The Suicide Prevention Transformation Projects (SPTPs)

Routes to a community (your community) without suicide!

I write this piece at a time when three significant events are happening in my life and work. Firstly, after 6 months of engagement with key partners in the global ‘Zero Suicide Community’, we’ve mapped out the ‘desired state’ vision for moving towards zero suicides, and how to achieve this; and just had a graphic designer (thanks Chris!) encapsulate this in a single visual:

Stakeholders often referred to ‘building’ a framework, and ‘building layers of support’ so the ‘building’ analogy was born. We have strong foundations as a (global, national, and local) ‘zero suicide community’, taking both top-down leadership approaches (eg what can government do, and what do we want government to do?) and ground-up leadership (what can we do, in many cases independent of government?). We then identified and developed four key layers to help us build strong sustainable infrastructure, purpose-designed to save lives.

I’ll return to this later with more context and explanation of how the transformation model works (and it does work!) and the various Suicide Prevention Transformation Projects (SPTPs) we now have up-and-running or ready-to-launch.

Secondly, I’ve been part of a One Team Gov Team organising an event for World Suicide Prevention Day 2020 (#OTGSP #WSPD2020) which has resulted in an amazing line-up of Speakers (almost everyone we asked said ‘yes’ — which meant we have realised this particular ‘desired state’) with more than 600 people registering to attend the event on 10 September, 2pm-5pm.

Here’s the full programme…

…with the Speakers profiled in two previous Medium pieces: firstly this…

…then this…

…and finally a piece profiling the terrific Organising Team…

We have Speakers from Samaritans and the National Suicide Prevention Alliance (NSPA), and the UK Chief Inspector of Railways. However, what pleases me even more is that half of our 14 Speakers have ‘lived experience of suicide’. They can ‘tell their stories’ (some will) and draw from their experience of suicide loss & grief as they outline what can be done to prevent others having to ‘join this club no-one wanted to join’.

We also have Speakers talking about digital mental health and suicide prevention initiatives, including current pioneering work, which has been a personal and professional passion of mine for the past 6 years — since I launched ‘Digital Life Saving’ at TEDxSydney in 2014.

Just as the telephone helpline was a technological breakthrough by Samaritans in 1953, 21st Century technology, especially digital communications technology, has given us so many new tools to effect new transformations, combined with and a complement to (not a substitute for) human intelligence and human support systems.

Thirdly, I’ve bonded with (shared values, shared philosophy, shared goals), and now formally partnered with, Steve Phillip who lost his son Jordan to suicide in December 2019 and has established the Jordan Legacy CIC as part of his practical steps to help others and save lives.

Steve is one of the Speakers for the OneTeamGov #WSPD2020 event, he has become a dynamic member of the ‘Zero Suicide Community’ and an enthusiastic embracer of the Suicide Prevention Transformation Projects (SPTPs). This is reflected in the Mission and Vision of the Jordan Legacy CIC:

We’re Solution-Focused (and full of Hope) but, first, some problem(s)

I’ve spent the past 7 years working in the field of suicide prevention, and I’ve learned a lot including, with the ‘right’ thinking and practical steps, we can move towards zero suicides. Which makes it all the more tragic that we have more than 6,000 deaths by suicide each year in the UK, more than 3,000 deaths by suicide each year in Australia, almost 50,000 deaths by suicide last year in the US, 1 million deaths by suicide each year globally, and someone somewhere in the world taking their own life every 40 seconds.

I’ve spent the past 6 months undertaking community & stakeholder engagement with people around the world who are part of the growing ‘Zero Suicide Community’ — those who share a belief that we can transform this tragic landscape, and who are taking practical steps in their paid-for and/or pro bono work to move towards zero suicides.

In ‘the mental health sector’, we have historic medical & professional definitions like ‘insanity’. In the broader world of business, government, social enterprise, etc, those of us who work in fields such as change leadership, executive coaching, and transformational change dynamics have a saying:

“The definition of insanity is doing the same thing again and again, and expecting different results”.

On this basis, many of those in government, business, charities, academic research, the mental health sector, and even working (self-defined) in ‘the field of suicide prevention’ could be deemed to be insane…because they seem to have been doing the same things for many years without significantly reducing the numbers of suicides. Indeed, in recent years, suicide rates have increased significantly in many countries, including the UK.

That statement will feel grossly unfair for many working in the field because individuals and organisations will be able to point to many efforts to save lives via early identification, early intervention, prevention activity, postvention support after a suicide to protect those newly vulnerable due to suicide loss, and other practical support for people known to be at suicide risk (at the group level) or in suicide danger (at the individual level). They might even be able to produce specific evidence to clearly demonstrate how their activities have directly led to lives being saved, although this is rare from my experience over the past 7 years of study and practice.

Where it’s totally fair comment is at the macro level, because the evidence is clear. Where suicide rates are higher now than they were 5, 10 or 20 years ago (and the latest ONS statistics in the UK — for 2019, published in the 9th month of 2020, just one of the issues to address! — reported the highest male suicide rate for 20 years, even before the COVID19 impacts), what we have collectively been doing simply isn’t working.

I hear many comments such as “we just need to give the current initiatives more time…we’ve only just started investing in this approach…we need to do more research…we need more money…we need a more joined-up approach” and so on. In the first 5 years that I worked in the suicide prevention field, I believed this myself, and I still believe there are some areas where we’ve only just started investing in the kinds of initiatives that will bring the numbers down.

However, it starts to wear after 5 years of personal & professional investment of my own time (and yours?) and it starts to sound defensive and unaccountable. The macro data shows the collective effort is not working in moving us towards a zero suicide goal, or even in significantly reducing suicide rates — so we must be insane to carry on doing what we’re doing!

Hope and despair are constant bedfellows. Every day I have to have hope to get myself and those I work with through the day. But also, I actually do have hope because every day I see examples of people and organisations taking practical steps to save lives; generating ideas for practical steps we can take to save lives; and with pockets of impactful activity.

Then, immediately, the sadness, anger, despair and other negative emotions return because these pockets of impactful activity are just that — pockets, often isolated pockets, rather than mainstream, across systems, across the country. But hope returns because of the potential for ‘what works’ to be widespread not isolated exceptions. Attention then always turns to ‘how can we better share and support approaches we know can save lives?’.

Much of my work (paid and pro bono) over the past 6 months has been with smaller charities, including some newly-founded charities, and with people who have ‘lived experience of suicide’, notably parents who’ve lost sons or daughters to suicide (ranging in age from 14 to 35) and others who’ve lost siblings, other family members, friends, and work colleagues. I’ve lost people myself, including my family experiencing two suicide losses since COVID19 Lockdown.

I’ve found working with these people and organisations to be sad and challenging but, more often than not, hopeful and practical — and hopeful because they’re so practical.

So, I’ve decided to devote myself for the rest of my life to working with those who share the belief that we can transform the suicide and suicide prevention landscapes and move towards zero suicides; who want to take practical steps to realise that vision; and who, in many cases, are already taking the practical actions required.

There are many sites and sources providing excellent information, resources, services, support, etc, some of which were highlighted in this post about the Wellbeing Support Grid

…but my advice to anyone approaching this field is to seek out practical ways to help (at the macro and micro levels) with the transformation we need to move towards zero suicide. What is the most impactful contribution you, your organisation, your communities can make to help save lives?

There are many well-meaning policy initiatives which generate a lot of data, words, plans and documents… however, we often find that these are not followed up with sufficient action.

How can you ensure action and impact, not just more activity — care and compassion on their own aren’t necessarily helpful! — and not just more data without actionable value, or more planning documents?

One of the biggest barriers to transformation in moving towards zero suicide is the institutional tendency to set low ambition targets, most commonly “10% reduction in suicides in the next 5 years”, even though the evidence, eg from MerseyCare (30% reduction in suicides in 3 years), shows that much more can be achieved. How can you help challenge this structural conservatism? How can you help take the ‘pockets of transformation’ and put them into the mainstream, or at least help others apply what is known to work elsewhere?

Another deliberately provocative comment I’ve made at events and workshops to try and put this into perspective is:

If we know we can take actions that help us move us towards zero suicides (eg the Henry Ford Health System in Detroit reducing suicides by 75% in 4 years and achieving zero within 8 years)…then setting a target of just 10% reduction in suicides in 5 years is needlessly condemning thousands of people to death each year”!!!

Yes, the framing and language is dramatic. Sure, it’s hard on those who are genuinely trying to save lives. And I know from many real life conversations, it is really tough for those trying to support people with life-threatening mental illness who often feel like there’s nothing more they can do. But the statement is not meant for such people, who are already trying to do everything they can to keep their loved ones and patients alive. It’s a statement for others to reflect on — am I doing everything I can do (and my organisation) to help save lives?

The evidence tells us that ‘most suicides are preventable’ (eg interviews with those who’ve survived suicide attempts commonly saying ‘I didn’t want to die, it’s just — at that moment — I could no longer live with the pain…’ or ‘it seemed like there was no other option’.

So we must raise our ambition and take the steps we know we can take to move towards zero suicide. I outlined the (change of) thinking and actions we need in this submission to the Australian Government Productivity Commission Inquiry on Mental Health:

Lifeline Australia had suggested a top-down target of 25% reduction in suicides in 5 years, which was a huge step forward on the institutionalised low ambition norm of 10% reduction in 5 years, but it’s still not good enough is it? And it hasn’t been adopted. The Australian Prime Minister and Health Minister have started using the language of ‘zero suicide’ but formal plans still tend to be inherently conservative.

Experience has taught me that working from the ground-up; engaging with people who have lived experience of suicide, especially those who’ve lost loved ones, like Steve Phillip (and other Contributors to the OneTeamGov #WSPD2020 event), is the best way to work with a group totally committed to the transformation goals, with belief that it can be achieved, needing to have hope, needing to ‘do something’, and focusing on practical steps to help:

As it says on the Jordan Legacy CIC website Our Mission page:

“The act of suicide is a practical act — it needs practical actions to prevent it”.

Myself and Steve, and the other Jordan Legacy Partners, and the Zero Suicide Community, have identified the (evidence-and-experienced-informed and ground-up-innovation-stimulated) practical steps that ‘work’ in saving lives. Hence the Suicide Prevention Transformation Projects (SPTPs) and the Suicide/Suicide Prevention Transformation Model.

The global Zero Suicide Community has provided excellent foundations. Ground-up leadership from the smaller charities, community projects (eg tailored action at ‘suicide hotspots’) and from people with Lived Experience is combining with top-down leadership, each with enormous potential to be more effective. We’re building the twin pillars of optimal mental health and zero suicide with a supporting infrastructure, as outlined below.

Mentally healthy and psychologically safe workplaces are crucial. Most people aged 18–59 spend most of their day in some form of workplace community. We’re not forgetting unemployed people (and with the suicide rate historically increasing by 0.79% for every 1% rise in the unemployment rate, this is a group we must support more effectively), or teenagers or students or older people (who struggle coming to terms with retirement, or become suicidal after losing a lifelong partner), but we know we have large numbers of 18–59 year olds ‘at work’ and often ‘at risk’.

Several surveys (eg the Australian Mentally Healthy Workplace Alliance) have shown 45% of employees have left an employer (or manager?) due to having a work environment that was not mentally healthy. And we’ve heard about people bullied at work, going to the HR Dept to seek support, only to be bullied by the HR Dept!

Studies like the recent analysis by Deloitte shows how employers can get a considerable return from investment in workplace mental health:

So, it’s essential to ‘build that layer’ of mentally healthy ‘communities at work’.

Above that in the model are two related layers — Design Out Suicide and Zero Suicide Plans. This includes the proven ‘Zero Suicide in Healthcare’ framework, but it extends out into Social Care, and into the broader community. The Design Out Suicide layer is a collective heading for a series of projects and initiatives to design out suicide risks and dangers at source, incorporating everything we’ve learned from disciplines like human-centred design thinking, and process re-engineering.

(Community) Zero Suicide Plans: a ground-up engagement approach. we identify what constitutes the ‘community’ — a geographic community, a demographic community, a community of interest, a professional community, a community at work — your community! Then we work with the dynamics of your community, for natural engagement, commitment and action, using templates and a menu of evidence-based actions you can take. Each ‘community’ makes a collective commitment to deliver its Zero Suicide Plan with, ideally, a commitment to publishing it so other ‘communities’ can engage in collective learning and shared success.

Design Out Suicide: a process (re)engineering and human-centred design thinking approach to suicide prevention and effective early intervention systems that de-constructs the process people who are suicidal put in place to take their own lives (their plan, the key steps in their plan, how they plan to kill themselves, where they plan to do it, etc. and re-designs it to build-in every possible safeguard, physical barrier to access to the means of suicide, and available support — technological and human — to prevent suicide activation or completion, and save lives or at least give a chronically distressed person a chance to think again. We engage with architects, construction companies, designers, engineers, surveyors, etc.

And, our top layer (at present), we have technology solutions, working hand-in-hand with human intelligence and human support systems. We have identified at least two routes to transformation via applications of technology. And we already have the technological ability to achieve these breakthroughs, we are working on the other issues — ‘the will’, the human logistics, the ethical dimensions, the detail of the complementary human support systems.

DigitalLifeSaving: a term we’ve used since the launch in 2014 at TEDxSydney to cover technology solutions to identify those in suicide danger where we would not know the person was in danger (no past history of mental illness, never accessed the health & social care system, just fine one day and in crisis the next, usually due to a sudden loss experience), and have appropriate and effective interventions, along with systems learning to improve prevention, using tools like augmented intelligence;

TrackingForLife: tools and apps for helping to keep safe those in known suicide danger where we do know who the individual is, eg. helping make sure they get home safely after discharge from hospital (in several countries, we’ve found that around one in four people who take their own lives have been discharged from hospital within the past 90 days — we often know a lot about these people and must get better at supporting them to stay alive). The latest available tools can alert relevant authorities, or nominated supports, when those with known suicidality are literally ‘in the danger zone’.

In the transformation model, we’ve combined the various projects and initiatives under the banner “Life Saving Systems” because there are numerous examples of technology and human intelligence coming together to create, sustain, and enhance systems that are capable of earlier identification, earlier intervention, and more effective suicide prevention.

If you can help us take the practical steps towards transforming the suicide and suicide prevention landscapes, to move towards communities without suicide — with many micro zeros eventually adding up to a macro zero — PLEASE JOIN US!!!

After all, what else could be more important than saving lives?!

Paul Vittles is an economist, researcher, consultant, community engagement pioneer, coach, counsellor, and facilitator. After three decades of practical transformation, working with government at all levels in the UK and Australia (including more than 80 councils, and many more attending Paul’s talks and workshops), Paul is now a Transformational Change Consultant(and a Sustainable Success Coach — taking into account optimal mental health, ethical practice, and human sustainability designed-in to business models).

Paul lectures at Business Schools on “Facilitating Transformational Change: Vision, Strategy, Engagement, Delivery”. Much of his practice is focused on transformational change in suicide prevention to move towards zero suicide.

Researcher (FMRS), marketer (FAMI), consultant, coach & counsellor who helps people and organisations with transformational change and sustainable success.