Emma Goodlad, Grants and Impact Officer at the Health and Social Care Allliance Scotland (the ALLIANCE) blogs for the Academy this week. Emma powerfully makes the case for meaningful public involvement and co-production in the development of a suicide prevention strategy.
New statistics published earlier this month reflecting the impact of suicide on people in Scotland were somewhat worrying, with a sharp increase in deaths by suicide in 2016. With suicide being the leading cause of death for young people in Scotland and the biggest killer of men aged 20-49 in the UK, the new suicide prevention strategy being developed by the Scottish Government needs to be forward thinking and brave in its aims and ambitions.
To develop a truly effective and useful suicide prevention strategy, one which guides people and professionals across Scotland on how to support people who are experiencing crisis because of intrusive suicidal thoughts and ideations, the Scottish Government needs to be led by people with real lived experience of suicidal thoughts, attempts and those who have lost loved ones to suicide.
This cannot simply be a consultation. When asked to be consulted on the recently published Mental Health Strategy, some third sector organisations expressed that they felt that the Scottish Government has a culture of over consulting, but under delivering on the feedback. People feel that they have opened up and told very personal, and often quite painful, stories of their own lived experience to try and guide and influence policy and strategy but are not seeing their experiences reflected in the final outputs.
To make sure that they are doing the right thing by people they need to put lived experience at the heart of the process from the very beginning to ensure that consultation is undertaken in an appropriate, sensitive and realistic way where people feel like their voices are truly heard and being used to improve the lives of others in the future.
As someone with both lived experience of attempting to take my own life, and working at an organisation who works in partnership with our members to influence and develop Scottish Government policy and strategy, I can see both sides of the coin. I understand that the state cannot realistically meet every demand or provide the necessary changes to services and support overnight, however when I most needed support I was let down by the very system we are told to tap into and ask for help from. If there was a clear suicide prevention strategy with realistic outputs and therefore outcomes, I may have never reached the point where I felt I could no longer cope and tried to take my own life. On the other hand I may still have reached that point and if I had, again, a clear and realistic strategy could have ensured that there was a clear pathway of support on hospital discharge to support me in the time between discharge and CMHT appointment.
Instead I was discharged, still in a state of disconnectedness from the world, with no involvement of my family in the lead up to my discharge from a High Dependency Unit and no coping plan put in place to keep me going until my appointment 8 days later with a Community Psychiatric Nurse. My family, friends and I were left to muddle through that week and deal with my ongoing depression and suicidal thoughts with no professional support purely because I had seen liaison psychiatry while still in a blur, recovering from the after effects and trauma of an overdose and had lied, like so many others, about still feeling suicidal because I was terrified that I would be sectioned under the mental health act.
I was lucky to have an incredible support network who got me through that incredibly difficult period and who now actively support me to look after my mental health and identify any issues. But what if that happens again? Would anything be different? Yes, it would be, but not necessarily because the support services are any different, but because my family and I know what needs to be different and would fight for different support.
Consultation is not co-production. I want my voice to be heard by policy makers, I want my experience of the darkest period in my life to be used for good. But I don’t want to be involved in a tokenistic consultation where nothing really changes, because the Government are afraid of raising expectations and letting people down if they cannot meet them.
I want to be part of a strategy which is brave, forward thinking and truly strives to make a difference in people’s lives and isn’t another strategy which goes into desk drawers across Scotland. I want to be involved in the development of a strategy where the consultation is a two-way discussion which is open and honest about what is realistic, what the challenges will be and work together to find realistic solutions to overcome these.
Let’s not forget that they have done this before. In 2008 members of the ALLIANCE worked with the Scottish Government to develop and produce Gaun Yersel’ The Self Management Strategy for Scotland. Gaun Yersel’ 9 years on is still held up as an excellent example of effective co-production to produce a realistic strategy document.
I call on the Scottish Government to be brave, put aside the fear of raising expectations and let’s work together for a Scotland where death by suicide rates are reducing, not increasing and strive for a support system to be held up as an example across the globe.