Grassroots works to create a world where suicide is prevented through open and courageous conversations. All our activities seek to increase awareness, reduce stigma, and encourage help-seeking. We want to make it easier for people thinking about suicide to access timely and effective support. Our staff and wider team of associate trainers and volunteers teach practical and evidence-based suicide intervention skills, helping people to become more ready, willing and able to have the kind of conversations that save lives. Since 2006 we have trained over 14,000 people from over 300 organisations.
Please briefly describe your project, group, team or service, outlining what you do and why it makes a difference.
Grassroots works to create a world where suicide is prevented through open and courageous conversations. All our activities seek to increase awareness, reduce stigma, and encourage help-seeking. We want to make it easier for people thinking about suicide to access timely and effective support. Our staff and wider team of associate trainers and volunteers teach practical and evidence-based suicide intervention skills, helping people to become more ready, willing and able to have the kind of conversations that save lives. Since 2006 we have trained over 14,000 people from over 300 organisations. We know from feedback and 6-month follow-up data that our training increases participants’ confidence and skills leading to many interventions that have helped to save lives.
Our pioneering Stay Alive mobile phone app was the first of its kind in the UK, and provides a new, dynamic approach to this complex and tragic issue. It has been downloaded over 90,000 times (with 12,000 active users in the last 3-months), has won various awards including a Patient Safety Award in 2015, and we know from feedback and evaluation that it has also helped save lives from suicide many times. To raise awareness and facilitate a cultural shift in the way we talk about suicide we have grown a thriving social media community with over 50,000 Twitter and 4,000 Facebook followers. In turn, we run public events and have a range of innovative awareness raising initiatives, like our citywide street art campaign that uses murals to challenge stigma, share information and get people talking.
What makes your service stand out from others? Please provide an example of this.
Our pioneering Stay Alive mobile phone app was the first of its kind in the UK, and provides a new, dynamic approach to this complex and tragic issue. It has been downloaded over 90,000 times, won various awards including a Patient Safety Award in 2015, and we know from feedback and evaluation that it has helped save lives from suicide many times. The Stay Alive app provides users with a wealth of features, whether they are at risk or want to support someone else. Features include: quick access crisis helplines and online resources; an interactive Safety Plan; a ‘LifeBox’ to keep life-affirming images and connections; a list of evidence based reasons to live; and clear advice for people at risk or those who are helping. The app was developed through partnership working with Network Rail, Switchplane and Sussex Partnership NHS Foundation Trust. The model of suicide intervention we teach is robust and practical. It empowers professionals and community members alike to support someone who is thinking about suicide, helping them to develop a safety plan and connect with further resources in the community. In turn, it improves the wellbeing of those supporting someone at risk, enabling them to move from a position of fearfulness, to feel ready, willing and able offer help in a considered and tangible way. Feedback, testimonials, and 6-month follow-up data shows that our training has helped to save lives again and again. We have been awarded significant funding from the Department of Health to upgrade the app over the next year up to March 2020.
How do you ensure an effective, safe, compassionate and sustainable workforce?
The involvement of people with lived experience of suicide is core to our approach, with representation throughout our volunteers, board and staff. This informs all our work, ensuring our approach comes from an authentic, considered and informed place. Grassroots is committed to equal opportunities for all and recognises the value of diversity in the organisation. We ask all our training participants to complete an Equal Opportunities Form. We use accessible venues for all training delivery. Our Stay Alive app is purposefully anonymous and confidential to encourage users who may otherwise have been put off by the stigma related to suicide. We previously worked with the charity Speak Out to develop the first ever suicide prevention tool for people with learning disabilities. Our Equality & Diversity Policy outlines our commitment to these important values.
Who is in your team?
Stella Comber – Chief Executive – 37.5 hours; Alex Harvey – Development Officer – 37.5 hours; Michael Jarvis – Charity Officer – 30 hours; Drew Carpenter – Project Support Officer – 30 hours; Jack Thunder – Community Change Maker – 30 hours; Sam Hubbert – 7.5 hours; Gus Campbell – Website Officer – 1.5 hours – plus a range of volunteers and freelance trainers.
How do you work with the wider system?
All our awareness raising, innovation, and educational work is reinforced by a strong commitment to partnership, and collaborative working; strengthening relationships between services and creating a shared language and approach to suicide prevention. Locally we have trained over 250 organisations in suicide prevention and mental health awareness, and our training offer has become a key part of induction for many organisations. The Stay Alive app feedback shows it is being used by a wide range of people for both professional and personal reasons, including: Health professionals such as GP’s and A&E staff; Mental health practitioners in both clinical and non-clinical settings; Health and social care workers such as housing, children and young people, and substance misuse services; Front-line emergency services such as police, paramedics and fire service personnel; Transport staff including train, buses and taxi services. The ‘Find Help’ page on our website offers an extensive overview of crisis support resources and some immediate suggestions for people experiencing thoughts of suicide or those supporting them; it is one of the most visited page on the site, with over 15,000 views per year. Partnership working is crucial for Grassroots to ensure suicide prevention remains a priority for the community, and our training and resources are received as widely as possible. Grassroots sits on a range of strategic groups both locally and nationally, including Suicide Prevention Steering Groups in Brighton & Hove, East Sussex, and West Sussex, and the NSPA (National Suicide Prevention Alliance). Involvement with these groups has led to a range of productive partnerships, including: the Public Health team; Sussex Police; local NHS; Fire Service; transport services; and many third sector organisations.
These networks provide information sharing opportunities, enabling us to connect with other suicide prevention efforts nationally, and coordinate work streams. The StayAlive app was a notable partnership project: Grassroots led on content development, Switchplane (a local digital agency) provided tech support, Sussex Partnership provided funding and clinical sign-off, and Network Rail provided the majority of funding. We provide an up-to-date crisis resource list on our website, and in hardcopy format to all training participants. This involves liaising with many partners, and ensuring services are correctly listed and current. Our Social Media policy has been developed through years of working with suicide prevention online, and we have shared this with many partners who are starting to address this increasingly crucial issue. Our ‘Talk to Us’ pledge engaged over 50 local businesses in suicide prevention, including the local bus company, funeral directors, marketing companies, and digital agencies. Ultimately our work is focused on creating suicide safer communities, and we strive to form partnerships wherever we can with the mission of preventing suicide.
Do you use co-production approaches?
We seek to engage our stakeholders in the develop of all our work. The Stay Alive app was developed following extensive online surveys and real-world focus groups with service users and clinicians from Sussex Partnership NHS Foundation Trust. We are open to feedback from training and try to integrate this into the develop and refinement of our training and approach. As previously mentioned, lived experience of suicide is crucial to Grassroots and we have people at every level – Trustee, Staff, Volunteers, Stakeholders – who bring their own lived experience to the work we do.
Do you share your work with others? If so, please tell us how.
Sharing is crucial to our approach. The Stay Alive is free to download, and we strive to share it as widely as possible. Our ‘Tell Me’ pledge has been adopted by several NHS Trusts and Public Health directorates across the country. As mentioned our website has an extensive overview of resources for people in crisis. We deliver a number of fully funded community courses per year, with free Real Workshops every month in Brighton & Hove, aiming to engage those who might attend training on a professional basis.
What outcome measures are collected, how do you use them and how do they demonstrate improvement?
We are always working to ensure our work has the greatest positive effect in preventing suicide: measuring our impact, developing on our successes, and making necessary changes to our approach. The standardised models of suicide intervention we teach are robust and practical. ASIST has been developed over 30 years and has a compelling evidence base for its efficacy, with many studies from around the world demonstrating improvements in participants skills, knowledge and confidence. Our own feedback, testimonials, and 6-month follow-up data gathered over 12 years tells us that our training has helped to save lives many times, and shifted cultures of fear for many professionals. To evaluate our training, we use standardised feedback forms which ask participants to rate their pre- and post- scores for a range of questions related to confidence, and knowledge and skills. Here’s an example from our ASIST training: “I feel prepared to help a person at risk of suicide? (1 = strongly disagree to 5 = strongly agree)”. The average scores for this question over the last year are 2.8 before the training, going up to 4.7 after the training, showing a significant shift towards a feeling of preparedness to help a person at risk of suicide. Detailed information on evaluation data is available per year in our annual reports. Our 6-month follow-up surveys seek to measure the real-world application of the training, and ask for detailed accounts of any interventions undertaken.
Here’s an anonymised extract from an ASIST participant’s 6-month follow-up log: “My friend has been struggling with their mental health for a while now and I felt something was a bit ‘off’. After a general catch up, I openly asked if she had been thinking of suicide and she confirmed that it had been on her mind. We researched possible support together and made a safety plan with numbers so could call in a crisis. I feel the course allowed me to identify the signs that someone may be struggling… and I was able to openly talk about suicide with her. I feel being direct allowed her to feel safe talking to me.” We have many such testimonials from people who have used the training to support someone, but due to the intensity of the subject matter it is rare to get feedback from someone who has received an intervention following the training. Below is a shining example of just this kind of feedback: “The training you have given to others has directly had an influence on my recovery from suicidal depression! I am working with Shauna Aura who was the first person I had ever spoken to who had Suicide ASIST training and this made such a difference to me. Someone who knew how to talk to me.” – Yvonne J Foster, Local Artist
Has your service been evaluated (by peer or academic review)?
Independent research from a Specialty Registrar in Public Health, has demonstrated a significant positive reported impact of the Stay Alive app, with responses indicating that it had contributed to preventing a total of 73 suicide attempts. A further independent evaluation of the Stay Alive app is underway as part of the DoH funded upgrade of the Stay Alive app.
How will you ensure that your service continues to deliver good mental health care?
Positioned as we are, with significant experience, evidence-based initiatives, and strong networks, we see an exciting opportunity to take our successes to an even wider community. We are focusing on developing an approach which is truly community focused and engages those people who would not reach out for support from traditional mental health services. This new approach is called Real Talk. Research shows that almost three-quarters of those who die by suicide don’t engage with traditional support services. To tackle this issue our Real Talk project will raise awareness and confidence in our wider communities, strengthening the support networks of those everyday heroes who can really make a difference to prevent suicide. This fresh approach is accessible, simple and emotionally-engaging, bridging a gap between services and real people. Real Talk will recruit and train volunteer suicide prevention Change-Makers; ambassadors who can bring a message of hope into their day-to-day lives. Change Makers will work to highlight the issue of suicide prevention by delivering awareness raising talks, running public events, and helping to champion Grassroots work, including further training, the Stay Alive smartphone app. Real Talk is for real people in real life. It is about a positive cultural shift, creating a movement to break the stigma around suicide, enabling people to make a difference.
What aspects of your service would you share with people who want to learn from you?
A key challenge in developing the Stay Alive app was identifying the significant funding required. This is a familiar challenge for anyone working in an innovative and new way to address a social issue. Our solution was complex, but essentially involved nurturing a strong partnership approach. Through strong networking the directors were able to identify key stakeholders who could support the project either through expertise or funding: Switchplane the digital developer pledged £5K in start-up costs after meeting through a business network; Sussex Partnership pledged £5K and provided clinical support and sign-off of the app content; and Network Rail pledged £60K+ after meeting with them at a steering group meeting for transport safety. Network Rail is impacted through deaths by suicide, and they have a strong commitment to helping prevent suicide. Finding these key partners enable the project to grow and ultimately succeed.
How many people do you see?
Over 1,000 trained in suicide prevention and mental health per year. Over 90,000 downloads of the app since its launch in 2014, with approx. 30,000 in the last year. Over 15,000 active users of the Stay Alive app in the last 3-months.
How do people access the service?
Training, App download, Website, Public Campaigns.
How long do people wait to start receiving care?
We are not a “Service” providing care the traditional sense. We contribute to the local JSNA, and are active on the Suicide Prevention Steering Groups locally.
How do you ensure you provide timely access?
Again, we are not a “Service” providing care the traditional sense. Depending on the source of funding for training we allocate places differently: Public Health funded training is directed individuals working/volunteering with particular at risk groups, with a limit of places per organisation to ensure a wide spread of candidates; Community funded courses are open to all.
What is your service doing to identify mental health inequalities that exist in your local area?
We contribute to the local JSNA, and are active on the Suicide Prevention Steering Groups locally.
How do you identify the needs of a person using the service (such as their physical, psychological and social needs)?
Google Firebase Analytics is an anonymous way of collecting data on the usage of the Stay Alive app. This helps us understand which parts of the app are most popular, and how it is being used. we also use online surveys to assess how users are experiencing the app, and understand what else is needed. Feedback forms and 6-month follow-up surveys for our training enable us to identify needs of participants.
How do you meet the needs of people using the service and how could you improve on this?
We are always seeking to improve our offer to the community through ongoing evaluation. The Stay Alive app was designed following consultation with the community, and it seeks to meet the needs identified by them.
What support do you offer families and carers? (where family/carers are not the service users)
As mentioned, the Stay Alive app is a resource for both people at risk of suicide, and those who want to support them. We know that it is being used by families and carers to help keep people safe. Likewise, our training and workshops help to empower families and carers of people at risk, giving them the confidence and skills to have conversations about suicide.
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