consultant Liaison Psychiatrist BCU HB Royal College of Psychiatrists Spokesperson on Suicide