My Practice

November 3, 2005 in Mental Health, Self harm/suicide

I have been involved in providing mental health support to the agricultural community for more than four years, and in particular to those who are experiencing suicidal thoughts.

We have developed partnerships that make sense to service users – key organisations and people within their own communities – who help shape their everyday lives. This evolving process is essential when building relationships with the agricultural community, which describes itself as private, proud and independent.

As for suicide, there is little consistency in approach for service users at their point of contact with services. Indeed, some feel as if policies and procedures deal with the risk to organisations, negative media reporting and professional protection, rather than the needs of the client.

Trying to bring together policies from a range of agencies has been a difficult and frustrating task. We feared ending up with a 200-page tome which tries to cover every eventuality from a number of perspectives: useful in gathering dust, but somewhat unhelpful when faced with the one situation not included.

We asked the families and people we worked with about compiling a short and precise protocol that addressed risk in a positive manner, ensured that all concerned were kept informed (rather than as an afterthought) and helped to clarify everybody’s role.

Clients want to be taken seriously, as we all do. This, they believe, can only be achieved with an understanding of their culture and a respect for their need to be managed in an environment conducive to their recovery.

They felt that if any agency at that first point of contact (including police, A&E, mental health workers, GPs, spiritual leaders and their union) could follow some basic steps, then they would feel more confident. The steps are:

Respond quickly – always take a request or attempt seriously. Respect what everyone is feeling.

Risk assess issues that are raised at that point – being open about where those risks lie, and whom they affect.

Be flexible, spending as much time as required by the client (or family) in the place conducive to their well-being. Review in real time, responding to changes.

Share responsibility and be there for as long as it takes.

Involve the family and take time to understand their fears and burdens.

Keep everyone informed – especially families.

Work together where possible.

I’m always impressed that, when we take the time to ask service users and families, they cut through the complexities and tell us simple things that make a difference.

We can use this alongside protocols that are in place for ourselves and other agencies, but it is possible to get local agreements to sign up to some consistent steps.

We are interested now in working similarly with our clients on confidentiality, discrimination and complaints.

Chris Coates is team manager of the Rural Emotional Support Team (Rest) in Staffordshire