Highland and Ayrshire to pilot Scotland's first suicide bereavement service

The aim is to provide "proactive" support to close friends and family members immediately after a bereavement by suicide.

Research estimates that people who experience the sudden death of a loved one are 65 per cent more likely attempt to end their own life if the deceased died by suicide, compared to natural causes.

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The Scottish service, whose creation has been spearheaded by Mental Health Foundation policy manager Toni Giugliano, is modelled after similar projects in Canada, the Netherlands, Northern Ireland and England.

In Cheshire and Merseyside, which has run a similar suicide bereavement service since 2015, it was found that 9% of people who died by suicide in 2014 had also been bereaved by suicide.

Following the introduction of its suicide liaison service, known as Amparo, this fell to 6% but was zero two years later among those who had received bereavement support.

Toni Giugliano (pictured with dog Harris) campaigned for the creation of a suicide bereavement support service in Scotland through his work at the Mental Health Foundation

In Scotland, there were 784 recorded suicides in 2018 and 833 in 2019, with fears that the impact of the pandemic could trigger further increases.

It is estimated that that if around 9% of these were in response to losing a loved one to suicide, then upwards of 70 cases a year could be avoided.

Mr Giugliano, the founding member of the Scottish Government's National Suicide Prevention Leadership Group (NSPLG) and now the SNP's candidate for Labour-held Dumbarton, said the lack of a suicide bereavement service has been a "real gap" in Scotland.

The suicide rate in Scotland has been rising overall since 2017, and in men since 2015

He said: "The modelling is quite clear from other parts of the world that people who've seen this kind of support, the numbers who then end up taking their own lives are minimal - absolutely minimal.

"People don't have to take this on. They can refuse it if they feel that it's not the right time, but they can opt back in several months later if they feel that at that point they would benefit from support at a later date."

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He added: "Right now in Scotland if you are bereaved by suicide, depending where you live, you get very minimal support.

"Perhaps the police will drop off a pamphlet but they don't get the support they would if they were bereaved, for example, by murder, where there's family liaison officers.

"It was felt that there was an injustice if you like that families bereaved by suicide were not receiving substantial support because the science, the data, is really clear: families who have lost a loved one to suicide are themselves at greater risk of taking their own lives because of feelings of guilt, and because of the trauma involved.

"It doesn't matter if they have witnessed the event or not, those feelings and experiences and deeply traumatic events can actually lead people to suicidal ideation and taking their own lives. They become at significantly higher risk of suicide."

Suicides registered in Scotland by local authority and five-year time period, by European age-standardised rate (with lower and upper confidence intervals) - ScotPHO

Highland has the second highest suicide rates in Scotland, while Ayrshire has been hit by suicide clusters and struggles with relatively high deprivation - a risk factor for suicide.

It was also seen as important that project be trialled in both urban and rural areas to test the logistics.

The pilot, expected to cost around £500,000 over the two-year period, is being built around a "hub and spoke" model combining a central office with local staff.

Police attending a probable suicide will be asked to refer relatives' details - with their consent - to a national hub which will then allocate a named suicide support professional to the family.

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Telephone contact will be made with the family within 24 hours and within the first seven days they will be offered a face-to-face meeting.

Practical support such as funeral arrangements or help in sorting out the deceased's finances can be offered, and a risk assessment would also be carried out to identify family members who may be experiencing suicidal thoughts.

The bereavement support workers could set up meetings with other local organisations, attend these with families, and continue to check-in - for example on birthdays or anniversaries - until the danger of harm is believed to have passed.

Former Deputy Chief Constable of Police Scotland, Rose Fitzpatrick, is chairing the National Suicide Prevention Leadership Group which will oversee the rollout of the pilots this summer

The goal is to act as a "supportive liaison" - not as a replacement for specialist mental health care or bereavement counselling - but Mr Giugliano stressed that it would also be "trauma-informed" support.

"This is a type of support that understands the traumatic event that someone has lived through and we really insisted on the trauma-informed support because we don't re-traumatisation to be an issue," said Mr Giugliano.

"If you've just lost a loved one to suicide, what you need in the immediate term is proactive, trauma-informed support to guide you through those really difficult moments.

"Right now, people would themselves be needing to contact a GP but in reality a lot of people in the midst of such a terrible time in their lives are too busy trying to sort out the event - dealing with grief and everything else - that they sometimes forget to look after their own needs."