September 13, 2023
One Life Lost is Enough
By Dr Cassie Rhodes
Almost exactly one year ago, to coincide with World Suicide Prevention Day 2022 (held annually on 10th September), we published a collaborative resource that remains an important highlight from my years at Tooled Up so far.
Together with leading suicide prevention charity, The OLLIE Foundation, we wrote new Guidance for Educational Settings Following a Suicide or Sudden Death. This comprehensive, 90 page, practical document containing evidence-based information and ‘lived experience’ advice, was created to help schools coordinate an appropriate, helpful and safe response in the extremely difficult and tragic event of a suicide or sudden death in their community. Our intention was to create a buoyancy aid for staff who may unexpectedly find themselves needing to navigate the immediate and ongoing impact of a sudden death. We wanted to produce something that would support individual staff and teams to look after themselves and their school, and help to manage the ripple effects caused by a sudden death as compassionately and gently as possible. I’m proud to say that it remains available for any school to download for free (from both Tooled Up and The OLLIE Foundation).
Whilst co-writing the guidance last year, I realised that, unlike lots of our Tooled Up resources, it isn’t something that any school staff member is likely to rush to read. The subject matter is emotive and potentially upsetting. The likelihood of a tragedy happening within a school community is thankfully very small and probably seems a distant prospect to most educators. Hopefully, it is not something that anyone reading this Wednesday Wisdom will ever need to respond to. However, worldwide, suicide is the second leading cause of death in young people aged 10-24 and is the fourth leading cause of death in 5 to 14 year olds. Tragically, over 200 school children die through suicide each year in the UK. The suicide rate amongst teachers is higher than any of us like to think and, sadly, many children are also bereaved by suicide. So, our guidance is something that I would love to see being used in as many settings as possible, providing support in the event of any of these terrible scenarios. Why? Well, we know that having a clear suicide response strategy (otherwise known as postvention), just in case it ever happens, is hugely beneficial to everyone in the community.
The guidance provides advice, exemplar materials, and important considerations for every stage of the response process, including how to navigate difficult initial conversations with a bereaved family, how to inform the rest of the school community sensitively and safely, what to expect from an inquest and other legal procedures, and how to manage memorials. It also shares the actions that should be taken to reduce the risk of suicide contagion (where a suicide or suicidal act within a community or geographic area increases the likelihood that others will attempt or die by suicide), and outlines how to identify and respond to a suicide cluster (where a number of suicides or suicide attempts occur closer together than would usually be expected).
We used our knowledge, the expertise of our colleagues and researchers, and testimonies from those with lived experience of suicide, to formulate checklists and bullet points that we hope are easy to follow and feel compassionate for everyone impacted by a suicide or sudden death. However, one of the things that struck me most in working on this project with The OLLIE Foundation, is that, in the event of such a tragedy, the human element in our response makes a vast difference to the loved ones and friends of the person who has died. This isn’t something we can simply add to a checklist, ready to be ticked off. A human response is compassionate towards everyone involved, acknowledges uncertainty and shows a willingness to adapt to the specific needs of the community. It’s about not being afraid to show emotion, or to openly acknowledge those moments when you simply don’t know what to say. A human response acknowledges that everybody’s experience of grief is as unique to them as their fingerprint, and therefore all anyone can do is offer our absolute best to support those in our care at this devastating time.
I urge all school settings to consider the advice in our guide and think about putting a plan in place, so that in the emotional aftermath of a sudden loss (however unlikely it may be), you’ll know what to do. Thinking about and preparing for a suicide or sudden death in your community can be extremely difficult, but I hope that at least some staff find the information within our guide useful.
Thankfully, there are many amazing organisations across the globe (The OLLIE Foundation is one) that are doing incredible work in suicide prevention, reducing stigma, tackling misconceptions and equipping individuals with the tools they need to keep themselves and others safe in moments of crisis. Progress is being made and, with better education, understanding and empathy, there is hope.
If you’ve not heard of The OLLIE Foundation (short for ‘one life lost is enough’), it is a suicide prevention charity, set up in 2016 by three Hertfordshire parents who each lost a son to suicide. They met in bereavement support and vowed to do all they could to stop another family going through the heartache they were experiencing. The charity’s mission is to reduce the incidence of suicide, particularly amongst young people, by sharing best practice and supporting curiosity, skills, capacities and knowledge, to help each generation stay safer from suicide and bereavement from suicide.
One way that the charity does this is through the provision of training and education to parents, children, teens and young adults and to all those with a duty of care for others. Through their work, the team at OLLIE aims to reduce the fears people have in talking about suicide and to advance the discourse around suicide studies and effective techniques and strategies in both early intervention and prevention.
At a recent catch up with Debi Roberts, OLLIE’s CEO, she gave me some crucial advice about the importance of ‘safe plans’ - something which all school staff and parents should be aware of. This critical tool can be used to help anyone (whether it’s our child, friend, partner, colleague or us, ourselves) who might be self-harming or experiencing suicidal thoughts.
A safe plan is a simple document that can play a vital role in keeping a person safe when they feel distressed or are thinking about suicide, reminding them of all the reasons they have to live. Evidence suggests that safe plans reduce suicidal ideation and behaviour, hopelessness and hospitalisations, and can enhance treatment attendance in some adults. These plans recognise that when thoughts of self-harm or suicide are overwhelming, staying safe takes a great deal of strength. Featuring both written and visual prompts, as well as important contact and emergency details, a safe plan connects individuals with people and services who can help during difficult times, emphasising that they are not alone and that help is available to keep them safe. It also encourages users to identify and create their own coping strategies. The plan does not provide a cure for the issues and feelings that a person is suffering, but it can help them feel a sense of efficacy in a situation that feels completely out of their control.
Safe plans are easy to adapt and can be used effectively in either digital or paper-based formats. They can be created face-to-face or online, and by almost anyone, including clinicians, non clinicians, school staff or individuals. As every person is different, every safe plan will be slightly different. Debi advises that they should be co-created and not written on behalf of a person who is in crisis. The individual should fill out the information, working with someone they trust – a friend, family member, teacher, doctor or therapist. Debi also notes that whilst these plans should of course be practical (including lists of who to call in a crisis), they should also be whimsical; filled with all the personal distractions that could support someone to stay safe for now. Ideally, the plan should be created whilst the individual is feeling well and can think clearly. Safe plans should be kept in a place where they can be found quickly in times of crisis. Giving a copy to a trusted person, or telling them where to find it is also useful. Best advice is to review the plan regularly, as needs change.
Within a school context, whilst there are amazing staff working in pastoral and wellbeing roles, a young person might choose to confide in any adult, so it’s optimal for all staff to know what a safe plan is and how to use one. To find out more, visit The OLLIE Foundation (where you can also download a template), Staying Safe or Papyrus (which is an organisation specifically aimed at preventing suicide in young people). You can even download safe plans directly to your phone. If you’d like some training, we strongly recommend OLLIE’s online training, ‘Talk Safe, Plan Safe’. These evening online sessions are free, though donations are welcomed. To see when the next session is and to book a ticket, click here.
The OLLIE Foundation has also developed prescription safety plans, specifically designed to protect the wellbeing of people prescribed antidepressants. It might surprise you to learn that antidepressants are taken by almost 15% of the population in England. Whilst these drugs are not recommended for use in children or young people, we know that many older teens do use them. Despite their proven benefits, potential side effects of antidepressants actually include depression and suicidal thoughts; the very things they are hoping to combat. The risk of side effects is greatest in people under the age of 30. Debi has found that people using antidepressants commonly say that potential side effects were not explained to them at the point of prescription. OLLIE’s prescription safety plan (which is now recognised in medical guidance papers) exists to help address the inherent conflict posed by medications that aim to alleviate symptoms, but which can exacerbate the very issues they intend to resolve. The plan provides clear guidance about potential side effects and a reminder that anyone using antidepressants should consult their prescriber for guidance if they experience significant mood deterioration after starting medication, just as they would for any other adverse reaction. OLLIE provides talks and training for professionals on why and how to use these plans and 'Wellbeing at University' talks for students and parents. For more information, pop them an email.
Within educational settings, it’s not only students who require mental health and wellbeing support. Sadly, there has been a marked escalation in suicidal ideation amongst teachers. Debi told me that, even though she is often asked to speak about staff wellbeing, and has read all of the statistics from academic reports, it was nonetheless shocking to attend a conference where, out of 250 attendees, 11 disclosed that they were, or had recently felt, suicidal.
During our chat, Debi noted that, “Sometimes workplace wellbeing and staff mental health initiatives can feel like a tick box exercise. And in reality, we know that posters on the back of toilet cubicle doors and free tea and coffee in the staff room just aren't enough. From head teachers to support staff, many tell us they’re ‘burnt out’, which insinuates a lack of self care or time management.” She’d like to see the issue of workplace wellbeing tackled at a policy level and is encouraged by some newly published recommendations by the British Medical Association, which she believes have the potential to transform our approach to mental health.
Amongst other recommendations, the report notes that a healthy work environment is crucial and that employers must step up in order to provide one. Adequate wellbeing support and prevention of workplace-related stress and burnout are essential. It notes that this should include rest spaces, mental wellbeing training for management, and accessible occupational health services that have supportive family, menopause and bereavement policies. For us all, a healthy work-life balance is not a luxury; it's a necessity.
The paper recommends that workplace cultures should also empower employees to seek help without fear. It’s vital to foster a culture where mental health is considered as important as physical health and where employees are aware of their rights regarding mental health-related sickness absence. This guidance provides a roadmap to a more compassionate and supportive society. We can all strive to champion these changes in our workplaces (schools or not), break down barriers, and work together to make suicide prevention a reality for everyone.
Only this week, the Department of Health and Social Care (DHSC) published a new suicide prevention strategy, setting out its aims to prevent self-harm and suicide for the next five years. Any primary school staff might consider attending The National College’s free webinar, which will focus on the implications of this new strategy for schools. For any school interested in further developing student and staff wellbeing, why not check out this free upcoming OLLIE Foundation event? It will feature talks on developing girls’ self-efficacy, confidence and leadership skills from the Lean In Girls Programme, representatives from Beyond Education talking about how they are helping to address mental health problems in young people and Debi Roberts, who will discuss OLLIE’s safer prescribing and ‘Planting the Seed’ programmes. Sign up now!
Finally, if you are a parent and you have any concerns at all about your child’s mental health, or your own, please make sure that you seek medical advice. Go to your GP. Talk to their school. If you feel that they or you are in immediate danger, go straight to A&E. Don’t be afraid, embarrassed or worried about what people might think. There are various excellent helplines for young people who feel suicidal, which all families and schools should be aware of. Papyrus offers a hopeline for young people experiencing suicidal thoughts and the Shout text line is available 24/7 on 85258.
Are you a Tooled Up member?
Regular users of Tooled Up will know that our platform is brimming with mental health resources for parents, carers and educators. All of our resources around parenting and children’s resilience are designed (as far as possible) to ward off mental health distress and educate parents around those ‘protective assets’ in children’s lives that enable good mental health and fitness.
For families where children and young people are currently going through a challenging time with their mental health, we have parent support resources on topics like teen depression, eating disorders, support for siblings of young people with eating disorders and self-harm with leading clinicians and researchers. We educate and also signpost to other useful websites, toolkits and resources.
If you are wondering where to start with our mental health resources, we suggest taking a peek at our ‘Quick Guides’ on subjects like anxiety, emotional literacy, self-harm, or at our important ‘Sources of Support’ resource.
Whatever is going on in your life, we want you to know we care, we are there to support you and to learn alongside you. It truly ‘takes a village’ to raise a child and we’re with you every step of the way.
Thank you for reading Wednesday Wisdom and don’t forget to send us your views on format, length and content!