The latest (22 July 2022) Research and Analysis Bulletin from Her Majesty’s Inspectorate of Probation examines Probation staff experiences of working with people at risk of suicide and/or self-harm. Written by Dr Jake Phillips from Sheffield Hallam University, Dr Colette Barry from the University of Ulster, and Professor Loraine Gelsthorpe, Professor Nicola Padfield and Dr Juliette Mullin from the University of Cambridge, the bulletin is based interviews on 51 members of probation staff, including interviews with frontline practitioners in approved premises (APs) and in the community. These interviews were focused on how confident staff felt around working with people at risk of suicide and/or self-harm, what training they had received, how they assessed and managed peoples’ risks and what challenges they faced in doing so, and, finally, what support they received from the organisation.
The researchers introduce the bulletin by setting the context, familiar to most readers. We know that people on probation are more likely to die from self-inflicted deaths and to present with risks associated with suicide and self-harm when compared to the broader population. They are more likely to present with mental ill health, to be isolated, to use drugs and alcohol, and to live in deprived conditions: all factors which are strongly correlated with elevated rates of suicide and self-harm. Moreover, being subject to probation supervision can exacerbate these risks and create new ones.
The key findings of the bulletin are:
- Interviewees said that self-harm, suicidal ideation, attempted suicide and suicide are highly prevalent amongst people on their caseloads. In addition to drug and alcohol use, mental ill health, and isolation. interviewees also highlighted transitions to and from custody, new legal proceedings, and relationship breakdowns as triggers which could increase the risk of people self-harming and/or being suicidal.
- Practitioners shared a number of techniques for assessing risks, ranging from using formal risk assessment tools to gathering information from differing sources and speaking to people on probation. Concerns were expressed regarding the ability to access all relevant information in a timely manner, as well as having the necessary time to build the all-important relationships with people on probation.
- Risk management in APs appeared to be more robust than in community settings, with participants having a good knowledge of what they could do to help people. These techniques included short-term and long-term interventions. In the community, participants mainly relied on external services such as NHS mental health services and charities. Interviewees emphasised that there were many barriers to using these services, including long waiting lists, insufficient services, difficulties for people leading chaotic lives in accessing mainstream services, and a tendency for such services to be ill-equipped to respond to the complex needs with which many people on probation present.
- All staff expressed the desire for more training although they also stressed that they were not and should not become mental health practitioners. Interviewees preferred face-to-face, practical and applied training, and suggested training around suicide and self-harm should be regular and ongoing rather than one off.
- The research highlighted the extent to which the death of someone on probation has a real impact on staff. Some support is available to staff after someone dies but for many this felt more procedural than supportive. Interviewees felt that support is also needed after a self-harm incident or attempted suicide. On the whole, staff were negative about the employee assistance programme known as “PAM assist”. Managers interviewed said they felt the responsibility to support staff keenly but did not always feel that they are able to do so sufficiently.
- A small number of interviewees had experience of attending inquests. They felt unprepared for them and experienced them as stressful events which were more about apportioning blame than learning from the circumstances of a death.
The researchers summarised their recommendations in the infographic reproduced below: