Presentation from Paula Mawson, Warwickshire County Council, at the Suicide Prevention Stakeholder Workshop on 14th May 2019.

1. Suicide Prevention in Coventry
and Warwickshire
Paula Mawson, Warwickshire County Council
Aisha Minhas, CWPT

2. Coventry & Warwickshire STP
• Population – Coventry 352,900, Warwickshire
564,562 (ONS mid-2017 estimates)
• City and large rural areas
• 3 Clinical Commissioning Groups (CCGs)
• 1 Mental Health Trust, 3 Acute Hospitals
• 2 local authorities, 5 district boroughs

3. Coventry and Warwickshire
faces many health challenges
• Population is expected to continue to grow between now and 2021
• Coventry (15%)
• Rugby Borough (11.1%)
• Stratford upon Avon District (9.5%).
• A mix of urban and rural populations:
• Proportion of people aged 65 or over - Rural 21% and Urban 17%.
• Coventry has a high ethnically diverse population:
• 33% of the city’s residents coming from minority ethnic communities
(compared to 20% for England as a whole).
• There is a large gap in life expectancy between the richest and
poorest areas of both Coventry and the county of Warwickshire.

4. Why we were chosen as
a Wave 1 Area

5. Coventry & Warwickshire Rates

6. Coventry & Warwickshire Rates

7. Warwickshire rates
Warwickshire trends in suicide rates 2001-03 to 2014-16
Source: Public Health England, Fingertips

8. Focus on middle-aged men (40-59 years)
Recorded Place of Death
X740
2
X788
2
Y200
2

9. Focus on middle-aged men (40-59 years)
Occupation – using Standard Occupation Classification 2010
X740
2
X788
2
Y200
2
*Less than 5 suicides

10. Key risk factors – Coventry & Warwickshire
 Financial challenges (work/debt/housing)
 Relationship breakdown
 Physical illness & chronic pain
 Previous self-harm (24% in last year)
 Social isolation
 Victim of violence / domestic abuse
 Recent bereavement
 Contact with criminal justice system
 Alcohol & substance misuse
 Transitions between services

11. Health & social risk factors - Warwickshire
X740
2
X788
2
Y200
2

12. Service Contacts – Coventry
Of those with recent MH input, ~50% had contact
with crisis team or acute mental health team in A&E.
60% of people had at least one contact with their GP
or MH services in the 3 months prior to death.
Over 1/4 saw their GP in the last week – majority
consulted about a physical health problem

13. Vulnerabilities at transitions – Coventry
• Discharge from inpatient mental health to
community services
• People awaiting appointments from a GP
referral
• People recently discharged from prison

14. Coventry & Warwickshire STP
Wave 1 Funding
Our STP Approach

15. Two local Suicide Prevention strategies
and Steering Groups

16. Wave 1 Funding - Our STP
Approach
• Leads and key stakeholders came together to form STP Steering
Group for suicide prevention funding
• Bid for funding as an output of collaboration to build on and
strengthen existing plans
• Followed by a wider stakeholder and community workshop to
further formulate plans including people with lived experience

17. Support from National Teams
• Plan Do Study Act (PDSA) approach helpful
• Driver Diagrams provide direction – developed
in stakeholder co-production workshop
• Learning days – wider pool of stakeholders and
learning from other STP areas
• PDSA approach vs population based approach

18. Reduce
suicides
among
middle-
aged men
(aged 35-
65 years)
Reduce
suicides in
Coventry and
Warwickshire
Make suicide
prevention
everybody’s
bbusiness
• “No wrong door” policy and effective data sharing
between services
• Reaching people who are not in contact with MH
services and highlighting links between physical
and mental health
• Expansion of access (24 hour) and/or navigate to
support services (holistic)
• Continuing after-care planning
• Co-produce services with those impacted by
suicide
• Safer mental health-friendly communities
• Collaborative and integrated care pathways across
services and sectors adopting a life-course approach
• Effective signposting and referrals
• Promoting education and raising good mental health
awareness
• Common language and one approach
• Engagement with services
• Development of a learning strategy
• Competency-based suicide prevention training for
all staff (including primary care)
• Targeted campaigns and interventions for high risk
groups
• Empower friends and family support units to
call/refer to services on their behalf
Remove stigma
Increase
timely and
appropriate
access to
quality
services and
support
Data,
evidence,
evaluation,
and
dissemination
• Consistent data collection, protection, and sharing
across the system
• Quality assurance and usage data of support
services
• Timely post-incident reviews, learning, and sharing
• The identification of priority geographies across
Coventry and Warwickshire
AIM PRIMARY DRIVERS SECONDARY DRIVERS CHANGE IDEAS
Early
identification
of individuals
at risk
Work with GPs, Primary Care , Community, Specialist,
and Acute care staff across all sectors to improve
training in suicide awareness and signposting for those
at risk
Expand the delivery of It Takes Balls to Talk enabling the
campaign to reach a wider audience of men between
35 - 65
Train staff in our Coventry & Warwickshire community
based assets in suicide awareness and prevention
Pilot the provision of Safe Havens
Ensure bereavement support is readily available for
those who have lost a person to suicide
Explore and embed opportunities for real time
qualitative and quantitative monitoring across C&W
Work with partners including Change Grow Live (CGL) to
develop a dual diagnosis pathway across primary and
secondary care
Co-produce a “depression pathway” with primary and
secondary care and service users
Safety plan audit
Promote/develop apps and other digital support
platforms
Develop and embed personalised risk management
tools
Use the year of wellbeing campaign to promote positive
mental health and suicide awareness in the population

19. Our Change Ideas
Progressing two agreed early priorities:
• Safe Havens
• It takes Balls to talk
Followed by the development of 8 other change
ideas from the driver diagrams into projects

20. Safe Havens
The main aim of the ‘Safe Haven’ service would
be to provide more appropriate support for
those individuals who are or could be
developing a mental health crisis. A Safe
Haven would provide a safe, welcoming
environment where mental health and wellbeing
support can be provided out of hours.
The Safe Haven has been developed based
upon models being delivered in other parts of
the UK

21. Safe Havens
Explore
•Explored and agreed two Safe Havens in two districts in Warwickshire in
frequently used locations for male suicides associated with overall higher rates
and close to local A&Es.
Agree
•Joint stakeholder Task and Finish group scoped and agreed a model. This was
further refined to a more third sector focused model following visits to other
areas such as The Cavern in Gloucester
Procure
•The procurement is led by Warwickshire County Council
•We have delivered two market engagement sessions with providers
•Launched tender December 2018
Launch
•Pilots to start in June 2019 for approximately 18 months

23. • We increased positive relationships with local sporting clubs and with
employers who have male dominated workforces
• Won several awards including a regional Parliamentary NHS70 award.
• Developed the concept of the “Listening Mate” and are creating a
culture where speaking out is seen as a strength.
• The National Zero Suicide Alliance featured us as national good
practice case study.
• Alex was gifted an office at the Unite Union office.
• Bid for and achieved funding for 2 years to engage a part-time Director,
along with administrative and project management support.
• We increased the frequency of sports events from 12 to over 30 a year
and workplace events from 1 to over 4 a month.
• We engaged with over 2000 people and held conversations with over
300 people at each event
• Our social media and regular radio appearances help spread the word
widely across Coventry and Warwickshire.
What happened in 2018?

24. Where next?
• We will continue our expansion to enable us to
reach more men
• We will begin a more formal, academic evaluation
of the impact of It Takes Balls to Talk.
• We plan to work alongside the City of Culture team
and the City Council to make Coventry a city of
culture and compassion, where men are confident
to express their emotions.
• We are redesigning and updating our website with
HeadRed who have offered to work with us partly
‘in kind’ as their way of supporting the campaign

25. Other 2018/19 Projects
• Risk Assessment and Safety Plans
• Co-locating CGL representatives in Mind Wellbeing hubs (dual-
diagnosis pilot)
• Suicide awareness training across community assets plan to
support a joined up approach for a sustainable training offer
• Health & Wellbeing Partnership Board (cross-sector) funding offer
to address health and wellbeing.
• Suicide Bereavement service Development
• Supporting people with Multiple Complex Needs (MCN) (social
support pilot)
• Co-production with those affected by suicide
• Stay Alive app

26. Co-Production
Plan
Coventry Men’s
Sheds to provide a
12-month Arts and
Crafts-based
project.
Execute
This will involve
running sessions
with a group of
men of the target
cohort that may
already attend
other Men’s Sheds
activities.
Deliver
Obtain an insight
in to how certain
life issues may
have led them into
contemplating
taking their own
life which will
support further
planning of suicide
prevention
activities.

27. Suicide Prevention Training
• To raise awareness of people who could be at
risk in in the wider community and what
prevention measures are available within the
community.
• SCHEMA suicide prevention and awareness
training has been provided to over 120
individuals from a range of professions and
myriad of backgrounds.
• Feedback video can be viewed here.

28. Stay Alive App
The Stay Alive app is a suicide prevention resource
for the UK, packed full of useful information and
tools to help you stay safe in crisis.
Features:
• Import safety contacts who can help if you are
having thoughts of suicide, direct from your device.
• Create your own Wellness Plan for your recovery.
A place for your positive thoughts, inspirations, and
ideas.
• Equal breathing exercises to distract you from
negative thoughts and help you stay calm.

29. Stay Alive App

30. Plans for 2019/20
The programme seeks to build on year one activities and take the projects from development to
mobilisation and delivery. The STP Steering Group is seeking to ensure sustainability of projects
using the funding opportunities to test ideas. In year two, several additional activities have been
identified against the priorities.
Priority Activities
Reducing the risk of
suicide in key high risk
groups
Map out existing services and support into a format that is easily
useable by clinicians to ensure a clear and consistent sign-posting.
Extend and where appropriate deliver evidence based mental health
awareness and suicide prevention training to non-mental health
professionals including social care and primary care.
Reducing the impact of
suicide
Consider the needs of emergency responders and mental health
workforce
Develop a more consistent offer across Coventry and Warwickshire for
those bereaved by suicide.
Improving data and
evidence
Explore opportunities for real-time monitoring systems across Coventry
and Warwickshire, linking with the West Midlands Combined Authority.
Working together Co-production with individuals impacted by suicide to develop
campaign resources aimed at the target group.

31. Questions / Comments?