Evaluation of the ‘PABBS’ Suicide Bereavement Training in Four Groups of Professionals - PowerPoint Presentation

1. Evaluation of the ‘PABBS’ Suicide Bereavement Training in Four Groups of ProfessionalsDr Kathryn GardnerSenior Lecturer in PsychologyUniversity of Central LancashireKJGardner@uclan.ac.uk @KathrynJGardner

2. Our mission:To bring together stakeholders (researchers, clinicians, health services, third sector organisations, service users, and the public) with a shared interested in suicide and self-harm research that can help improve services and reduce suicide and self-harm in the future.https://sites.manchester.ac.uk/mash-project/sshare-now/ SSHaRe NoW Co-FoundersDr Caroline Clements, University of ManchesterDr Jennifer Chopra, Liverpool John Moores UniversityDr Kathryn Gardner, University of Central LancashireCameron Latham, Expert-By-Experience (EBE) and Managing Director of service-user led businessDr Pooja Saini, Liverpool John Moores UniversityDr Peter Taylor, University of Manchester

3.

4. 1 Cerel J, Brown M, Maple M et al. How Many People Are Exposed to Suicide? Not Six. Suicide and Life-Threatening Behavior. 2018. doi:10.1111/sltb.1245035people are exposed to, affected by, or bereaved from each suicide135 people may therefore need supportThis must be the right kind of support and provided by people with the right skills Background: Why do we need to evaluate suicide bereavement (PABBS) staff training?

5. NHS LTM by 2023/24 in England:“All systems will have suicide bereavement support services providing timely and appropriate support to families and staff “

6. “Dedicated suicide bereavement support specialists should be available”“Staff working in postvention services should be skilled and understand the complexity of suicide bereavement”Survey of over 7,000 people bereaved or affected by suicide in the UK (McDonell, Hunt et al., 2020)

7. ‘Some’ experiences of professional staff who support those bereaved by suicide Foggin et al., (2016), Nilsson et al., 2017:Distressed Emotionally distant to protect selfInadequate/guilty that could’ve done morePowerless and helplessLacking confidenceDifficulties knowing what to doUncertain about professional responsibilityNot enough time to provide supportLacking in training Foggin et al. (2016)Staff often feel anxious and their experiences of providing support are often at odds with feeling skilled or that they understand

8. The slides in this talk present an evaluation of PABBS that was commissioned by L&SC ICBL&SC Suicide Bereavement Pathway lists multiple services/sources of support, such as…Primary care/GPHospital bereavement teamsUnderpinning effective service provision for bereaved clients, is training and support for staff

9. Knowledgeable ConfidentSkilled Training is ‘key’ to building staff knowledge, skill & confidence in responding to those bereaved by suicidePABBS training is designed based on the evidence and theory

10. Is PABBS training effective?But…. is the training equally as effective in other professional groups? e.g., police, armed forces?In GPs/mental health practitioners

11. Suicide impacts all professions, but exposure to suicide is higher in frontline staff and there are nuances to each role (e.g., the police are often first on the scene = unique experience/higher risk of Post Traumatic Stress Disorder)31Average number of career suicide scenes1 in 5 can’t shake the scene/have nightmaresCerel et al. (2019)

12. Method: what did we do?= 61 professionals

13. Method: what did we do?The training:The 61 professionals completed a one-day PABBS training courseThe PABBS training is a one day highly interactive face-to-face workshop, delivered by two facilitators with extensive knowledge and practical experience of working in the field of suicide prevention and postventionTraining topics included suicide prevention, attitudes and stigma, suicide and its impact on health professionals, bereavement, suicide bereavement, parents bereaved by suicide, and building resilience and instilling hope

14. The figures highlight the potential vulnerability of those attending the training and justifies the need for two highly skilled PABBS trainers

15. ‘Quantitative’ evaluationProfessionals rated themselves on knowledge, skill and confidence in responding to suicide, both before and after the training did scores improve and to the same extent, in all 4 groups?‘Qualitative’ evaluationProfessionals additionally provided written statements in response to some questions that asked about the appropriateness of the training in terms of content, materials, quality, and impact of the training etcWhat did each of the 4 groups think?

16. Results: what did we find?Quantitative evaluationThe take-home message: No significant differences between the 4 groups (and that’s a good thing!) This means that the PABBS training is equally as effective in all 4 groups (hospice, acute hospital staff, police and armed forces) by initiating positive changes in:perceived knowledge of bereavement by suicideskill in supporting those bereaved by suicideconfidence in responding to those bereaved by suicide

17. BUT….before the training even took place, police rated themselves:Equally as knowledgeable as the other three groups Less skilled than the other three groupsEqually as confident in responding in comparison to the armed forces and acute hospital staff but felt less confident than hospice staffHighlights the potential vulnerability of this group (high exposure to suicide but feel less skilled and less confident)Highlights the importance of training for police to help address an unmet need

18. Qualitative evaluationPositive feedback across all 4 themes e.g., “brilliant & useful”, speakers were “genuine, passionate, open”But some staff from the police and armed forces suggested modifications, mostly in relation to theme 1 and 3. Some requested a more bespoke/tailored training package that is relevant to the nuances of their role e.g., there was “no reference to Armed Forces death by suicide” “It would be good to see specific course material for different sectors” (police officer)

19. RecommendationsPABBS training is made available to those providing workplace suicide bereavement support, ensuring that evidence-based training is embedded within suicide bereavement pathwaysTraining is adapted and tailored to the needs of different professional groups, with emergency services and the armed forces being immediate priority Ongoing monitoring and rigorous quantitative and qualitative evaluation of PABBS training is needed to demonstrate impact and long-term effectivenessThe PABBS training is a pathway to client benefit, hence the real value of the training must be evaluated in future studies to identify whether professionals apply their learning in a way that positively impacts those they are supporting

20. Acknowledgements and questionsNeil SmithSenior Advisor - Multi Agency Strategic PartnershipLancashire and South Cumbria Health & Care Partnership.Helen ParryClinical Network ManagerNHS Lancashire and South Cumbria Integrated Care Board  The slides in this talk present research funded by L&SC ICB Vicky WagstaffNHS England/NHS improvement

21. ReferencesCerel J, Jones B, Brown M, Weisenhorn DA, Patel K. (2019). Suicide Exposure in Law Enforcement Officers. Suicide Life Threat Behav, 49(5), 1281-1289. doi: 10.1111/sltb.12516..Foggin, E., McDonnell, S., Cordingley, L., Kapur, N., Shaw, J. and Chew-Graham, C.A. (2016). GPs’ experiences of dealing with parents bereaved by suicide: a qualitative study. British Journal of General Practice 66, e737-46.Nelson PA, Cordingley L, Kapur N, Chew-Graham CA, Shaw J, Smith S, McGale B, McDonnell S (2020) ‘We’re The First Port Of Call’ – Perspectives of Ambulance Staff on Responding to Deaths by Suicide: A Qualitative Study, Frontiers in Psychology, 11, 722, https://doi.org/10.3389/fpsyg.2020.00722Nilsson, C., Bremer, A., Blomberg, K. and Svantesson, M. (2017). Responsibility and compassion in prehospital support to survivors of suicide victim - Professionals' experiences. International Emergency Nursing 35, 37-42NHS Long Term Plan. https://www.longtermplan.nhs.uk/wp-content/uploads/2019/07/nhs-mental-health-implementation-plan-2019-20-2023-24.pdf McDonnell S, Nelson PA, Leonard S, McGale B, Chew-Graham CA, Kapur N et al (2020) Evaluation of the impact of the PABBS suicide bereavement training on clinicians’ knowledge and skills: A pilot study. Crisis, https://doi.org/10.1027/0227-5910/a000646