HSC(6)-02-22 PTN 20

Lynne NeagleAS/MS

Y Dirprwy WeinidogIechyd Meddwl a Llesiant

Deputy Minister for MentalHealth and Wellbeing

 

Ein cyf/Ourref MA/LN/1901/22

 

 

Russell GeorgeMS

Chair, Health,Social Care and Sport Committee Welsh Parliament

Cardiff Bay Cardiff CF99 1SN

 

 

26 August 2022

 

DearRussell

 

I am writing to provide you with an update on progress against the recommendations in the ‘Everybody’s Business’ report which is attached at Annex A.

 

Since the last update, we have made what I believe to be a step change in our approach to prevent suicide in Wales. This approach includes the establishment of a Cross Government Suicide Prevention Strategic Group which met for the firsttime on 17 March and most recently on 14th July.The Group has been established to strengthen programme management arrangements and to drive forward cross government and multi-agency work to prevent suicide in Wales. The group is chaired jointly by the Deputy Director for Mental Health and Vulnerable Groups and Professor Ann John, and includes senior officials from across Government including Health, Transport, Planning and Digital. The new Cross-Government Group will meet quarterly and will report directly to me via the Together for Mental Health Delivery and Oversight Board. We are also working with the National Advisory Group to refresh the terms of reference in the contextof the Cross-Government Group and with a focus on oversight of research, evaluation and data analysis.

 

In April, we launched the Real Time Suicide Surveillance System (RTSS) in Wales which was developed in partnership with Public Health Wales, all Police forces in Wales, and the NHS Wales Health Collaborative. The RTSS is now collecting data relating to sudden or unexplained deaths that are suspected to have been by suicide. The launch of RTSS demonstrates a collective and shared priorityto prevent suicide,enabling us to respond much more quickly to any possible changes in rates, to activate preventative measures, and to ensure that immediate support is made available to the individuals and communities most affected.

 

Our National Suicide and Self-Harm Prevention Co-ordinator is also working with a multi- agency group to finalise the guidance for Responding to people bereaved, exposed or affected by suicide. The guidance has been informed by insights into the needs and experiences of people living with bereavement by suicide in Wales, following a listening exercise that explored the points in their bereavement journey when they interface with statutory or voluntary services. The guidance aims to ensure services provide a more compassionateresponse. The guidanceincludes the need for a national suicidebereavement support and liaison service and I have asked officials to explore options to develop or commission this support later this year.

The RTSS and the planned national suicide bereavement liaison service are supported by the additional funding that I have allocated to suicide prevention from 2022/23. This investment will build on our previous investment in this area and must also be considered in the context of our wider and continued investment in mental health services and support. In particular, our transformation of crisis services form part of our suicide prevention approach and we are on track to deliver 24/7 access to urgent mental health support via 111 later this year.

The transformation of the approach that I have outlined demonstrates the Welsh Government’s commitment to this important agenda and provides the foundation for systematic and multi-agency approachto suicide prevention in Wales. We have consequently been able to completeand close a number of the recommendations in Everybody’s Business. Four of the recommendations were deemed complete at the February 2021 review and are now showing at the end of the table under the ‘completed actions’ section. Of the remaining recommendations, we consider a further eleven can now be closed and these are clearly identified in the attached annex. The remainingactions will continueto be delivered within the context of the work to evaluateand develop the successor to the currentTogether For Mental Health and Talk to Me 2 strategies and we will providea further updateon progress towards the end of the year.

 

I would like to thank the Committee for its continued focus on suicide prevention and self- harm.

 

Yours Sincerely,

 

Text Box:

 

Lynne Neagle AS/MS

Y Dirprwy Weinidog Iechyd Meddwl a Llesiant Deputy Minister for Mental Healthand Wellbeing


Health, SocialCare & Sport Committee - Everybody’s Business Welsh Government Status report on recommendations

Everybody’s Business, a report on suicide prevention in Wales, December2018 August 2022

 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

1

We recommend that a suicide prevention training framework should be adopted and implemented across all public services in a similar way to the framework for domestic violence, where training requirements are specified depending on the role. In particular, GPs would be one of the groups of professionals with greater training / skills requirements, and it is important that they and their practice staff have confidence to ask the right questions, and respond compassionately and effectively when dealing with patients who may be at risk of suicide. We believe that the National Advisory Group should take this forward as an immediate priority, particularly given that a training framework has already been developed and is being launched in England

We have previously reported that Professor Ann John (Chair of the Suicide and Self Harm National Advisory Groups) contributed to the children and young person’s component of the self harm and suicide prevention framework (Health Education England, University College London (UCL), National Collaborating Centre for Mental Health (NCCMH)) (published October 2018), which is in 3 parts:

·         Children and young people

·         Adults and older adults

·         Public (community and public health).

 

The National Lead (Claire Cotter) is currently leading on the development of a ‘capability framework’. This will set out the capabilities required at a universal level across multi-sectoral workforces, working with Health Education and Improvement Wales (HEIW), and digital experts. Specific groups of front-line workers are engaged to develop this resource through co- production, to build capability and confidence in the system e.g. local area coordinators; further education welfare officers; primary care teams; a health board. We expect this work to be concluded by the end of the secondment period (March 2022).

The work around universal suicide prevention training continues to evolve

 

A digital platform is currently in development providing a ‘suicide and self harm (SSH) Cymru training hub’ to help front line workers to navigate what is a crowded market of training products and programmes in an informed way. It will also provide short-cuts to free on-line training videos and e-learning resources available across the UK

 

There are also training frameworks available on the ACES AWARE Hub, and another being developed through Traumatic Stress Wales.

 

It is possible that the digital training hub will expose gaps in training provision, as people seek products to suit their particular development needs. The National Coordinator is liaising with AGORED and Adult Learning Wales to look at developing specific  units  (curricular  and  learning

outcomes) and potentially a national qualification.



 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

 

The training material for the GP DES is complete but the necessary engagement with GPs has been delayed due to the pandemic. New timescales will be agreed in due course.

 

2

We recommend that the Welsh Government should take the lead in promoting existing materials, such as the “See. Say. Signpost.” training resource as part of a campaign to raise public awareness and embed the message that suicide is everybody’s business and can happen in any community at any time.

We continue to share and promote resources and the National and Regional Co-ordinators will play a key role in identifying further opportunities to raise awareness of materials.

 

The NHS Wales Health Collaborative now includes specific information on suicide and self-harm and signposts to other key websites for information.

 

The Public Health Network Cymru website also has a page, and is developing a new page on suicide and self- harm on the revised platform (currently being updated). This website has facility for a community of practitioners and professionals.

In addition to the update provided in February 2021, please see the update to the previous recommendation.

 

This work will continue in the course of ‘business as usual’ and further activity will be included within the routine National Co- ordinator updates made available to stakeholders. We will also continue discussions on how best to raise awareness through the work of the Cross Government Group on Suicide Prevention and through the work programme of the National Co- ordinator on Suicide and Self Harm.

4

We recommend that the Welsh Government and National Advisory Group work with Network Rail and the Samaritans to evaluate the success of the Small Talk Saves Lives campaign with a view to rolling this out to a wider range of organisations

A wide range of initiatives are in place across Wales. Regional suicide prevention leads have now been appointed and are mapping what is available in each area, as well as the outcome measures that are available to evidence impact. Decisions around longer term funding or the upscaling of specific programs will be considered alongside setting the priorities for our recurrent regional funding programme, led by the national coordinator in discussion with the National Advisory Group.

 

Additionally, regional coordinators now attend a bi- monthly Wales and Borders multi-agency meeting

We have strengthened arrangements to identify good or notable practice through the National and Regional Co-ordinators. We have also established a Cross-Government Suicide and Self-Harm prevention Group. This group will ensure that work across Government, including Planning and Transport, is embedded as part of the wider approach to prevent suicide. The National and regional suicide prevention co- ordinators will feed into the cross- Government group.


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

 

organised by Network Rail, and attended by rail operatives including Transport for Wales (TfW), Samaritans and the British Transport Police. This group will link with the Real Time Surveillance work, and they continue to develop opportunities for suicide prevention.

 

We have also strengthened our engagement with our Knowledge and Analytical Services Team, through the recently established Delivery and Oversight Board so as to ensure that all interventions that are developed have a clear evidence base. A number of work streams are reported to this board, one of which being suicide and self-harm prevention.

We are also refocusing the National Advisory Group to ensure our approach is evidence based.

 

We will also be working with Knowledge and Analytical Services as part of our work to develop the successor to Talk to Me too to ensure an evidence-based approach.

 

On the basis that we have established new and robust arrangement to strengthen the analytical and evaluation support for the Suicide and Self-Harm Prevention Programme we consider this action closed.

 

With regards to the Small Talk Saves Lives campaign, the latest Real People Real Stories campaign launched across the UK (including Wales) in 2022 and the Samaritans secured major advertising coverage. In addition, a petrol pump campaign was run in every rural local authority in Wales, alongside radio coverage in the South Wales Valleys area. The campaign also featured on ITV Wales News.

 

The Samaritans have a partnership with Network Rail and a regional lead who is employed by Samaritans and covers Wales and the West of England.


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

5

We recommend that the Welsh Government take urgent action to ensure that all GPs in Wales are aware of and understand the GMC guidelines on sharing information and the consensus statement agreed by the UK Department of Health, Royal Colleges and other partners. We support the campaign by Papyrus to encourage chief executives of NHS bodies to provide assurance that they will support staff who make a best interest decision to break patient confidentiality in order to protect

life

Whilst we have highlighted this issue internally with policy leads, we have not been able to prioritise further work on this action. This will be taken forward as part of our staged approach to respond to recommendations in this report and the broad range of recommendations across other related Committee reports.

 

NICE is currently consulting on new guidance on self harm. Welsh Government will issue a Welsh Health Circular on decisions about confidentiality rights when supporting patients who are considered at risk of suicide or self-harm following the publication of the NICE guidance later this year.

6

We recommend that the Welsh Government must take all necessary steps to ensure parity between mental and physical health services. This should be tied to “A Healthier Wales”, and the Welsh Government must ensure that its plans for the development of health and social care services give the same priority to mental health and wellbeing as to physical health. This includes ensuring the allocation   of   appropriate

resources, and that patient outcomes, in terms of improved

In the budget for 2021/22, an additional £42 million for mental health has been allocated to support the delivery of priorities laid out in the Together for Mental Health Delivery plan 2019-2022. This represents significant additional and recurrent funding for mental health services that will increase the baseline to support services to meet changing mental health needs. This additional investment takes total spending on mental health to £783m in 2021-22. Included within this total is

£726 million that will be provided to Local Health Boards in 2021-22 as part of the mental health ring-fenced allocation to support current mental health services and support.

 

Work continues to better integrate mental health services with physical1 health services, for instance

Ensuring parity between physical and mental health is firmly embedded in health strategies in Wales and the Programme for Government makes a commitment to continue to prioritise investment in mental health. On this basis, this element of the recommendation in closed.

 

In terms of outcome measures for mental health, training and resources to embed the use of patient reported outcome and experience measures in all mental health teams in Wales began in June 2021 and this work will continue to be supported until March 2023.


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

mental health, are measured and reported. If the Welsh Government is serious about achieving parity between mental and physical health, it must consider whether the introduction of meaningful targets would ensure health boards give sufficient focus to improving mental health services and patients’ experience of care

plans are being finalised for the mental health crisis programme of work to become part of the Urgent and Emergency Access Programme Board. Similarly, as part of the Strategic Programme for Primary Care work is being taken forward to ensure mental health is integrated element of this work.

 

During the pandemic, mental health services have been prioritised and positioned as essential services alongside key ‘physical’ health services which demonstrates the level of importance that we place on our mental health services Wales.

 

In terms of waiting times, there are good examples where mental health and physical health targets align, for instance for emergency care where the 4 hr emergency assessment criteria for mental health is aligned with the waiting time target in A&E. In addition, targets for routine assessments and referrals to treatment for mental health both have a 28 day target compared with the 26 week referral to treatment for physical health conditions. We are also strengthening the leadership for the Core Data Set work to ensure a focus outcomes and to identify opportunities to accelerate progress ahead of the implementation of WCCIS.

This work is now being taken through the Mental Health Data and Outcomes Measures Board which reports to the Together for Mental Health Ministerial Oversight Board.

8

We recommend that the Welsh Government develops an all- Wales triage model which would see community psychiatric nurses based in police control

Improving all age crisis care is a priority in our 2019-22 Together for Mental Health Delivery Plan, including ensuring 24/7 provision. Previous updates have included information about the range of pilot projects to test models of telephone based triage. We have made

As previously referenced, we committed

£6million to improve crisis services in 2021/22 and we are making good progress in rolling out 27/7 access to urgent mental health  support  via  111.  Our  planned


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

rooms. We believe this work should be carried out in line with the six month timescale set out in the Children, Young People and Education Committee’s Mind Over Matter report (its recommendation 15):

 

   That the Welsh Government, within six months of this report’s publication, in relation to crisis and out-of-hours care:

▪ work with Welsh police forces to scope an all-Wales triage model which would see mental health practitioners situated in police control rooms to provide advice when children and young people (and other age groups, if appropriate) present in crisis;

  outline how resources could be directed towards enabling crisis teams in all health boards to provide training and cascade expertise to other frontline services, particularly colleagues in A&E, in border areas (to improve cross-border relations with those centres most often accessed by Welsh domiciled patients), and in schools (to normalise conversations about

good progress in improving crisis care which has been supported by £3.4million of funding over the last 3 years (£1m 2018-19, £1.4m in 2019-20 and £1m in 20/21) to support a range of approaches (telephone triage, conveyance and crisis cafes).

 

Findings from a recent Welsh Government commissioned review of all age urgent access (‘Beyond the Call’ Report, published 21 December 2020) demonstrate the breadth of needs that people in crisis experience. These include a broad range of social and welfare issues and all partners agree that a multi- agency pathway is required to respond to needs. To support the improvements needed from a health perspective as part of the multi-agency approach, I have committed an additional £6m for crisis care in 2021-22. Work is already underway to test a 111 crisis pathway in three health board areas with a view to scaling up this work. We have also established mental health conveyance pilots with St John Cymru to provide more appropriate and timely mental health transportation. The aim is to roll this work out further during 2021-22.

 

 

We have also commissioned a review of crisis and psychiatric liaison services by the NHS Delivery Unit to inform our ongoing response. The timescales for this review has been delayed due to the pandemic. This has primarily been due to allowing services to concentrate on sustaining essential services during very challenging times, including the need to adapt services models within the restrictions. However, the review is underway

implementation for April has been impacted by the pandemic and challenges remain for health boards in the recruitment of key staff. Health boards are at different phases of implementation and we are aiming for 24/7 coverage across Wales by the end of the year – with some health board on track to have the service in place before the summer. Once fully implemented, the service will provide a direct line for police officers to call to request advice. Health boards are working locally with police forces where there are existing triage models in place.

 

Continuing the transformation of crisis services is a priority for the additional mental health funding that we have secured for 2022/23. Funding will be directed to support the improvements recommending by the NHS Delivery Unit following its review of crisis care. Health boards submitted plans for this funding at the end of May and officials are considering the bids..

 

We also continue to pilot the mental health conveyance service with St John Cymru. This pilot has received positive feedback from stakeholders, particularly from Approved Mental Health Practitioners and the Police. Plans are in place to roll-out the service following the successful pilot period


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

suicide and self-harm in particular);

  ensure that follow-up support is being provided by health boards after discharge, provide information on how health boards monitor this provision, and commit to making this information publicly available to ensure transparency and accountability ensure that all health boards are adhering to the requirement to hold designated beds that could be staffed adequately for unders-18s in crises, indicating how this will be monitored and reported in future, and what steps will be taken if such beds are not available;

   implement with pace and in a uniform way across health boards the single point of access approach to specialist services, to ensure timely and appropriate access to support, urgent or otherwise; and

  reflecting on the results of the review of crisis care, outline what more needs to be done to deliver a safe and cost-effective 24/7 crisis care service in all areas of Wales, how that will be done, and by when

and the aim is to complete fieldwork by the end of October 2021. At the conclusion of each HB review a full local report will be provided to the relevant Board by the NHS Delivery Unit. Therefore the majority of HBs will have received their local reports during the spring and summer with the final HB being reviewed in the Autumn. At the conclusion of the local reviews a national report will be produced and published before the end of the calendar year. This timetable is dependent on restrictions and health boards’ ability to engage fully with the review.

 

Schools guidance in respect to responding to issues of self-harm and thoughts of suicide in young people was published in 2019.

Welsh Government commissioned the NCCU to undertake a review of designated bed usage in 2021. The NCCU and the NHS Delivery Unit are now developing updated guidance with more regular data capture to support improvements.

 

Guidance on the delivery of liaison psychiatry services (LPS) in Wales was published in December 2021. This document provides guidance on the functions of Liaison Psychiatry Services (LPS) in Wales. It has been developed in conjunction with key stakeholders throughout Wales and all professional groups have been represented. This guidance applies across the age range and whilst differentiation may be needed, no age range should receive services of a lesser quality. Service user and carers’ voices have been sought and are reflected in this document. It contains eight standards to support equitable access to and provision of LPS in Wales and reflect both The National Institute for Health and Care Excellence (NICE) and professional body standards. Collecting information in relation to the standards will assist health boards to develop a clear picture of service demand, uptake and delivery. It is expected that both qualitative and quantitative information will

become available as services develop and mature. Auditing information about the LPS


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

 

 

should enable health boards to make evidenced-based decisions about the future provision of that service. Psychiatric Liaison Services has also been made a priority within this years’ service improvement funding.

9

We recommend that the Welsh Government takes urgent action to establish to what extent those discharged from inpatient care are currently receiving follow-up care within the targeted timescale and provide an update to the Committee within three months. This should include steps to ensure that IT systems can  identify  whether  this  is

happening

Response to 9, 10 and 11:

 

As part of the Mental Health Core Dataset, contact within 2 days of discharge is a key target – WG is working with NWIS and stakeholders to implement robust performance monitoring around this target via Welsh Information Standards Board procedures. In the meantime, officials are working with health board to ensure follow-ups post discharge are undertaken and recorded locally.

This continues to be progressed through the work of the Mental Health Data and Outcomes Measures Board.

 

The draft core mental health dataset has been circulated to health boards to impact test and to understand which elements are already recorded by health boards and which elements would need to be added. This has helped identify any elements which would be difficult to record. The report on this impact testing has now been received by the NHS Collaborative. The core data was submitted to the Welsh Information Standards Board in July as part of the approval process.

 

Alongside the outcomes training referenced in recommendation 6, the University of South. Wales has been commissioned to work with health boards and other stakeholders to develop outcome measures for mental health services. The initial mapping work report is due by Summer 2022.

10

We recommend that the Welsh Government introduces six monthly monitoring and reporting of the target in the Together for Mental Health Delivery Plan that all patients discharged from inpatient care receive follow up care   within   the   specified

timescale

11

We recommend that, in light of the evidence that suicide risk is greatest on the third day after discharge, the target for patients discharged from inpatient mental


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

health care to receive a first follow-up appointment should be changed to ensure that patients are followed up within 48 hours

 

 

12

We recommend that a target be introduced for waiting times for psychological therapies to ensure that those in need receive this support within a suitable timescale.                                        Accessing appropriate therapy early can provide the intervention that’s needed and prevent someone from requiring crisis care at a later stage

Since the publication of these recommendations, we continue to support work to improve access to psychological interventions and therapies and it remains a priority area within the Together for Mental Health Delivery Plan 2019-2022. In 2018/19, we provided £4m of extra funding direct to health boards to support them to improve access to psychological therapies and further investment was made in subsequent rounds of service improvement funding (n 2019/20 and 2020/21), totalling an additional £3.5m.

 

This funding was allocated on the basis it should build on previous investment and that health boards could demonstrate how the funding would support the implementation of Matrics Cymru, the Guidance for Delivering Evidence-Based Psychological Therapy in Wales published in 2017. The supporting National Psychological Therapies Management Committee (NPTMC) Action Plan, published in 2018 was designed to assist health boards evaluate and plan their services against the guidance and the accompanying evidence tables.

 

Following the initial audits undertaken in 2018 in respect to the NPTMC Action Plan, we will be asking health boards to review the implementation of those plans as part of this years’ work programme. We will request evidence from them about how they intend to focus on areas where further development is required. This will

We remain committed to publish waiting time data on specialist psychological therapies, but this work has been delayed during the pandemic.

 

Whilst the data is not yet robust enough to publish, operational data is reported by all health boards and used by the Welsh Government to hold services to account. The NHS Delivery Unit has been commissioned to undertake a review of psychological therapies to understand the consistency and variation in services and data reporting across health boards.

The waiting time data that will be published only reflects one element of access to psychological therapies – the specialist services. Data is already published for Local Primary Mental Health Services, which includes psychological therapies and we have strengthened low level support, for instance through the introduction of online Cognitive Behavioural Therapy – another form of psychological therapy.

 

The work to develop the mental health core dataset will ensure that we are able to reflect a fuller picture of provision across Wales.


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

 

be supported by service improvement funding where needed.

 

This year, work has also been undertaken to assess and map the current psychological workforce including capacity, supervision and training needs. This broad analysis has been shared with Health Education and Improvement Wales (HEIW) to inform the workforce planning they are undertaking. Following discussions, this rapidly included additional places to train psychologists from the 2020-21 academic year.

 

We are also supporting an interim infrastructure to support the ongoing provision of psychological therapies, ensuring that the range of therapies available is strengthened, and that service user choice is embedded as routine practice across mental health services. This work includes the systematic and robust review of the evidence tables that underpin Matrics Cymru as it is crucial that they remain updated to ensure that the health boards are able to provide evidence based interventions.

 

Work has also been commissioned to produce a report on the most effective mechanisms for safety planning and it is anticipated the principles identified there will further inform the most appropriate psychological interventions for those experiencing suicidal thoughts and those that have self-harmed.

 

The national coordinator is also working with the National Liaison Psychiatry steering group and the core data  set  project  board  to  ensure  that  there  is

We are working with HEIW and Improvement Cymru to continue to develop the infrastructure to support health boards to improve access to psychological therapies. This work will ensure that we have a robust process to consider the evidence base of interventions that underpin Matrics Cymru and Matrics Plant.

 

Matrics Plant Implementation Plan was published in September 2021.This plan has been designed to support the implementation of Matrics Plant: Guidance on the Delivery of Psychological Interventions for Children and Young People in Wales. It is anticipated that it will assist health boards and partners in ensuring that both the spirit and detail of Matrics Plant are transferred into action.


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

 

consistency of assessment in liaison psychiatry settings. We are also committed to ensuring that any new evidence based practice identified in this area is shared with all appropriate colleagues.

 

13

We recommend that the Welsh Government accepts the call made in the mid-point review of Talk to me 2 to develop and implement a Wales-wide postvention strategy for suicide, and that this work should be taken forward as an immediate priority. This should include details of follow up support for individuals bereaved by suicide, and in organisational settings. It should incorporate the recommendation in Mind over matter that guidance should be issued to all schools on talking about suicide (and as a priority, to schools where there has been a suicide or suspected suicide). The Welsh Government should ensure that sufficient ring-fenced resource is available to implement this postvention strategy.

The Welsh Government has provided grant funding (2020/21) for a bereavement support project/service within each of the three regions involving SOBS (NW), MIND (Mid/West), and 2WishuponaStar (Gwent) and these will provide valuable insights to inform a pan- Wales approach

 

The National Coordinator attends the National Bereavement Steering Group which is currently developing a framework for all types of bereavement, this will be going out to formal consultation on the 22 March.

 

People with lived experience of bereavement by suicide are currently being engaged, with the support of voluntary agencies, to share their bereavement journeys so that we can better understand the challenges and opportunities to provide the right support in the right way. This is due to report 31st March 2021, and will form the basis for a postvention strategy, which will set out the costs that will need to be met and the resources that will be required to provide a national response during 2021/22

Informed by the insights gained from the listening exercise conducted in 2020/21 with those living with bereavement by suicide, a multi-agency task and finish group has been meeting to set out guidance for a Wales- wide response to those exposed, affected or bereaved by a sudden death that could be a possible suicide (rapid response would mean pre-inquest). This has included mortuary staff, coroners office, funeral directors, primary care, suicide bereavement support agencies, blue-light and rescue services.

 

The Real Time Surveillance System will provide information to help services to ensure that those bereaved by suicide are offered timely and appropriate support.

 

A draft guidance document is now out for wider review. A key recommendation of this work is the provision of a National Bereavement Liaison Service to make a proactive offer of support following a suspected suicide. Officials are exploring options to develop or commission this support.


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

 

 

Guidance on talking about suicide was provided to all schools following publication in September 2019. Officials in the Welsh Government are in the process of developing proposals to review awareness in schools and are considering what further support is needed in this space.

14

We recommend that the Welsh Government and Public Health Wales actively promote the availability of the Help is at Hand Cymru resource. This should include proactively engaging with third sector support groups and ensuring that frontline staff, particularly emergency services, who have contact with those bereaved by suicide are not only fully aware of Help is at Hand Cymru but, crucially, have access to copies of the resource so that this can be distributed to those bereaved at the point of need. As this resource is already available, this should be implemented within 3 months

A version of ‘Help is at Hand’ has been produced for Wales and is available on-line (Dewis Cymru) in English and Welsh. Funding has been made available to support ongoing printing and distribution costs. Recent print runs were distributed directly to Local Health Boards, a number of third sector organisations, police forces and Public Health Wales for dissemination to wider stakeholders.

 

It is noted that ‘Help is at hand’ is now due for review and the National Coordinator is linking with colleagues across the 5 UK/Ireland nations who all use the ‘Help is at Hand’ resource in order to consider further amendments needed, which will also be informed by the recent English review. Early discussions point towards a potential digital option that could be developed collaboratively with other nations. Work around a Real Time Surveillance system will also provide opportunities to enable use of  this resource to become more

embedded and ensure that the information is available at the point of need.

The digital supplier developing the training hub will be supporting the development of a digital version of Help is at Hand, which will provide an opportunity to review the content, update the signposting to services and resources in Wales, and to consider other ways of making the content available. This will be available in Autumn 2022.

 

While this is being developed a ‘business card’ with a QR Code to the current version on the Dewis Cymru website is being printed to make available to front-line responders across Wales

 

The same QR Code will be able to take people to the new digital version when it becomes available

15

We recommend that the Welsh Government should, as part of an all-Wales postvention pathway,            give                            active

Response to this recommendation will be considered as part of our work detailed in recommendation 13.

See ‘National Bereavement Liaison Service’ information in recommendation 13.


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

consideration to providing funding for support groups for those bereaved by suicide, so that people across Wales are able to access much-needed support. We believe such groups can play a key role in supporting the mental health and wellbeing of those bereaved through suicide. This could in turn lead to reduced  demand  for  NHS

services

 

 

16

We recommend that the National Advisory Group and regional suicide forums should engage with people who have personal experience of suicide ideation, including survivors of suicide attempts and people bereaved by suicide to ensure that all suicide prevention activity is informed by lived experience

Engagement with people with lived experience is currently through those voluntary agencies who are directly involved with those affected by suicide, and there is also representation from people with lived experience on the National Advisory Group and the regional and local suicide prevention forums. Each region has also allocated an administrative funding pot to cover the costs of coproduction, travel expenses etc. as appropriate to facilitate this ongoing work.

 

Recent examples of people with lived experience being involved in suicide prevention activity include sitting on interview panels for national / regional leads and direct engagement in the development of a national response to bereavement by suicide

People with lived experience, and agencies set up by those with lived experience attend all three regional forums and the National Advisory Group

 

A listening exercise directly engaged with people with lived experience to inform how we respond to people bereaved or affected by a suicide

 

This work will continue in the course of ‘business as usual’ and further activity will be included within the routine National Co- ordinator updates made available to stakeholders.

 

Therefore this recommendation is now considered as complete.


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

17

We recommend that the Welsh Government works with NHS employers in Wales to ensure that all employees who have dealt with cases of suicide/attempted suicide are able to access appropriate support

Welsh Government has worked with social partners within NHS Wales employers and trade unions to make available a multi-layered wellbeing offer for health and social care workers in Wales, including a confidential Samaritans listening support helpline, funded by Welsh Government, which is dedicated to all health and care workers in Wales.

 

There are also a number of free-to-access health and wellbeing support resources and apps such as Mind, CALL, Sleepio & Daylight and SilverCloud.

 

All NHS employers continue to have Employee Assistance Programs, with wellbeing services offering a range of support. There is also a number of support resources that staff are sign-posted to through HEIW’s webpage specifically on suicide, trauma and bereavement:

 

One significant avenue of support is through the Health for Health Professionals Wales Service (HHP). HHP Wales provides all doctors in Primary and Secondary Care with access to British Association for Behavioural and Cognitive Psychotherapy (BABCP) in their area. Doctors can self-refer and are assessed by a doctor adviser, qualified in physicians’ health, before being referred for face to face counselling. The service consists of four elements:

               A helpline, which explains what the HHP service can provide and puts clients in contact with a doctor adviser;

              A network of doctor advisers who ring the client within 24 hours to discuss their concerns;

We expect all health boards to provide appropriate support to all staff following traumatic events.

 

Health for Health Professionals has been renamed ‘Canopi’ and provides mental health support to health and social care staff. This includes support for post- traumatic stress.

 

This work is ongoing, and the National Coordinator is in conversation with the Royal College of Psychiatrists regarding the management of vicarious trauma, but also how we can prepare staff for inquests, for example.

 

We are also signposting to the First Hand resource Home - First Hand (first- hand.org.uk) that supports those affected by the suicide of someone they didn’t know


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

 

              Access to a network of British Association of Behavioural and Cognitive Psychotherapies (BABCP) accredited counsellors;

              Access to expert clinical support/opinion for all doctors and counsellors in more complex cases.

 

It was agreed that Welsh Government should access UK Government funding announced on the 11 March 2020 for a number of measures to assist the NHS, public services and businesses with the preparation and response to COVID-19. An additional funding amount of

£1m was requested for 2020-21 to enhance service delivery and upscale psychological support and extend outreach across the whole of the NHS workforce. Funding is now further agreed for 2021-22.

 

The HHP Wales expansion has created an established provider service for the entire NHS Wales workforce that has demonstrated itself to be reliable, responsive and trustworthy. HHP Wales has been designed to work in conjunction and to be complementary to the services offered by occupational health departments and the support available to an individual through their GP and other NHS services. By continuing to work closely with Traumatic Stress Wales (also accelerated in its implementation to support the Covid response), HHP Wales will be well placed to assist NHS staff with presentations directly related to Covid-19 experiences such as post-traumatic stress disorder, prolonged grief disorder and moral injury. It is also expected that NHS staff will present with mental health symptoms related to economic and other family impacts.

 


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

18

We recommend that the Welsh Government recognise male suicide as a national priority and allocate appropriate funding to identify and implement new approaches to reducing the stigma associated with mental health to encourage men to talk about and seek help. This should include scope to roll out existing projects more widely

The Welsh Government is providing grant funding (2020/21) to support a number of projects in the regions that focus specifically on men, to develop ways of engaging particular groups of men and encouraging help-seeking behaviour. The National Coordinator is also establishing a forum to bring all of the projects together to learn from good practice. Alongside this work regional coordinators are mapping initiatives in all areas of Wales to feedback on what is available and to consider any perceived gaps in this area.

 

Wales is also represented by Professor Ann John on the Advisory Group for the National Confidential Inquiry into Suicide and Safety In Mental Health. Under these arrangements, a study is currently being under taken to examine the characteristics of middle age men who die by suicide and to make recommendations to strengthen preventative action. The report will be published in 2021 and will inform our next steps

An Independent Advisory Group (IAG) provides independent external oversight of the work of the National Confidential Inquiry into Suicide and Safety in Mental Health. The IAG includes representatives from key stakeholder groups, and lay member

Preventing Suicide is a priority for the Welsh Government and a new cross-Government Group has been established to strengthen the approach. We have also committed additional funding for suicide prevention in 2022-23.

 

We have recently established the Real Time Suicide Surveillance system in Wales, This will provide more timely access to information from all probable suicides (including male suicides) to identify opportunities for prevention and to ensure appropriate support is provided.

 

As part of our programme to review and develop a successor strategy to Talk to Me too, we will be engaging with key stakeholders and reviewing the evidence to ensure new actions are evidenced based. Given the prevalence of suicide for middle aged men, we would expect this to be a key area of focus.

 

We are also working with our National Suicide Coordinator to agree a programme of work to review the evidence of suicide prevention programmes and intervention with a focus on middle aged men.

 

This work will continue in the course of ‘business as usual’.


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

19

We                endorse                      the recommendation of the mid-point review of Talk to me 2 that the implementation of NICE guidance on self-harm be a priority for the Welsh Government. This should be implemented within 6 months of the publication of this report

The National Coordinator is currently working with Improvement Cymru and the Liaison Psychiatry teams to identify challenges and opportunities to improve services in secondary care where NICE guidance is not being met

 

We will also liaise with the NICE Improvement Facilitator for Wales to explore other areas where we need to focus on to ensure the implementation of NICE guidance, for instance primary care.

A workshop was held in February 2022 to raise the profile of the new NICE Guidance for the assessment and management of self- harm that was out for consultation at that time.

 

The Guidance is expected to be published later this year when a further workshop will be held for those identified as key agencies for implementation, to explore opportunities and barriers and to inform how we support front-line workers to work to the guidance

21

We recommend that the Welsh Government takes a lead in the current work with HEFCW and for it to expect further and higher education providers in Wales to introduce Student Mental Health Charters. This work should be done in time for the start of the 2019-20 academic year to ensure that students in Wales benefit from the work as soon as possible

The Minister for Education has remitted HEFCW to work with partners in the HE sector to address student mental health and well-being. This included allocating HEFCW

£3.5m in 2019 to support well-being and health in higher education, including student mental health.

HEFCW worked with universities in Wales and students to develop a Wales-wide, strategic approach to well- being and health, including mental health. In November 2019, HEFCW published its Well-being and health Policy Statement, in which it commits to ensuring providers’ Wales-wide commitment to well-being and health, including through support for Student Charters, #stepchange [now Step Change: mentally healthy universities] and Suicide-safer Universities.

 

In 2019, HEFCW also published updated guidance on Student Charters. This included the addition of a requirement to include a statement of commitment to supporting student well-being, including mental health

Welsh Government, working with partners, continue to prioritise this area of work and have earmarked another £2m for mental health and well-being within HEFCW's grant in aid for 2022-23, maintaining the level of funding in previous years.

 

This work will continue in the course of ‘business as usual’.

 

Therefore, this recommendation is now considered as complete.


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

 

and signposting to related well-being and health, including mental health

 

In 2020, HEFCW required universities to submit well- being and health strategies. HEFCW will monitor the implementation of the strategies to ensure they remain fit for purpose.

 

The National Coordinator for Suicide and Self-Harm is also working with the national network of Welfare Officers for Further Education colleges, to discuss their experiences of managing suicidal ideation and self harm and is working with them on policy development. Similar links have been made with HEIs and the national network of Student Services Directors. This recommendation is now considered complete.

 

22

We recommend that relevant staff from the Welsh Government and other agencies receive appropriate training, such as the Samaritans’ “Working with compassion” kit, to show a greater awareness and understanding of the higher suicide risks associated with rural communities, particularly among farmers and their families. This would enable them to respond compassionately when dealing with bereaved families, and promote a greater understanding of the difficulties

families in this situation can face

We are taking a range of approaches including through public awareness messaging and improving the information that is available on health board websites. We also work closely with the third sector to ensure information on mental health and mental health services is shared widely.

 

We have also invested in a range of easy to access support – both online and via the telephone. Some of this support is also available 24/7 to ensure support is available at any time. The roll-out of online Cognitive Behavioural Therapy in Wales was based on a successful pilot by Powys Local Health Board which includes some of our most rural communities in Wales. Powys are also working to develop intelligence led services for the prevention of suicide and self-harm,

including support pathways for those bereaved by

This work is ongoing and will continue in the course of ‘business as usual’.

 

Therefore, this recommendation is now considered as complete.


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

in not only carrying on with their day to day farming business, but also in meeting timescales associated with Welsh Government farming processes. We would encourage relevant Government staff to use their discretion to alleviate further stress on bereaved families, for example by deferring farm inspections in appropriate circumstances

suicide. Data collation and analysis is in progress to understand if there are trends within particular Powys communities /demographics; to map and gap service provision and ultimately to target identified need and ensure clear pathways are in place as a means to early intervention and prevention. This work also ties in with a focus on Substance Misuse “Harm Reduction”, particularly in relation to Drug Related Deaths and will support the delivery of appropriate responses to personal crisis’, early intervention and management of self-harm.

 

We are also aware of other sources of support, for instance, FarmWell Wales; an online information hub part-funded by the Welsh Government EU Transition Fund which is available to farmers throughout Wales, this aims to provide farmers with the most up-to-date information and details of support services available. These resources are actively promoted by stakeholders who have given positive feedback on the initiative.

 

On the Welsh Government website we have also ensured that mental health and wellbeing support for farming families is effectively signposted so people know where to access support.

 

Welsh Government Farm Liaison Staff and Farming Connect front line contracted staff have attended Mental Health First Aid training which was delivered by the DPJ Foundation and tailored to the farming Industry. In addition visiting officers within Rural Payments Wales have received training on mental health awareness and

 


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

 

managers have also attended additional on-line mental health awareness training with the DPJ Foundation.

 

23

We recommend that the Welsh Government liaises with the Home Office with regard to reviewing the process for assessing and managing prisoners’ risk of suicide and self- harm to ensure that it is sufficiently robust to identify those at risk and provides the

right support for those who are managed through the process

The Ministry of Justice and HMPPS Wales has been working with health boards to revise to the Assessment, Care in Custody and Teamwork (ACCT) process for the case management approach for people at risk of suicide and self-harm within prisons. HMPPS piloted a revised version of ACCT including HMP Swansea, from February to June 2019. The revised guidance is now complete and will now be signed of formally by Prison Health and Social Care Partnership Boards before being implemented in Wales.

The revised guidance has been signed off formally by Prison Health and Social Care Partnership Boards. This recommendation is therefore considered complete.

24

We recommend that the Welsh Government ensures that the Children, Young People and Education Committee’s Mind Over Matter recommendations are implemented in order to improve and protect the mental health and wellbeing of children and young people in Wales. On suicide specifically, we recommend that the Mind Over Matter recommendation on guidance to schools (its recommendation 16) should be taken forward as an immediate priority: That the Welsh Government,  in  relation  to

suicide specifically, work with expert organisations to:

The Committee received a full update on progress with Mind Over Matter recommendations in February 2020, this included confirmation that Guidance: responding to issues of self harm and thoughts of suicide in young people, was published September 2019

 

 

The Welsh Government is providing grant funding (2020/21) in the Mid/West region for the delivery of NSSI (non-suicidal self injury) training to people who work with young people, which includes promotion of the published guidance.

 

In October 2020 the CYPE Committee published its Mind over Matter: two years on report. This highlighted the progress that has been made, particularly in the field of Education, in addressing the issues and recommendations contained in the original Mind over Matter report.  The Welsh Government’s response to

Further activity in response to this action will be reported in updates against the Mind Over Matter recommendations.


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

  provide, within three months of this report’s publication, guidance to schools on talking about suicide and self-harm, to dispel the myth that any discussion will lead to “contagion”;

  work with expert organisations to prioritise the issuing of guidance to schools where there has been a suicide or suspected suicide; and

  ensure that basic mental health training, including how to talk about suicide, becomes part of initial teacher training and continuous   professional development, so that all teachers are equipped to talk about it

the follow-up report (2 December 2020), noted that given the progress made to date on many of the Mind over Matter recommendations, we have already agreed to review the membership and expand the scope of the Joint Ministerial Task and Finish Group on a Whole School Approach to Emotional Wellbeing and Mental Health (JMT&FG) to become a ‘Whole System’ Ministerial Task & Finish Group to drive progress for the remainder of this Senedd term. Whilst the focus will remain around school age children, the whole system approach better reflects the current work of the group and enable it to provide leadership and expand across the additional relevant areas. In particular health and social services led actions. The group has been meeting monthly since the start of the year, with the last meeting before the Senedd elections taking place on 22 March.

 

In relation to schools guidance on suicide and self- harm people working with children and young people can now access guidance Responding to Issues of Self-harm and Thoughts of Suicide in Young People’ which was published on 10 September 2019. The document is available online and hard copies have been made available to schools and youth services. The guidance aims to support people who have direct contact with children and young people, providing them with practical advice about what to do if they have concerns or are faced with self-harm or suicide.

Further activity has been commissioned by the Welsh Government and developed by Swansea University and co-produced with young people. With the aim to address the link between online bullying and suicidal

 


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

 

and self-injurious behaviour and will provide a better understanding of what to do when they encounter these issues.

 

As part of our whole school approach, we have also developed new framework guidance for schools. The guidance has been designed to help schools develop and build their own consistent and equitable whole school approaches to meet the wellbeing needs of learners. We have made available £9m in our 2021-22 budget to support this work.

 

26

We recommend that the Welsh Government identifies the most appropriate agency to identify known suicide locations and places signage in those areas encouraging people to seek help

Since the publication of this inquiry, we have invested in both the national and regional infrastructures. Now at a regional level we are establishing forums and local multi-agency groups are responding to themes that are highlighted. This work has evidenced that it would not always be appropriate for one single agency to respond as we need to ensure that we are flexible within our response.

Work is ongoing through the regional coordinators and the Cross-Government Suicide Prevention Group to identify key sites, and they work with relevant colleagues in transport, Samaritans, network rail, canals authority, police and other first responders as needed on a site-by-site basis.

 

The new Real Time Suicide Surveillance System will also provide more timely access to information, including the local of the incident to inform future preventative activity

 

This work will continue in the course of ‘business as usual’ and further activity will be included within the routine National Co- ordinator updates made available to stakeholders.

 

Therefore, this recommendation is now considered as complete.


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

 

 

 

27

We recommend that the Welsh Government explores what formal arrangements could be put in place to promote and monitor adherence to the guidelines, given the negative impact that the irresponsible reporting of suicide can have. This should include looking at arrangements in place elsewhere, including the Republic of Ireland

Samaritans and the Independent Press Standards Organisation (IPSO) continue to develop and publish media guidance, both of which the Welsh Government continues to work with as key stakeholders.

Regional Coordinators forward reports of concern to the Samaritans press officer in Wales and Prof Ann John, to ensure a coordinated and appropriate response can be made.

 

This work will continue in the course of ‘business as usual’ and further activity will be included within the routine National Co- ordinator updates made available to stakeholders.

 

Therefore, this recommendation is now considered as complete.

28

We recommend that the Welsh Government engage with universities, the Samaritans and other relevant parties such as the National Union of Journalists and publishers to explore how training for journalists at university, through continuous professional development or on the job training could include the importance of adhering to the guidelines on reporting suicide and promoting an understanding of  the  negative  impact  of

irresponsible reporting

 

The new national bereavement guidance includes specific information for ‘touch point’ agencies who can impact on an individual’s bereavement journey. This includes through media reporting and work is underway to engage with universities as part of the implementation of the guidance.

Therefore, this recommendation is considered complete.


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

29

We recommend that the Welsh Government engages with the UK Government on its Internet Safety Strategy Green Paper to ensure that action is taken to protect children and young people online. Additionally, we are keen to see the potential for social media to have a positive impact on people’s mental health and wellbeing maximised. We believe that all opportunities to promote good mental health through social media/internet sites should be explored, for example through more active promotion of sources of support

Welsh Government liaised with UK Government in respect of the publication of the Green Paper.

 

We continue to look at opportunities to use social media and digital media to raise awareness of support and this been a particular focus during Covid 19 and working with Public Health Wales on the How are you doing campaign, to promote positive mental health and signpost to support.

 

The Cross-Government Suicide Prevention Group will include digital and online safety as an element of the broader work programme            including                                identifying opportunities arising from the Online Safety Bill. Welsh Government officials are currently considering the full impact of the Bill within Wales and across all policy areas which the Bill may touch upon.

 

This work will continue in the course of ‘business as usual’ and further activity will be included within the routine National Co- ordinator updates made available to stakeholders.

 

Therefore, this recommendation is now considered as complete.

30

We recommend that the Welsh Government / National Advisory Group provides a clear steer to the regional forums to ensure a consistent approach to their membership, structure and reporting arrangements. The Welsh Government should monitor the effectiveness of the regional forums to ensure that they deliver sustainable and consistent  outcomes  across

Now that the National and Regional Coordinators are in place, we will review the regional forums, including membership and governance structures. This work will be undertaken in the context of the new Together for Mental Health Ministerial Delivery and Oversight Board for Wales that I have convened. A key function of the board is to hold the key work streams that make up the mental health programme of work to account and to provide assurance on delivery. The suicide and self- harm programme is one the work streams that will report in to the board. The board first met in February and will meet again on 24 March.

The three regional forums have been supported and strengthened through the appointment of the regional coordinators. Two of the three forums have a new Chair, and developed workshops have been facilitated in Q4 (2021/22) to help the forums to review their existing strategies and action plans

 

These forums now share a common template for their TORs and will receive appropriate levels of data from the real-time surveillance for their quarterly meetings.


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

Wales,     and    provide                 regular updates to the Committee

 

 

This work will continue in the course of ‘business as usual’ and further activity will be included within the routine National Co- ordinator updates made available to stakeholders. The Cross Government Group on Suicide prevention will also be kept aware of this work.

 

Therefore, this recommendation is now considered as complete.

31

We recommend that the Welsh Government / other public bodies (LHBs / LAs) make specific funding available for suicide prevention to ensure that it is sustainable in the long term. The Welsh Government should work with the National Advisory Group to ascertain how much funding is needed to ensure this sustainability, and ring-fence the appropriate amount

The National Coordinator and the coordinator team are looking at how suicide prevention can be better integrated and embedded in public service delivery across the board/government departments; how this can be more explicit in policy/strategy.

 

In the meantime, we have provided seed funding to regional forums in order to take forward local approaches in their areas, however this funding should not be seen in isolation as laid out in the covering letter.

A new, cross-Government Suicide Prevention Strategic Group has been convened to strengthen the programme management arrangements for the suicide prevention work programme. This will include driving work across Government and prioritising investment to support this approach.

 

Additional, recurrent funding has been allocated to the suicide prevention work programme in 2022/23.

In particular, the new funding will support the newly established Real Time Suicide Surveillance System in Wales launched in April 2022 and to improve suicide bereavement support.

 

 

 

Additionally, the wider service transformation also has a focus on preventing suicide – for instance the work to improve crisis care and the establishment of


 

 

Recommendation

Welsh Government Update February 2021

Welsh Government Update August 2022

 

 

 

the 111 mental health single points of contact.

 

Talk to me 2 is currently being externally evaluated and the findings from which will inform any appropriate next steps.

 

 

Recommendations considered complete

 

 

3

We recommend that the Assembly Commission offers suicide prevention training for Assembly Members, Assembly Members Support Staff, Commission staff and contractors. We hope that, as well as equipping Assembly Members and staff to respond appropriately, this will show an example to other employers, and we would urge the Welsh Government to promote suicide

The Assembly Commission will need to update separately regarding the implementation of the recommendation.

 

The Welsh Government HR Directorate (Workforce Department) have reviewed the provisions that are available to staff in respect to support and have strengthened the offerings available. More widely, Welsh Government have an active Health and Wellbeing Strategy that encompasses mental health and wellbeing. This is featured on the staff intranet. The Health and wellbeing Strategy, Toolkit, Reasonable Adjustments Policy and training covers mental health.

This is also covered in the Disability Confident training

Recommendation complete.


 

 

prevention training to all of its staff

for SCS and line managers. ‘Let's Talk’ performance management process includes conversations about mental health and wellbeing. Support and resources have  also  been  strengthened  throughout  2020-

21 including:

 

·         Training provided by Able Futures covering line manager capability in handling sensitive conversations and providing support to staff experiencing mental ill-health; peer to peer support; and how we can look after our own mental health;

·         A playlist of extensive resources available on the Welsh Government Learning Lab;

·         Recruitment of cohorts of Mental Health Allies and Respect Mentors due to commence late March 2021;

·         Bespoke support in mental health provided to specific business areas by Employee Assistance Programme provider and HR.

 

This action is now considered complete.

 

7

We recommend that the effectiveness of the urgent referral route for GPs implemented by Hywel Dda Health Board be evaluated with a view to rolling this approach out across all health boards in Wales

As stated within our original response, standards are already in place requiring health boards to meet target times from referral to assessment. The Welsh Government Guidance ‘The Role of Community Mental Health Teams in Delivering Community Mental Health Services: Interim Policy Implementation Guidance and Standards (2010)’ includes the expectation that people who are referred as an emergency are assessed within 2-4 hours, urgent referral within 48 hours, and routine referrals within 28 days as per the Mental Health Measure Wales (2010).  Hywel Dda health board has

confirmed that they do not have a protocol that differs

Recommendation complete.


 

 

 

from the existing expectations around GP referrals to Community Mental Health Teams (CMHTs) which exist across Wales and therefore this recommendation is deemed complete. However to note that the update of this guidance is included within the work programme of the Mental Health Network in 2021/22.

 

This action is now considered closed.

 

20

We recommend that the Welsh Government ensures that its forthcoming loneliness strategy reinforces the message that loneliness and isolation should be central considerations when budget and policy decisions are

made

The strategy was published in February 2020. Within the document there is a section specifically addressing mental health and suicide prevention and a number of references to ensuring loneliness is considered within budget and policy decisions throughout. This recommendation is considered complete.

Recommendation complete.

25

We recommend that the Welsh Government writes to all planning authorities in Wales emphasising the importance of ensuring that all new structures include measures to prevent them being used as a means of

suicide

Letter published on GOV.WALES suicide prevention measures in building design and planning (April 2019).

 

This recommendation is therefore considered complete.

Recommendation complete