Suicide prevention through online staff training

The University of Plymouth’s Turbo Teach programme aims to upskill personal tutors and academic staff to talk about the subject of suicide with students during the coronavirus (COVID-19) pandemic.

The University of Plymouth’s Wellbeing Team created a Suicide Safety Strategy in conjunction with the University of Plymouth Students’ Union (UPSU) and Plymouth Suicide Prevention Strategic Partnership.

The aim of the strategy is to help raise understanding of suicide, including suicide prevention and improved mental health, resulting in fewer incidents of suicide attempts and death by suicide.

Preventing suicide through staff training (particularly training of personal tutors) was identified by the university as one way to reach a large number of students. Other initiatives included:

• rapid intervention training to all student services frontline staff
• development of a trained bereavement officer team from across Counselling, Pastoral and Spiritual Support and the students’ union to support staff and students in the event of a student death
• the introduction of an annual suicide awareness event for staff and students.

UPSU and the university’s Wellbeing Team researched, developed and delivered a ‘Turbo Teach’ via Zoom with the aim of engaging academic staff during lunch breaks. A Turbo Teach is a focused teaching interaction providing specific subject information in a time limited manner and was designed to fit around staff availability at lunch.

The sessions aimed to dispel myths around suicide, address common concerns and identify ways to support students that may be experiencing suicidal thoughts. The training looked at how to manage a crisis remotely and ensure the student receives the correct level of support, both from the university and externally.

In addition, attendees are signposted to specific training including mental health first aid training accessible to all staff. This was created and delivered jointly by trained mental health specialists, and was informed by existing suicide awareness training programmes and resources including World Health Organisation, ‘Preventing suicide: A global imperative’ and Mental Health Foundation: suicide.

The Turbo Teach sessions were introduced to address a number of challenges:

• from 2018-19 to 2019-20 there was a 13.8 per cent increase in student referrals to student wellbeing services, seeking support and disclosing suicidal thoughts
• during COVID-19 teaching was being conducted remotely and staff and students were not able to access onsite services as easily. Staff were concerned about how to handle disclosures of suicidal thoughts from students, and their anxieties were heightened by the prospect of having to respond to students in an online setting
• feedback from UPSU suggested that students are willing to talk openly and directly about suicidal feelings - however, feedback from staff indicated that although many are willing, not all staff felt sufficiently equipped or confident in beginning these difficult conversations with students
• personal tutors reported a lack of time and found it hard to commit to in depth training
• students were reporting that access to external mental health support services was becoming more difficult, meaning that university mental health service staff were having to provide additional and ongoing support to students at risk of suicide, self-harm and severe mental health problems.

The aim of the Turbo Teach programme is to provide academic staff, who are more likely to encounter vulnerable students, with the skills and confidence to feel equipped to have conversations about suicide when appropriate. The programme delivers three Turbo Teach sessions, accessible to all faculty staff.

The staff self-selected to attend the training and trigger warnings about sensitive content were given at the start of the session, alongside the number of the Employee Assistance Programme. Turbo Teach trainers highlighted the importance of self-care and ensured that attendees were aware that they could access advice via the Student Services Hub.

Additionally, the university’s Mental Health Adviser team sought feedback from each faculty on the type of content they wanted and the best way to deliver this.

The training was piloted in May 2020. A mental health adviser and a counsellor delivered three online sessions to academic staff and personal tutors, with a maximum of 35 attendees per session.

The sessions involved a mix of group engagement, discussion, examples via role play and case study discussions. During the sessions:

• staff were encouraged to explore emotions connected with discussing suicide and myths around suicide
• case studies were used for staff to challenge how they would react and to demonstrate best practice
• passive and active listening skills were explained and engaged with
• staff learnt about online crisis management, including internal and external signposting, referral processes, and resources that can be accessed virtually and in the physical world (such as Livewell Southwest’s 24/7 First Response crisis phone service, SHOUT and Hopeline)
• staff were taught ways to ask direct questions to gather information
• evidence-based risk factors known to increase a student’s likelihood of attempting suicide (e.g. losing a friend or family member to suicide) were explored
• protective factors known to reduce the risk of suicide, such as connectedness, were also examined to help identify hope when working with students, alongside how resilience may be built and maintained by students. See 'Self-harm and suicide in adults' from the Royal College of Psychiatrists for further information on protective factors). 

Staff were provided with a post-training questionnaire, which provided positive feedback about the sessions:  

• all attendees answered yes when asked ‘Do you feel more prepared for discussions around suicide?’
• the training was rated 4.84 out of 5.

Examples of attendee feedback:

'I just needed to thank you for your training session yesterday. It was difficult to hear, but I’m so glad I attended, as I had to put it into action today with a tutee... I can't tell you how much it helped!'

'…It was a really useful session. I’ve had a couple of instances of having to talk to students about this stuff (as I’m a pastoral tutor), and this really helps as it’s made me feel a bit more confident in my approach. So thanks for your really helpful, practical suggestions and a great session.'

In addition, qualitative ad hoc feedback has been received where staff have reported being able to put the training into practice with perceived improved outcomes compared to if they hadn’t been on the training.

Staff referrals of students to the Duty Mental Health Team have also contained improved quality of detail in reference to suicidal thoughts and intent, allowing for clearer triaging by the Duty Mental Health Worker.

There were more staff wanting to access the training than space allowed, so more courses were rolled out during 2021-22.

There are also plans to adapt the sessions for students’ union officers, course representatives and societies representatives. The information on how to manage a suicidal student will be amended due to the different levels of responsibility and roles, with clear signposting for students. It will include more of a focus on identifying early signs of deterioration in mental health and suicidal thoughts, and how to communicate empathically.

As university teaching returns to full in person delivery there will also be a need to adapt the content, while being mindful that in person longer workshops may not be as popular with academic staff.

Could the approach be replicated?

The team envisage this project could successfully be replicated in many different institutions. The project would need appropriately qualified facilitators, such as counsellors, mental health nurses or equivalent registered professionals and amendments made for signposting to local services.

In addition, inclusion of university specific policies addressing how to locally manage actively suicidal students whilst working remotely would also need to be addressed.