Using education, partnerships and research to promote a suicide-safer strategy

Reducing the risk of suicide among students through an evidence-based and pragmatic whole-institution response.

In 2014, the University of Worcester established a multi-agency project to develop a holistic suicide prevention model to contribute to a ‘Suicide Safer’ university, city and county as an active partner in local suicide prevention planning.

The project delivered a strategic approach to suicide prevention, with annual action plans supported by dedicated project leadership.

Higher education (HE) student suicide rates have risen over the last 10 years (ONS 2018; Gunnell et al 2020), and recent evidence highlights the impact a suicide death can have on staff and students.

In these situations, any university staff may be called on to offer support. If these staff don’t have the appropriate training and resources, students may not benefit from simple early interventions that might avert a crisis.

The University of Worcester Suicide Safer project was established to develop wellbeing interventions and effective individual and institutional suicide prevention responses.

Collaborative partnership delivery has been orientated around four key strands:

1. Campaigning and awareness raising about mental health and student suicide
2. Education and training on mental health and suicide prevention for staff and students
3. Developing and promoting new resources
4. Developing and contributing to academic research

Campaigning and awareness raising

This focused on tackling stigma and signposting support. This included suicide awareness and prevention campaigns, promoting support and destigmatising talking about suicide. Examples include:

• screening of the film ‘finding Mike’. To support the screening of the film, guidance was provided on where attendees could access immediate support if the film triggered unwanted feelings or distress. Copies of the University of Exeter and Devon County Council Leaflet 'Its Safe to Talk about Suicide' were provided to all attendees. Alongside the event the University ran a 'Mental Health Fair' with stands from internal and external support agencies for students who may be struggling with mental health or suicidal thinking/behaviour to talk to.
• running public lectures at The Hive (the city’s shared university and public library)
• Coventry and Warwickshire ‘It Takes Balls’ campaign at BUCS and Varsity
• hosting a ‘Time to Change’ Hub. The University has a partnership with Time to Change who ran training with our students on site. In 2018, the University of Worcester was a co-applicant on a successful bid to host a ‘Time to Change’ Hub in Worcestershire, led by Worcestershire County Council Health and Wellbeing Board.

Education and training

This aimed to improve suicide prevention skills and to embed mental health and wellbeing awareness into student and staff induction.

This includes training in Mental Health First Aid (Morgan et al., 2018) for support staff and ASIST suicide prevention training (Rogers, 2010) for security staff offering out of hours support. Online mental health (Charlie Waller Trust (CWT), 2018 ) and suicide prevention training (Zero Suicide Alliance, 2017; HEE 2018) for HE staff was trialled with staff groups and embedded into induction and training.

New resources

These include suicide prevention and postvention online tools e.g. 4 Mental Health 'Safety Planning', Grassroots 'Stay Alive' app, and Samaritans’ self-help and Fika mental health apps.

Student interventions include self-help and ‘Look After Your Mate’ training from Student Minds There is also an agreement where the university’s CMH service could refer students directly to NHS Healthy Minds groups or access their SilverCloud programme. Healthy Minds ran groups exclusively for students on site.

The University Counselling and Mental Health (CMH) Service developed the STAR (Support, Triage, Advice, Referral) model which offers daily triage appointments providing prompt assessment and student support.

Guidance was produced for staff on supporting and signposting students, and a partnership with SHOUT crisis text service was established.

Research

The university contributed to UK student suicide research through two funded PhD studentships, exploring prevention and postvention practice, alongside involvement in other research projects.

Findings have been presented at national and international conferences and events. Dr Hilary Causer’s thesis, Bearing witness: A grounded theory of the experiences of staff at two United Kingdom Higher Education Institutions following a student death by suicide was shared at the AMOSSHE Winter Conference 2020.

Enablers

The project was supported by the university’s leadership and was initiated by the Vice Chancellor and chaired by the Pro Vice Chancellor. The group also engaged key influencers in the organisation to ensure changes were successfully embedded in practice.

A well-established partnership between the students’ union and student services supported a successful campaigning programme and promotion of new and existing resources.

Training in mental health and suicide prevention is embedded within staff induction and our rolling staff development programme, in collaboration with external partners – notably PAPYRUS and CWT. Lecturers include student mental health and wellbeing awareness in course inductions and within the curriculum.

Experienced practitioners within the CMH service have taken a lead role in supporting students, developing NHS partnerships and providing guidance and training for colleagues.

National and international networking has been critical to learning about new resources, initiatives, training opportunities, research evidence and sector developments, and has facilitated relation-ships with potential delivery partners.

Barriers and challenges

Demands on staff time were minimised by embedding key modules in staff induction, staff development and management and leadership training.

Pressure on finances was eased through partnership working, with shared training events reducing the cost of training and resources in return for evaluation and feedback or use of university facilities.

The university occupies multiple campuses, with a high proportion of students on external placements. This necessitated the development of digital and remote interventions. The STAR system enabled an agile response during the coronavirus pandemic as key support was already available via telephone or video call and the SHOUT crisis text service was already available.

The objective of this approach is that staff are better informed and more appropriately trained, with access to a range of simple, non-specialist interventions which aim to reduce the risk of student crisis or suicide. Pressure on counselling services has reduced, enabling more effective triage. The Star system enabled many students to be seen on the day with 40 per cent reporting that they have resolved the issue in one session.

Out-of-hours provision for students has been enhanced through the promotion of the 24/7 crisis text service and by offering security staff the opportunity to undertake ASIST suicide prevention training. Feedback from students and staff relating to project initiatives and events has been overwhelmingly positive. Sophie Williams, CEO Students’ Union, UW said:

'The high level collaboration has meant a more joined up approach to supporting students in their mental health. The Suicide Safer project group has created a wide network and has allowed us to tap into resources outside of the University with greater ease.'

The project has supported other higher education institutions to develop suicide prevention plans and has fed into Universities UK national task groups on student mental health and suicide.

It has been identified as a positive practice example in national guidance, sector publications and national media reports relating to student suicide prevention.

A new book, informed by latest research and practice developments including this project, will be published on November 2021: 'Preventing and Responding to Student Suicide. A Practical Guide for FE and HE Settings' Eds. Professor Jo Smith (University of Worcester) and Dr Sharon Mallon (Open University) London: Jessica Kingsley (EAN\ISBN-13 9781787754188).

Since 2014, the project has evolved to become embedded in our whole-institution approach to mental health and wellbeing. The university continues to be actively involved in the Worcestershire Suicide Prevention Partnership, contributing to achievement of a county-wide suicide prevention action plan.