Take the Training, Have a Conversation…about Suicide!
Asimple message that could save hundreds of thousands of lives in the UK, and millions around the world.
This piece draws from the Towards Zero Suicide/MEL Research Tracking Survey (formerly The Jordan Legacy/MEL Research Survey, which I designed & developed as The Jordan Legacy’s collaborative partner); also from other research & engagement I’ve undertaken since returning to the UK in August 2019; and from interactions on the #ZeroSuicideSociety Humber-to-Mersey #JoinTheDotsTour, 11–23 June 2024.
Suicide Prevention Training — the Problem, the Opportunity!
Firstly, let me just give you some headline figures before a few sensitivity messages and then more detail behind the survey and more depth on the crucially important topic of training to facilitate an informed, competent, confident conversation about suicide & suicide prevention.
This includes, in this particular write up, why people should ‘take the training, have a conversation’; why employers should make sure their managers & employees ‘take the training, have a conversation’; and why funding should be made available to support ‘take the training, have a conversation’ — both the human/moral/ethical case and ‘the business case’.
The dark green line in the graph below shows there’s been a significant increase in the proportion of people having some form of mental health training, from 10% in Autumn 2022 to 14% in the two most recent surveys, although that’s still only 1 in 7 people in the UK.
The light green line shows there’s been no change in the proportion of UK adults (aged 16+) having some form of suicide prevention training.
It’s just 6% of the population who’ve had suicide prevention training.
Or, to put it another way, 94% haven’t!
This is literally life-saving training, which also has many other benefits through the transferable skills & knowledge it imparts, and yet 94% of the population have not yet benefitted from it!
Those Who Need It Most Are Not ‘Taking The Training’!
Shockingly, it’s not just the general public.
We often hear of staff who’ve worked in the NHS for many years not getting this training, like Sam Southern from Blackpool, who lost her husband Glen to suicide in June 2020, the day before Fathers’ Day, leaving Sam with 6 kids, the youngest aged 2 and 5, her life (and those kids’ lives) devastated by suicide.
Sam worked in the NHS for 17 years but never had any suicide prevention training so she didn’t know how to talk about suicide or how to ‘spot the signs’ and was totally shocked when she lost Glen to suicide — feeling totally helpless, then feeling guilty for not having sought training or education to be able to prevent a potentially preventable death by suicide.
Sadly, and many might say tragically, we regularly hear about GPs who’ve had no formal training in suicide prevention, because there’s no legal or regulatory requirement for them to have such training.
They do have to have annual training in other disciplines, like CPR (Cardiopulmonary Resuscitation), where they have to take the training and demonstrate they’ve taken the training, with annual audits.
But, revealingly, many GPs say the last time they had to use their CPR training to resuscitate someone was 10 or 15 years ago, whilst they have people in their medical centres having thoughts of suicide every week.
So they have annual training and annual audits for a skill they might use once every 10 years, but often nothing for a skill they might need every week, ie having a conversation with someone experiencing thoughts about ending their life.
You & Your Organisation or Community Need to ‘Take the Training’!
Now, at this point, you might be thinking ‘ah, so GPs and NHS staff need training in suicide prevention, but not me and not my organisation’?
Wrong thinking I’m afraid.
Anyone can be affected by suicide, and everyone can help prevent suicides.
And just one suicide — a single preventable suicide death — can have a devastating impact on your workplace, workforce, community, school, college, university, social club, sports team, family, friendship circle.
There’s a known ripple effect.
Two studies — one in the US by Julie Cerel, one in the UK by Suicide Bereavement UK — both found that for every death by suicide, an average of 135 people are directly adversely impacted by that single death.
And that’s before we start talking about the impact of a suicide attempt, with estimates of at least 20 suicide attempts for each suicide death; with many people personally experiencing a suicide attempt; or needing to support people through suicide attempts; or witnessing a suicide attempt; inc learning that those who make a suicide attempt have a high likelihood of making another attempt; learning that those bereaved by suicide have a higher likelihood of taking their own lives because of the inconsolable grief combined with guilt & shame, and other adverse impacts due to stigma.
The Human & Economic Cost…and Our Opportunity!
So there’s a massive impact on a human emotional & psychological level.
It also impacts on business performance & productivity.
‘The business case’ for investing in suicide prevention training is very strong.
Someone impacted by suicide loss, or knowing someone experiencing a suicide crisis, or someone experiencing a suicide crisis themselves, or someone having thoughts about ending their lives, or someone witnessing a suicide or suicide attempt…is not a fully engaged, productive, high-performing worker.
It’s part of the calculation taken into account by top economists like David McDaid from the London School of Economics (LSE) in his report for the Samaritans, published in March 2024, The Economic Cost of Suicide, which calculated that preventable suicide deaths cost the UK economy almost £10 billion per annum (yes, that’s £10 BILLION PER YEAR — worth bearing in mind when the Government says it can’t fund suicide prevention!), and each individual suicide death costs, on average, £1.46 million:
We also have robust research now from sources like Deloitte, across many studies, across many countries, showing that poor mental health costs UK employers £51 billion a year (yes, that’s £51 BILLION PER YEAR!)…
…and, in addition to the poor mental health of employees themselves, most are caring for children, older people or people with disabilities, and an increasing number of people with mental health issues needing support or treatment, with unacceptably long waiting lists for NHS Mental Health Services (did you know that people who tell their GP they’re having thoughts of ending their lives are frequently put on a waiting list for assessment or treatment, for 3–6 months?!)…
…and 46% of working parents are concerned about their children’s mental health (did you know that, in 2023, the waiting list for children referred to NHS Mental Health Services clicked over 1 million?!)…
However, here’s another crucially important finding from this impressive body of work, and it’s a positive number this time.
Deloitte’s latest calculations from evaluating a range of mental health at work initiatives is that the average return on investment in support of mental health at work is £4.70 for every £1 invested.
Creating & Sustaining a Mentally Healthy, Psychologically Safe Workplace Saves Lives; Helps You Be an Employer of Choice; Optimises Performance & Productivity; and Helps You Achieve Sustainable Success
Studies now show that around half of employees have left a workplace because of a poor mental health environment, and employees seeking work are increasingly looking for a positive, supportive, mentally healthy, psychologically safe workplace where they can survive and thrive.
There’s often talk about being “an Employer of Choice” and competing in a tough market to “recruit and retain talent” but if you don’t create and sustain the right environment to make employees and potential employees feel it’s a safe, supportive space they’ll leave, or they’ll stay and not be productive, not perform, they’ll add to absenteeism levels or — often harder to spot this one and certainly harder to monitor &measure — to presenteeism levels.
And these ‘cases’ will often end in messy disputes, appeals, tribunals, compensation claims, pain & suffering in court or out-of-court settlements, which no-one really wants; which costs employers financially; which costs employees & managers in terms of their health; and which creates suicide risk for all caught up in the mess.
Also, in a ground-breaking study I carried out in Australia in 2014, taking Nobel Prize winning Econometrics and applying it to the Employer of Choice concept to measure sub-conscious drivers of choices — by flashing randomised job offers or workplace scenarios in front of employees on the screen and asking them to just click ‘Yes or No’, with the computer analysis calculating what was driving their choices without them even realising it — a mentally healthy, psychologically safe workplace environment where it’s possible to talk about topics like mental health & suicide is second only to pay in driving employees’ workplace choices:
Note that in the screenshot slide above, it refers to an ROI of $2.30 per $1 invested in mental health, which was a pioneering study in Australia in 2014 (just 10 years ago — this is all still new!) by PriceWaterhouseCoopers.
As previously highlighted, this work has since been developed around the world by Deloitte, including in the UK; it’s much more sophisticated now; and the latest estimate of ROI is £4.70 for every £1 invested.
Another Australian reference I can point you to, which I originally designed in 2014 and carried out the first published survey in 2015, although it’s been significantly developed and enhanced by many very smart people since, is the SuperFriend ‘Indicators of a Thriving Workplace Survey’, now in its 9th year with an expanded sample size of 10,000 to enable analysis by sector or industry:
For those not aware, SuperFriend is an excellent not-for-profit mental health & suicide prevention foundation set up in Australia in 2007 by the insurance & superannuation sector due to enlightened self-interest, as they were finding that half, or even more than half, of workplace claims were mental health related, not physical health, injury or disability, with emerging data — 17 years ago! — of the economic cost of suicide as well as the human cost.
The Human Devastation & Business Disruption of a Suicide Death
The macro numbers can seem distant from your own situation but one of the saddest aspects of suicide specifically is that I have these two experiences, alongside each other, at least once a month:
- I speak with employers and managers to try to get them on board with suicide prevention initiatives to avoid experiencing the devastation that just one suicide can cause, but they resist; they find it too hard to talk about it; they fear talking about suicide; they don’t think they’re going to be affected; they don’t think suicide prevention is a priority for their workplace; and they say they don’t have the resources, not even the money to fund some basic training.
- I get a call from a chairman, CEO, senior leader or business owner to say “we’ve just had a suicide death, everyone is devastated, we don’t know what to do, can you help us?”
This is why we call what we do suicide PREVENTION, trying to avoid Scenario 2 by challenging the institutionalised inertia of Scenario 1.
I also once worked with an electricity distribution business that had a suspected suicide (was it an accident, was it a suicide, will we ever know?!) and ‘live wire work’ was completely suspended for 3 months, costing the company millions & millions of dollars.
Now most businesses won’t have this specific human & financial cost outlined above but you might have your equivalent, depending on who you lose to suicide, how you lose them, where, when & why.
Those bereaved by suicide, including your colleagues (or clients or key customers or business partners) will agonise for years about the ‘why’ question, and ‘was there anything else we could have done?’, often concluding that there was, resulting in a huge burden of guilt.
Losing a colleague to suicide, like losing a family member or friend, can mean not wanting to go to a certain location any more, or not travel by a certain means of transport, or not want to work on the ‘anniversary’ of their death. It can disrupt lives and businesses for many, many years.
And those witnessing a suicide (or suicide attempt) are deeply affected, not only wrestling with the ‘why?’ question but also with the ‘who?’ question as they didn’t know the person or their loved ones or their colleagues or the other people who also had this most distressing witness experience.
====A SHORT INTERMISSION WITH SOME IMPORTANT MESSAGES====
If you quote any of the results from this survey/this report, please give your source as the ‘Towards Zero Suicide/MEL Research Tracking Survey’, and please link to this published summary to ensure accuracy, to avoid misrepresentation of the data, and to spread the word about the need for us all to ‘take the training, have a conversation’.
Please also note the following.
Given the subject matter, all those taking part in the survey are directed to appropriate sources of support.
If you or anyone you know needs support, there are many options (and it’s important to know there are many options!), including via the Resources page on The Jordan Legacy website…
…and this excellent set of resources from Grassroots Suicide Prevention:
Please also check out local sources & services in your area, including your local Suicide Prevention Lead (if you have one), your local Public Health team, and by putting your postcode into the Hub of Hope:
Of course, this write-up is going to be covering the subject of suicide (along with the positive and hopeful subject of suicide prevention!) so if you find this triggering or distressing in any way, please seek support (using the help & resources outlined above or other familiar sources).
Please be reassured by the number of amazing people working to prevent suicides and reduce the number of suicides, like those we had on our stage and in our audience at the #ZeroSuicideSociety Humber-to-Mersey #JoinTheDotsTour Launch Conference at The Baths Hall on Wed 12 June…
…and all those we interacted with throughout the Tour across the M62 Corridor:
=======END OF INTERMISSION WITH IMPORTANT MESSAGES=======
Gaining Competence & Confidence through Suicide Prevention Training: High & Immediate Impact
Now, here’s some really important messages about suicide prevention training that should be of interest to everyone because anyone can be affected by suicide and everyone can help prevent suicide.
I highlighted earlier that only 6% of the UK population have ever had any suicide prevention training, so that means 94% haven’t had any.
This is a major problem.
But it’s also an incredible opportunity.
Imagine how many lives we could save if we could get the number having life-saving suicide prevention training to 10%, 25%, 50%, 75%?
Imagine how many of the 6,000+ preventable suicide deaths in the UK every year — more than 100,000 preventable suicide deaths since the suicide rate was halted in its long-term downward trend in 2007 — we could avert if we all had some basic suicide prevention training?
Imagine how many of the 200 school-age children we lose to suicide each year in the UK could still be alive if we all — including all parents, all teachers & all schools’ staff — had some basic suicide prevention training?
Imagine how many of the 100 university & higher education students we lose to suicide each year could still be alive if we all — including all lecturers & teaching staff, all university administrators, all parents and all other students — had some basic training in suicide prevention, including being aware of how almost all suicide deaths in universities are preventable?
Imagine what could be different if we all took some time out to ‘take the training, have a conversation’ — changing the current situation where suicide is the biggest killer of women aged under 35 and the biggest killer of men aged under 50, with the majority of those ending their lives each year being in employment, often working in offices, shops, factories, building sites (10% of all suicides are Construction workers!) and spending more time at work than at home in many cases?
Some people, who are not currently knowledgeable about suicide & suicide prevention, might be thinking “it’s too hard…I haven’t got time…we haven’t got the resources…we don’t have a training budget…”.
Well, here’s a challenging thought.
If you click on this QR code, it takes you to an online training course on the Zero Suicide Alliance (ZSA) website on how to have a conversation about suicide —ie ‘take the training, have a conversation’! — and it’s just 20 mins and it’s free:
“Only 20 minutes — is that enough?” I hear you say, and maybe “is this serious training?”.
Yes, it’s serious training, it’s very serious training.
It’s evidence-based; it’s informed by people with lived experience of suicide (eg people bereaved by suicide or who’ve lived through a suicide attempt); it’s NHS-endorsed; it’s been taken 2.7 million times (good, but not good enough!); and it covers the basics you need to have a conversation about suicide and potentially save lives.
And it’s online, it takes just 20 mins, and it’s free — why isn’t everyone taking this training?!
It also covers transferable life skills that can help you in all aspects of life, work, career & relationships, eg spotting signs, asking direct questions, listening, having difficult conversations, signposting to help available.
Is it enough?
No, it’s probably not enough, but it’s a start.
And the 20-mins Zero Suicide Alliance course is called ‘Gateway’ training.
It’s designed to be a starter, to quickly learn the basics, and then you can go on (some people within each workplace, sports club, community, school, etc at least) to undertake more intensive, longer-form training in accredited courses like ASIST and Suicide First Aid (and the suicide prevention components within the Mental Health First Aid programme).
If, like 94% of the population, you haven’t had any suicide prevention training, our Survey suggests that you’re likely to be feeling you don’t have the skills or the confidence to ‘have a conversation’ about suicide or to talk suicide prevention.
Indeed, just being told to ‘have a conversation’ or just ‘talk about suicide’ is scary, even traumatising, so please ‘take the training’ THEN ‘have a conversation’.
More than half the adult population are not confident about “How to best ask someone if they are having suicidal thoughts” (57%) or “How best to continue the conversation if someone says they are thinking about suicide” (51%) — two core topics covered in all the training courses, along with “How to spot the signs that someone is at risk of suicide” (55% not confident):
In addition, more than 2 in 5 (44%) are not confident about “How to spot the signs that someone might be struggling with their mental health”:
If, however, you’re among the 6% of the population who’ve had some suicide prevention training, the confidence levels are radically different.
Listening to ‘lived experience voices’ certainly helps, as does having broader mental health training with a suicide prevention component, eg Mental Health First Aid (MHFA) but the biggest impact is from specific suicide prevention training.
Compared with more than half the population not confident about starting or continuing a conversation about suicide, it’s only around a quarter for those who’ve had suicide prevention training — a huge impact.
The impact of the suicide prevention training is also in confidence levels for “How to spot the signs that someone might be at risk of suicide” — 55% of the whole population not confident, but just 21% of those who’ve taken had suicide prevention training — and “Where to direct someone for support if they are at risk of suicide” — 44% of the population not confident, but only 13% of those who’ve had suicide prevention training being ‘not confident’.
And this is probably all you need to know to have confidence that investing in suicide prevention training has a positive impact, often a considerable positive impact, and an immediate impact.
I’ve also facilitated peer support groups for those who’ve ‘taken the training’ and they often give examples of how they’ve put the training into practice, how they’re more confident generally, and — in particular — how they’re now confident (or at least less uncomfortable) asking the key direct questions “Have you had thoughts about ending your own life?” and “Have you made a plan to end your life?”.
The evidence is clear that asking these very direct questions doesn’t harm (you can’t make someone suicidal by asking the question), it just helps (people who are suicidal are often relieved that someone has at last asked these questions); and these questions must be asked in order to save lives, prevent suicides, and reduce the suicide numbers.
I highlighted these points — including covering ‘facts & myths’ — in the write-up from the first wave of the Survey in 2022, which was a written piece accompanied by an online presentation and a panel discussion event, involving two highly experienced training providers, who also both have lived experience of self-harm & suicide:
This is Simple & Straightforward: Let’s Not Make It Complicated!
As a Research Fellow, and prominent suicide prevention consultant, coach & counsellor, I often get asked about academic research studies which people claim, for example, “show that MHFA doesn’t have any measurable positive impact, which is concerning”.
And I also hear the usual calls for “more research” and “more sophisticated research” including “the gold standard in research — randomised control trials”.
I understand the needs of some people, including the academic research community and some corporate leaders, to feel as if the research has been more intensive and/or more extensive but this can become a barrier to getting the basic training ‘out there’ which then provides more scope for more and better ‘real world impact’ studies, rather than technically more sophisticated research which can be divorced from the real world.
When I take a closer look at the academic and applied research that has been done to date, there are 3 key issues I’d highlight.
Firstly, some of these studies have been carried out by people who’ve been openly critical of training programmes like MHFA because they see a lot of aggressive promotion of these courses, a corporatisation and almost commodification, with mass ‘box ticking’ to be able to say “all our staff have had training”. So, there might be a bias there and/or a reflection of the reality that there’s a lot of ‘box ticking’ in the ‘mental health market’.
Secondly, most of these studies have tended to focus on broader mental health & wellbeing training or programmes, not specifically suicide prevention training; and the open criticism of these broader programmes, especially MHFA, is not so apparent for specific suicide prevention training like ASIST or SFA.
Thirdly, based on the published literature and my own research & evaluation over the past 10 years, in Australia & the UK, one research finding that leaps out — wherever the right questions are asked — is that management & leadership commitment is absolutely crucial.
With ‘commitment from the top’ and managers at the top 2 or 3 levels committed to creating and sustaining a mentally healthy, psychologically safe workplace, and minimising suicides (ideally, aiming for zero), there tends to be a flow-on effect which means any training programmes invested in appear to be having a measurable positive impact, including actions taken after the training, and post-training support for those trained…and, for the especially committed, those training the trainers!
Conversely, where management & leadership commitment is lacking, training courses appear less likely to have a measurable positive impact, if any.
It’s not rocket science!
With strong commitment from managers & leaders & business owners, any training course appears to be helping, certainly not harming, and to be a sound investment, including being part of a wider business strategy to have sustainable business success through putting ‘wellness’ at the core of the business and the business plan.
And without that commitment from the top, it‘s inevitably ‘box-ticking and arse-covering’!
So, if you have commitment to making a positive difference, you almost certainly will make a positive difference, whichever specific training courses or programmes you choose off-the-shelf or with suitable tailoring, working in collaborative partnership with providers who are prepared to be more flexible and meet your specific needs, understand your specific context/sector/industry/profession/market/customers/clients/staff.
Generally, suitable tailoring to your needs, and client/participant engagement around the course content, method of delivery, case studies used, degree of interaction, etc will pay dividends.
The more it’s ‘off-the-shelf’, the lower the impact will be.
Again, this is not rocket science, is it?!
Suicide Prevention Training — Market Dynamics & Your Options
One of the great strengths of the ‘market for suicide prevention training’ is that there are many excellent providers around, all keen to provide basic awareness training and deeper education programmes.
There’s the Zero Suicide Alliance (ZSA) online courses I mentioned above — and which I promoted across the M62 Corridor in our recent Humber-to-Mersey #ZeroSuicideSociety #JoinTheDotsTour, including its ‘Gateway’ training — online, just 20 mins, free!
I promoted this — why wouldn’t you?! — across our Tour, and I continue to do so at every opportunity, for no reason other than I can’t think of a better way to have an immediate positive impact on people & organisations…and still can’t think of a good reason not to!
The photos below illustrate this ‘education & training on-the-road’ approach although please get in touch with your local training providers for training — I’m just a catalyst and a joiner of dots!
I also want to take this opportunity to not only highlight that all these areas, certainly all those our #JoinTheDotsTour visited, have excellent local suicide prevention training providers, but to say loud-and-clear:
Please Pay These Wonderful People!
Many of them run high quality suicide prevention services on a shoestring, with no regular income stream, and little or no government funding.
They usually charge very little, certainly no more than needed to cover their running costs; they save the NHS a fortune by keeping people out of expensive in-patient units; and, even where their training courses and other services are free-at-the-point-of-delivery, this is not a reason to abuse their goodwill or exploit their generosity but an opportunity to make a donation to help other people benefit from their much-needed community and business support.
And, more than incidentally, most of these local services have been set up, and are being run by, people with lived experience of suicide — bereaved by suicide or ‘been there themselves’ in experiencing a suicide crisis — so it’s crystal clear why they’re doing what they’re doing, and it isn’t to make money or profit from anyone’s pain & suffering, it’s to help avoid other people having to endure the pain & suffering they’ve experienced.
There are a number of different training providers accredited to globally-recognised programmes like ASIST from LivingWorks, and Suicide Prevention First Aid; and several national ‘charity brands’ provide training.
And there are usually lots of options in your area, with the added benefit of valuable local knowledge, eg local support services available, peer support, safe, supportive spaces where people can go, etc.
The main downside of ‘the mental health & suicide prevention training market’ is that the various providers can be very competitive at times in a field that requires collaboration, co-operation, and great sensitivity; and they can get a bit proprietorial, with an ‘our training is best’ mindset.
Of course, with 94% of the population not having had any suicide prevention training whatsoever, the focus for providers should be on collaboratively ‘baking a bigger pie’ not competing for slices of a small pie; and there should be ‘plenty of business to go round’!
There really should be no place for competition in any aspect of suicide prevention.
I often go further and say that, in the suicide prevention field:
“Competition Kills People. Collaboration Saves Lives”!
Please Check Out ‘Specialists’ Who Are Usually Good Generalists Too!
Some people will seek out training via trusted ‘brands’ like Samaritans and Mind, which is understandable, and often a very good source of training or appropriate support.
As I’ve said previously, there are benefits from developing collaborative partnerships with local training providers who know your area and your issues, and have a lower cost base.
Bear in mind though that the global training programmes are often delivered by accredited local trainers, so there are benefits here too.
Don’t be afraid to shop around, then perhaps stick with what ‘works’ for you, then shop around again if it stops ‘working’ for you.
And always recommend those who wow you — they deserve it!
Then there are some specialists, eg in certain sectors, industries or professions — and there might be benefits in working with such specialists and/or going through your trade bodies, industry associations or professional societies, although there are drawbacks too, eg insularity.
If you operate in a rural area, you may want to approach a person or organisation who understands the specific issues faced by rural communities or working in a rural area, eg Melanie Costas of Rural Mental Health Matters:
And there are a growing number of specialist training courses and programmes, eg for issues around autistic people and interacting with autistic people (latest estimates are that more than 10% of all those who end their life in the UK are autistic people)…
https://www.zerosuicidealliance.com/autism-suicide-training
…domestic abuse & domestic violence (ground-breaking research in Kent & Medway could trace at least 1 in 3 suicides in their area to DA/DV), military veterans & first responders, eg check out Save a Warrior…
…veterinary sector/profession, check out VetLife…
…people who are neurodiverse, eg check out Ausome Charlie Hart:
And a big shout out to our main Tour Partner on the #ZeroSuicideSociety Humber-to-Mersey #JoinTheDotsTour, 11–23 June, the Rugby League Cares Foundation.
Rugby League Cares doesn’t run specific suicide prevention courses or programmes (yet!) but covers suicide briefly in some of its excellent mental wellbeing & mental fitness programmes:
When our Tour got to Warrington on 20 June, Rugby League Cares had worked in collaborative partnership with the excellent Warrington Wolves Community Foundation to run two of their superb programmes — Offload in the morning for a large group of professionals in the mental health & wellbeing field, and Ahead of the Game for a smaller group of parents who also coach kids’ sports teams.
These two programmes can be delivered to anyone, but focusing on these two groups worked well.
And the whole concept works especially well taking place at the Stadium…
…and it’s a particularly good bonding & learning environment here:
…and a shout out for the excellent trainer Ellie MacDonald who was with us on our #JoinTheDotsTour for our ‘Hope Gathering in Hope Street’ after setting up her new business #HelloHope:
…and, finally, my good friend and, more importantly for potential customers, highly-rated trainer Seamus Corry:
I’d better stop there; I could go on…and on…and on!
A Proposed BSI/ISO Standard for Suicide Prevention, inc Training
It’s also vital to understand that all the basic training courses and all the deeper learning programmes all have the same basic core material around, for example, listening with respect, listening without judgement, asking direct questions, spotting signs, signposting, etc.
And this may all soon be consolidated into a defined Standard as the British Standards Institute has just approved a proposal for a Standard for Suicide Prevention, including Training/Learning & Development, which could become a global ISO Standard.
This has been created as an idea and initiative by global standards guru Marcus Long after Marcus lost his 21-year old son Adam to suicide.
After 3 years of intense grief, Marcus re-emerged with the ideas, energy & commitment to facilitate a suitable Standard for Suicide Prevention, with BSI’s help, that could apply to all organisations as a framework for suicide prevention policies, measures, processes & practices with continuous, systemic action learning & improvement, and designed-in assurances for ‘making excellence in suicide prevention a habit’.
Here’s Marcus at the #ZeroSuicideSociety Humber-to-Mersey #JoinTheDotsTour Launch Conference, at The Baths Hall in Scunthorpe, Wed 12 June, after breaking the very well-received news that the BSI Board had approved this initiative:
Other Survey Results, Access to the Data & Acknowledgements
This particular report has focused on the education & training perspective and relevant questions/data from the Towards Zero Suicide/MEL Research Tracking Survey (formerly The Jordan Legacy/MEL Research Survey).
Below, I’ll summarise some of the other key results from the latest wave of the Survey, Spring 2024, and key data for patterns & trends.
Each wave, Spring and Autumn, I’ll write a summary report with commentary, in addition to the slide deck.
All of the slides, and access to all of the data, is available via the portal that MEL Research has set up to ‘democratise the data’ (I love that!):
https://melresearch.co.uk/suicide-suicidal-thoughts-tracking-research-statistics/
And here’s the direct link to the PowerPoint Summary Report from the latest wave of the Survey, Spring 2024:
Please note that I set up this Survey in partnership with MEL Research when working in collaborative partnership with The Jordan Legacy, hence why it was initially branded as The Jordan Legacy/MEL Research Survey.
I designed the questions, and oversaw the design, analysis & reporting of the survey.
MEL Research carries out the Survey, as part of its ‘Research with a Purpose’ Omnibus, which facilitates survey research around a number of important issues — vital research, without which we’d have gaps and shortfalls in the data necessary to tackle social, economic, health & environmental issues.
MEL Research produces tabular analysis and a data summary slide deck/PowerPoint-based Report for each wave, and is also going to be undertaking further data analysis as the aggregated sample over several waves of the survey where the same questions have been asked (in the same order), has built up, enabling that robust analysis.
Most importantly, MEL Research does all of this vital research, analysis, reporting & dissemination pro bono — at no charge to Towards Zero Suicide CIC, previously at no charge to The Jordan Legacy, and at no charge to anyone wanting access to the prepared data & reports (obviously, they would have to charge for any bespoke analysis or changes to the core specification).
And MEL Research ‘owns’ the data at the end-of-the-day but has been as generous as it can possibly be in working in collaborative partnership with myself, The Jordan Legacy, and now Towards Zero Suicide CIC, in sharing this vital data, and in making it as widely available as possible.
So, a big cheer and round of applause for MEL Research!
Summary of Other Survey Results + Some Key Notes
You can access all of the survey results via the links provided in the previous section above, but just a couple of notes here from me.
Mental Health Tracking Questions
When I designed these questions, I studied many other published surveys and got feedback from data users.
Two key problems were: firstly, ambiguity in the question wording for other surveys and therefore the interpretation of the data; and, secondly, the use of technical or medical language.
So, for example, questions on other surveys asked about ‘mental health disorders’ (hmmm) or ‘mental disorders’ (yuk!) or had multiple questions trying to assess diagnosable mental illnesses.
We didn’t have the space to do this anyway, with a very limited number of questions but we also felt we could be much clearer and simpler, and ‘plain talking’, with just one or two key questions.
So, our question asks people if they’ve had “mental health issues that needed treatment or support” and we have a timeframe question as well so we can measure how many have had such an experience in the past 12 months:
When we ask for a self-rating on the extent to which their current state of mental health is good or poor, the proportion answering ‘fairly poor or very poor’ has fallen significantly from more than 1 in 5 in our first 3 waves from Spring 2022 to Spring 2023, to around 1 in 6.
However, for the more behavioural measure of ‘experienced mental health issues in the past 12 months requiring support or treatment’, the figures have been more consistent.
This Tracking Survey can monitor trends over time, and be sensitive to important changes, but we also need to be able to stand back from the detail and see that between 1 in 5 and 1 in 7 have reported experiencing such mental health issues in the previous 12 months and that, in the most recent survey, it’s at 15% which is very similar to the 16% saying their mental health is poor right now.
A consistent survey finding is that people who identify as disabled, and those who rate their physical health as poor, are significantly more likely to rate their mental health as poor.
We know from other surveys & data sources that disabled people and those with long-term physical health problems, including those in chronic pain, have higher rates of suicidal thoughts, suicide plans, suicide attempts, and death by suicide. This is reflected in our Zero Suicide Society model & framework, which includes a dedicated piece, top-right:
Suicide & Suicide Prevention Tracking Questions
The questions specifically about suicide are really important of course.
In any walk of life, business, government policy, etc, if we want to tackle a problem, we need high quality, robust, up-to-date data on ‘key metrics’.
Not having this previously for suicide & suicide prevention was a barrier; potentially a key barrier to getting the suicide numbers coming down.
Some charities, government departments, academics, clinicians, politicians & media commentators regularly quote out-of-date data, or the data is not clear.
Our 3 key goals here are to have accurate data, clear data, and up-to-date data on the key measures.
We often hear it quoted that ‘1 in 5 have had suicidal thoughts’ or sometimes ‘1 in 5 will have suicidal thoughts in their lifetime’.
In this Towards Zero Suicide/MEL Research Tracking Survey (formerly The Jordan Legacy/MEL Research Survey), we can see that it’s actually 2 in 5 who’ve “ever had thoughts about taking your own life” with 1 in 5 saying they’ve “seriously considered” suicide:
6% of those in our latest survey say they’ve made a suicide attempt. Some might think people ‘won’t be honest’ in answering such a question, and there may well be some under-reporting of these numbers, but these are people answering online surveys without being identified, and with suitable reassurances, and empirical research suggests a high degree of ‘honesty’ in answering clear and direct questions like this.
Adding together the % making suicide attempts and the % making plans to end their lives, we have around 1 in 10 of the population in these highest ‘at risk’ or ‘in danger’ categories — note that the biggest single ‘risk group’ for suicide is those who’ve lived through a suicide attempt; they’re likely to attempt again without proper support and treatment.
The chart below shows the distribution of responses on the timeline question, ie when they last had thoughts of suicide.
The proportion of the population as a whole having had thoughts about ending their life in the past month has been around 6–9% in our surveys.
Even at its lowest point of 6%, that’s around 1 in 16.
At 9%, that’s around 1 in 11 people.
The Need to Regularly Check In With Those Around You
Here’s a sobering thought.
If you’re at work or at play in a room or office or factory or bar or theatre, with family or friends or work colleagues or a community organisation…and you scan the environment around you…1 in 16 of those people — rising potentially as high as 1 in 11 — have probably had thoughts about ending their life in the past month.
And that’s why we all need to ‘take the training, have a conversation’.
Take the training to help you ‘spot the signs’.
Take the training to help you ‘ask the question’.
Take the training to help you signpost to appropriate help.
Take the training, have a conversation, save lives!
As the trend line chart below shows, the numbers of people seriously considering suicide, making plans to end their life, and making suicide attempts are not going down.
Every suicide loss is devastating and affects many people, for many years, forever in most cases. And it affects organisations and relationships.
Also exposure to suicide is not rare — 7 in 10 people are exposed to suicide, it’s just that 7 in 10 people don’t openly talk about it.
And, again, these numbers are not coming down.
And let’s finish with the chart we started with.
Over the past 3 waves of the Tracking Survey, from Spring 2023 to the most recent wave, Spring 2024, there’s been no change in the % of the population as a whole confident in talking about suicide or spotting signs of suicide, in all cases it being well below half of the population saying they’re confident in talking about suicide or spotting the signs.
And, in this same time period, there’s been no change in the proportion having had some form of suicide prevention training.
A maximum of 6% have put into practice ‘take the training, have a conversation’.
We know that if we get that line at the bottom on an upward trend, we’ll get the number of people (competent and) confident in talking about suicide (and suicide prevention) and spotting the signs, and we know that will help get the numbers of suicides on a downward trend, towards zero.
So let’s all work together to get that training line going up and the number of suicides going down.
As it says on the wall in Sean’s Place in Bootle, we’re “In This Together”:
Note on the Sample Structure
The Spring 2024 & Autumn 2024 waves have had the sample boosted, from the usual 1,500 to 1,900, in order to have higher numbers in Yorkshire & Humber and North West (minimum 200 in each) for more reliable statistical analysis in those two Regions.
This has been done because the #ZeroSuicideSociety Humber-to-Mersey #JoinTheDotsTour travelled through these two Regions, 11–23 June 2024, and we wanted to study any significant differences in the results in these two English regions compared with the rest of the country, and to study any significant changes in the results in these two Regions between Spring 2024 and Autumn 2024, which could be as a result of Tour activity & profile.
Finishing with a Message of Hope
When studying these survey results; seeing the suicide numbers not coming down; seeing the numbers of people considering suicide, making plans & making attempts not coming down; seeing the number taking suicide prevention training at just 6% and not increasing; it’s understandable that we might feel disheartened or pessimistic, perhaps even low on hope and bordering on despair at times.
However, hope resides in the opportunity we have here as well as the problem we have. Hope resides in the potential to save lives through practical action, actions we can all take, including people and whole organisations (schools, hospitals, workplaces, communities, families, etc) all ‘taking the training, having a conversation’.
Let’s do it, and imagine what we can achieve if we can get more than half the population to ‘take the training, have a conversation’!
Yours, with hope — I’m in the hope business! — Paul.
Paul Vittles is a Research Fellow (FMRS), transformational change consultant & coach, and loss, grief & trauma counsellor, who specialises in mental health and, particularly, suicide prevention.
Paul has lived with mental illness for 20 years, he has lived experience of suicide (from multiple perspectives), and he’s worked professionally in suicide prevention since 2013.
After co-authoring the ground-breaking report ‘Moving Towards a Zero Suicide Society’ with Steve Phillip of The Jordan Legacy, published in 2023 (1st Edition July, 2nd Edition Sept), Paul has been Chief Facilitator for the #ZeroSuicideSociety Transformation Programme.
In April 2024, Paul founded Towards Zero Suicide CIC dedicated to rolling out the Zero Suicide Society Transformation Programme; and Paul also designed, planned & facilitated the Humber-to-Mersey #JoinTheDotsTour, 11–23 June.
Contact:
Paul Vittles on LinkedIn (the only Paul Vittles on LinkedIn!)
https://www.linkedin.com/in/paulvittles/
Towards Zero Suicide CIC LinkedIn Page
https://www.linkedin.com/company/towards-zero-suicide-cic/
X (formerly Twitter)
@ PaulVittles
