Suicide: policy context

The Scottish Government's Choose Life strategy and action plan was launched in December 2002. This ten year National Strategy and Action Plan has seven objectives:

  • Early Prevention and Intervention: providing earlier intervention and support to prevent problems and reduce the risks that might lead to suicidal behaviour
  • Responding to Immediate Crisis: providing support and services to people at risk/in crisis, to provide an immediate response and to help reduce the severity of any immediate problem
  • Longer Term Work to Provide Hope and Support Recovery: providing on-going support and services to enable people to recover and deal with the issues that may be contributing to their suicidal behaviour
  • Coping with Suicidal Behaviour and Completed Suicide: providing effective support to those who are affected by suicidal behaviour or a completed suicide
  • Promoting Greater Public Awareness and Encouraging People to Seek Help Early: ensuring greater public awareness of positive mental health and well-being, suicidal behaviour, potential problems and risks amongst all age groups and encouraging people to seek help early
  • Supporting the Media: ensuring that any depiction or reporting by all sections of the media of a completed suicide or suicidal behaviour is undertaken sensitively and appropriately and with due respect for confidentiality
  • Knowing What Works: improving the quality, collection, availability and dissemination of information on issues relating to suicidal behaviour (and self-harm) and on effective interventions to ensure the better design and implementation of responses and services and use of resources.

Choose Life was established by the National Programme for Improving Mental Health and Well-being in Scotland and now resides as a cross cutting programme within NHS Health Scotland. The Choose Life website is the key suicide prevention portal for Scotland. The website provides details of local and national activity, as well as information on training, research, awareness raising and other initiatives.

In 2010, a national suicide review group, led by the Scottish Government, met to consider the findings of the two evaluations undertaken so far to assess the impact of the strategy. As a result,a refresh of the National Strategy and Action Plan has been published to better reflect what the focus of the work needs to be over the next three years.

Choose Life refreshed objectives

    •  Identify and intervene to reduce suicidal behaviour in high risk groups.
    •  Develop and implement a co-ordinated approach to reduce suicidal behaviour. 
    • Ensure interventions to reduce suicidal behaviour are informed by evidence from research and evaluated appropriately.
    •  Provide support to those affected by suicidal behaviour.
    •  Provide education and training about suicidal behaviour and promote awareness about the help available.
    •  Reduce availability and lethality of methods used in suicidal behaviour.

Key high risk groups

Although the Choose Life strategy acknowledges that anyone can have thoughts of suicide, evidence gathered during the life of the strategy suggests that certain groups are at a higher relative risk of suicide; these are:

  • people experiencing mental illness (primarily depression and bi-polar disorder)
  • people who misuse substances – especially alcohol
  • people with co-existing mental illness and substance misuse
  • people who have a history of self-harm or who have attempted suicide
  • people in psychiatric care and those recently discharged from psychiatric hospital
  • people recently bereaved
  • people living in areas of socio-economic deprivation
  • people with low socio-economic status
  • people who are unemployed
  • people who have experienced life stress – especially physical and/or sexual abuse
  • people who are lesbian, gay, bisexual or transgender

The Scottish Government publication Towards a Mentally Flourishing Scotland 2009-2011, sets out targets and commitments for the development of mental health services in Scotland. Published in May 2009, it makes a commitment to reduce the suicide rate between 2002 and 2013 by 20%, supported by 50% of key front-line staff in mental health and substance misuse services, primary care and accident and emergency being educated and trained in using suicide assessment tools/suicide prevention training programmes by 2010.

*Suicide prevention is an umbrella term for collective efforts both nationally and locally. In Scotland, suicide prevention efforts are guided by the Choose Life national strategy published by the Scottish Executive in 2002. Suicide prevention interventions fall into two broad categories: prevention targeted at the level of the individual and prevention targeted at the whole of the population.