Interventions and partnerships: a Suicide Safer approach to wellbeing

The University of Lincoln’s approach to collaboration and partnerships has been key to its #OneCommunity ethos around becoming a suicide safer university. This case study focuses on interventions and partnerships initiated by a specialist group within the university and demonstrates how a holistic approach to suicide prevention underpins the work.

The university’s Suicide Prevention, Intervention and Postvention Group (SPIPG) oversees the delivery of all the recommendations and actions of the Suicide Prevention Action Plan.

Membership includes student representatives, senior colleagues from across the University and members of the students’ union. External partners include Public Health, NHS Mental Health Commissioners, Lincolnshire police, education providers from across the city, charities and third sector organisations.

Through the work of the group, the university has been able to respond to issues around suicide prevention which has enhanced the support it provides for students. The group is governed by the university’s Education and Student Life Committee which has oversight and authority over the work undertaken by the group.

Internal data collected shows that the number of students accessing support at the University of Lincoln has grown significantly since 2014, with many students experiencing suicidal ideation or intent. This can take place at any time, on any day and in any location but, in particular, out of hours (8pm–4am).

The university’s SPIPG set about tackling some of the issues in order to:

• make the physical environment safer for students
• use well-established partnerships to enhance the work that the university does out of hours.

The SPIPG takes an approach of examining current challenges presented to the university in relation to suicide prevention and uses its experience to tackle and resolve those challenge through a number of means.

Two examples are outlined below where successful interventions and developments of partnerships have resulted in keeping students safer in relation to suicide prevention.

Action through intervention

Student representation on SPIPG is considered key to its work. The student representatives have all volunteered to be part of the group and all have lived experiences of suicidal ideation and self-harm.

The students attend the meeting and reflect on their own experiences providing an insight into how the group can respond more effectively to incidents or enhance the service. Participating students are supported by their Mental Health Advisor and prior to each meeting students are contacted by the Advisor who is also present at the meeting, and after the meeting the Advisor checks in with the student to ensure that they can share and reflect on the meeting content.

The students agreed to share their experiences via short films produced by the Student Digital Life Team (this example video is by a former student and employee of the university who is now working in mental health services and who has given permission for it to be used publicly).

These videos can be used to highlight some of the more complex challenges faced by students at university and help the university community develop an understanding of their experiences and how all have a part to play in intervention. The University only shares videos with explicit consent and support in place. The videos for current students are only used as part of presentations or discussions about the service to closed groups. Prior to the production of the videos, the Mental Health Advisor had conversations with students about the context of videos, and questions that would be asked. The Mental Health Advisor sought formal agreement that the students were willing to participate, and students give permission to use the video for particular audiences and have full control of dissemination. Prior to videos being shown the presenter gives a disclaimer of content and talks to the audience about safe space.

An example of a successful intervention as a result of student representation is that one of the students with lived experience, which for them occurred out of hours, raised the issue to the group about the layout of some apartments providing an access to means for students with suicidal ideation. This issue was taken outside of the meeting to discuss and resolve through liaison with Accommodation, Estates and Student Wellbeing. The university is very conscious of reducing means to access where they are raised as a concern.

Action through partnerships

The work of SPIPG also includes input from key partners from across the region. The aim is to work alongside community partners to transform mental health care across Lincolnshire.  

One of these partnerships is with Lincolnshire Clinical Commissioning Group and through this relationship the university applied for NHS Winter Pressures funding. This is to support and deliver the Commissioning Group’s plan to improve health outcomes for patients with a mental illness and reduce their reliance on physical health acute services such as ambulances and A&E.

The funding application focused on the challenges of intervening in out of hours incidents. The funding application was successful and an overnight mental health duty worker was appointed in February 2021. The role is to respond to out-of-hours calls alongside the university’s Security Response Team, working with students vulnerable to suicidal ideation or self-harm. The post is a university employee and is fully integrated into the daytime Student Wellbeing Team and regularly meets with the Head of Student Wellbeing to review their work.

What have been the barriers or challenges?

As the coronavirus pandemic began, it was difficult to bring the SPIPG together. Some of the key partners were unable to attend as they were needed to support their own areas of work in response to COVID-19.

The University also saw an increase in the number of students accessing support in accommodation as they were self-isolating or experiencing anxiety and distress as a result of the ongoing situation.

Whilst the group was unable to meet initially, the momentum continued and a focus on moving the work of the group forward was prioritised so that, by the time they were able to meet, some positive outcomes were in place to share with the group.

Action through intervention

Student representation on the SPIPG is key to ensuring that the university understands and is able to respond to student concerns.

For example, following the concern raised via the student representative on the SPIPG on the issue of safe apartment layout, a consultation took place between the university’s Student Wellbeing Team, Estates and Accommodation.

This consultation discussed access to locations within student accommodation that could be used, safety in place and impact on students overall. It was agreed that access to the identified potential means should be removed temporarily and a full review undertaken.

Action through partnerships

Following the appointment of the overnight mental health duty worker commissioned by the NHS in February 2021, to date (from February to July 2021) the duty worker has been able to respond to 85 per cent of the call-outs that would previously have gone to Lincoln Accident and Emergency and has escalated these where appropriate. The mental health duty worker works with the Security Incident Response team to attend concern for welfare calls and provides one-to-one support for the student involved and provides follow-up and check-in if required, linking up with the Crisis Team if appropriate.

The university found, at the height of the pandemic, 90 per cent of their students still remained in their student accommodation, and therefore required access to vital mental health services. 

Through the work of the overnight mental health duty worker, key areas identified as causal factors for suicidal ideation included undiagnosed mental health conditions, academic stress, substance misuse, accommodation, and relationship issues. This has allowed teams to develop targeted support in line with the Suicide Prevention strategy and refer into the wider Student Services teams or to their personal tutors regarding many of the academic concerns.

Could the approach be replicated?

Having robust partnerships across the community is fundamental to improving the health and wellbeing of students. The approach of engaging with students and partners via a focused and experienced group can easily be replicated across the sector through building relationships and engagement with key partners.

Universities should be encouraged to engage with their students with lived experiences, their local mental health concordats or mental health commissioning groups They should express the importance of joint partnership working and highlight how this work has seen a vast reduction in students accessing A&E mental health services.