Suicide Prevention Pathway

From research, we know that deaths from suicide and repeat hospital presentations for suicide attempts can be reduced when a structured prevention pathway is implemented that combines best clinical practice, leadership commitment, evidence-based treatments as well as ongoing data collection and review. The Hertfordshire Suicide Prevention Pathway, developed and co-produced with experts by experience, incorporates this along with a structured approach to care and smooth transitions for service users across our system.

 The Suicide Prevention Pathway has the following six components:

Screening to identify service users at risk of suicide.

Assessment enhanced by introducing the Chronological Assessment of Suicide Events (CASE) approach.

Risk formulation using a prevention-oriented approach to enable broader understanding of the issues to support care planning.

Brief interventions including safety planning, counselling on restricting access to lethal means, crisis numbers, brief service user and carer information, and rapid follow up.

Structured follow up to re-assess suicidality; review the safety/ care plan; communication with carers, families, and health professionals; identification and involvement of other agencies and identification of any barriers to treatment. 

Transition of care including warm handover to ongoing care.  There is a community befriending element of the pathway, linking people to holistic support post-discharge.

Chronological Assessment of Suicide Events (CASE) approach

The CASE approach training, informed by work at Gold Coast Health in Australia is a part of this new pathway. We have pioneered the use of the CASE Approach in the UK which is a flexible, practical, and easily learned interview strategy for eliciting suicidal ideation, planning, and intent.

Training Materials to Support Clinical Staff

 We’ve created new resources that can be used by our clinical partners to support staff with their suicidal risk assessments. Please click the links below to download materials as needed.

 A clinical framework document has also been created to provide additional detail regarding the pathway.

In addition, a new e-Learning has been created for clinical staff and community partners. The new online education can be accessed through the NHS Learning Hub.  A free registration for the NHS Learning Hub is required to access the Suicide Prevention Pathway eLearning.

 Suicide is a significant issue, not only does it result in the premature death of the person, but it has also wide-reaching effects on the families, friends, and communities. We know that people bereaved by suicide are themselves at increased risk. These are only some of the reasons to take a new prevention approach to suicide.

 If you would like to receive more detail about the new Hertfordshire Suicide Prevention A&E Pathway, please contact Dr Rakesh Magon, Consultant Psychiatrist, Deputy Medical Director & ICS Mental Health Lead, Hertfordshire Partnership University NHS Foundation Trust at rakesh.magon@nhs.net, or Dr Nisha Jayatilleke, Associate Medical Director, Hertfordshire and West Essex ICB at nisha.jayatilleke@nhs.net.