Consultation Response Form
Your name: Nancy Rowland
Organisation (if applicable): British
Association for Counselling and
Psychotherapy
Email / telephone number: 01455
883396
Your address: BACP House, 15 St
John's Business Park, Lutterworth,
Leicestershire, LE17 4HB
Question 1 Is the Strategy focussed on the right areas to deliver improvements in
Wales? Are there any issues that should also be addressed? If so please provide
evidence and suggestions.
The British Association for Counselling and Psychotherapy (BACP) welcomes the
draft Suicide and Self Harm Prevention Strategy and Action Plan for Wales. Selfharm and suicide are persistent challenges faced by society and sufficient support
needs to be provided for those affected.
The level of provision of services that support those who self-harm or have suicidal
intentions is relatively unexplored in the Strategy. The Strategy’s introduction states
that ‘the successful implementation of the Measure and Together for Mental Health
will make a significant contribution to the prevention of suicide and self-harm in
Wales’. Yet neither policies have safeguarded funding for Wales’ mental health
services, which support those who are at risk of self-harming or committing suicide.
NHS Wales’ expenditure on mental health problems has significantly reduced, in
2011-12 £641.8 million was spent compared to £617.5 million in 2012-13 (Welsh
Government, 2014). BACP would recommend that Talk to Me 2’s strategy outlines its
role in protecting funding these services which play a key role in suicide and selfharm prevention.
Additionally, there is little information on how the strategy will promote specific
interventions; BACP recommends this is explored in the strategy and reflected in the
action plan, as specific interventions which are effective for self-harm or suicide
prevention may be promoted in addition to those which are promoted in Together for
Mental Health. Psychological therapies are an effective intervention for those with an
intent to commit suicide or self-harm. NICE clinical guidelines regarding the use of
psychological interventions for the longer-term management of self-harm suggest
interventions could include cognitive-behavioural, psychodynamic or problem-solving
elements (NICE, 2011). A report by the Royal College of Psychiatrists (2010) has
also outlined research evidence which suggests that CBT is effective in reducing
levels of depression and incidents of self-harm, and that problem solving therapy can
lead to improvements in mood and social adjustment. Research evidence suggests
that psychological therapies can also be effective in the prevention of suicide, along
with a range of approaches to psychotherapy and counselling (Winter et al, 2013).
The strategy identifies that professionals come into frequent contact with members of
the public who have experienced self-harm and suicidal behaviours and states that it
will focus on priority care providers such as primary care staff, with the text largely
focusing on General Practitioners. BACP recommends that the strategy should
specifically also refer to mental health practitioners. As recognised by the strategy, a
quarter of those who commit suicide are known to mental health services and this
provides an opportunity for intervention.
NICE (2011) Self-harm: longer-term management NICE guidelines [CG133]
https://www.nice.org.uk/guidance/cg133/chapter/1-guidance#psychosocialassessment-in-community-mental-health-services-and-other-specialist-mental-health
[Accessed 02/03/2015]
Royal College of Psychiatrists (2010) Self-harm, suicide and risk: helping people who
self-harm Final report of a working group
http://www.rcpsych.ac.uk/files/pdfversion/cr158.pdf [Accessed 25/02/2015]
Welsh Government (2014) NHS expenditure programme budgets: 2012-13
http://gov.wales/docs/statistics/2014/140611-nhs-expenditure-programme-budgets2012-13-en.pdf [Accessed at 24/2/2015]
Winter, D., Bradshaw, S., Bunn, F. and Wellsted, D. (2013) A systematic review of
the literature on counselling and psychotherapy for the prevention of suicide: 1.
Quantitative outcome and process studies. Counselling and Psychotherapy
Research, 13(3), 164-183
Question 2 Are there other reference materials which could be included in the
Strategy? If so, please provide details.
N/A
Question 3 Are the Priority Actions within the Action Plan appropriate to ensure
delivery of the Strategy? Are any Priority Actions missing? If so please set them out
here.
Objective one’s priority action, the delivery of a Wales framework for the training of
professionals who frequently come into contact with people at risk of suicide and selfharm, including for those specialist workers with a longer term, therapeutic
relationship with the person at risk is welcome. Also welcome is the request that
professional bodies representing those proving treatment should be specifically
involved in the development of a framework to ensure the framework is fit for
purpose. Additionally, BACP supports the inclusion in objective one of establishing
an annual National Suicide Prevention Forum to ensure a co-ordinated approach to
suicide prevention where necessary across the UK and Ireland. BACP believes that
the use of National Suicide Prevention Forum is integral to achieving the strategy’s
objectives and this should be reflected in the overall strategy.
The inclusion of signposting resources within the priority actions, such as social
media, Help is at Hand Cymru and the National Wales Suicide and Self-harm
Prevention website, will assist in linking individuals to services. BACP would
recommend that the signposted services meet relevant guidelines and are staffed by
professionals trained in working with people who have self-harmed, are suicidal or
are bereaved by suicide. The creation of a resource of services would ensure
consistency in signposting and assist in ensuring that all services which are
signposted meet particular standards.
The Talk to Me 2 Strategy sensibly places a great focus on people at risk of suicide
or self-harm, such as men in midlife and older people. BACP recommends that a
priority action should be created which specifically focuses on informing
professionals of these at risks groups, providing services with information about how
to work with them.
BACP notes that the strategy makes little reference to existing UK bodies or
alliances, for example the National Suicidal Prevention Alliance, which are resources
which could be utilised in the development and delivery of the strategy.
Question 4: We have asked a number of specific questions. If you have any related
issues which we have not specifically addressed, please use this space to report
them:
N/A
Responses to consultations are likely to be made public, on the internet or in
a report. If you would prefer your response to remain anonymous, please
tick here: