Shropshire, Telford & Wrekin: Bereavement support for people affected by suicide

Every death by suicide causes grief and distress for family, friends and the wider community. Evidence suggests that people who are bereaved by suicide can be at higher risk themselves.

The Shropshire, Telford & Wrekin Integrated Care System (ICS) covers two distinct areas – the county of Shropshire and the unitary authority area of Telford & Wrekin. Working together, their public health teams have invested NHS England suicide prevention funding to set up a suicide bereavement service.

This service is delivered by two voluntary sector organisations, Telford Mind (covering Telford & Wrekin) and Shropshire MHS (covering Shropshire). Two directly employed suicide bereavement officers provide a listening ear, support and signposting to other services. People can access support at any time after a death, either through referral by a professional or self-referral.

Support is offered face-to-face, by telephone, online and in the community, in a person-centred and flexible way, for as long as required. The officers can also attend inquests at the Coroners’ Court alongside friends and family, if that is requested.

From its inception in January 2021 to March 2023, 352 clients had accessed the suicide bereavement service, with about 40 clients on the books at any one time.

Shropshire, Telford & Wrekin’s NHS England funding has also been used for joint programmes such as real-time surveillance and upskilling the wider suicide prevention workforce (including teachers, NHS staff and housing officers). Public events have been held to reduce stigma and encourage people to seek help.

More localised projects addressing the needs of communities have also been funded. These include ‘Assist and Engage’ in Telford & Wrekin, set up in response to an identified gap in support for people who attend the local A&E department with suicidal ideation. Many people in this situation were being told that they did not reach the criteria for additional mental health support, or that they had to deal with their substance or alcohol misuse issues first.

‘Assist and Engage’, delivered by Telford Mind, offers support workers during a weekday ‘twilight’ shift. Anyone who presents at A&E with suicidal ideation has access to this supportive non-clinical intervention. People can also be referred from mental health services, the emergency duty team or crisis team. Lyn Stepanian, Public Health Practitioner at Telford & Wrekin Council, explained: 

They get the support they need at that point in time, rather than being sent home from A&E with a leaflet.

It took time to embed this offer with mental health services, but trust and understanding has built over time. “It’s now highly successful. It is difficult to say whether we have saved lives, but 14 months in only two people had been re-referred. People tell us that without that support they would have considered suicide and possibly taken their life.”

One of the local A&E consultants recently commented:

As doctors, we are sometimes unable to really spend time with an individual in crisis and unable to take the holistic approach. With this service, they are able to identify the different factors that contribute to an individual's mental health…Through this, the individual is then able to be supported with more thorough support, which in turn helps A&E greatly and is much appreciated.

Shropshire, Telford & Wrekin’s funding ends in March 2024, leaving much of this work in jeopardy. The local suicide prevention action groups have asked Shropshire, Telford & Wrekin ICS to continue prioritising suicide prevention.

Lyn Stepanian said:

We expected, when the Government released their new strategy, that there would be some assurance about funding – but there was none. So we considered contingency plans, which would mean stopping services and relaying that news to our clients. Our suicide bereavement officer was thinking about looking for another job. These are highly skilled people who are hard to recruit. We went cap-in-hand to our ICB and they agreed to fund the first quarter of 2024/25. Beyond that we really can’t say.

Telford & Wrekin Councillor Ollie Vickers, Co-Chair of the Joint Health Scrutiny Committee, wrote a recent blog post for the Centre for Mental Health on the need for ongoing suicide prevention funding. He wrote: 

The benefit of this funding being managed at a local level has been that we’ve been able to use our knowledge of the communities in our area to target interventions effectively, creating programmes that will make the most difference in saving lives.

Councillor Kelly Middleton, Telford & Wrekin’s Cabinet Member for Healthy, Safer and Stronger Communities and Partnerships, said: 

The work we do sets out to drive change by increasing suicide risk awareness and skills for intervention. Our action plan was co-produced by stakeholders, partners, the suicide prevention action network and people personally affected by suicide.

By enhancing research, data collection and monitoring, and continuing to develop an offer of bereavement services and postvention support, we are working to keep people mentally well and aware of the support available. It is therefore hugely important that funding for this vital work within our communities continues.