World Suicide Prevention Day 2020 – A story from Together’s criminal justice team

Thursday 10^th September 2020 is #WorldSuicidePreventionDay and to raise awareness of this vital issue we wanted to share a story from Together’s criminal justice service and specifically the Liaison and Diversion team. That team is funded by NHS England through their National Liaison and Diversion Operating Model. The liaison and diversion team is made up of a network of Together practitioners who assess the needs of vulnerable individuals in settings that include magistrates’ courts, crown courts and police custody and assist those people in learning where they can get the right help. Once people who require support have been identified our Community Link teams can begin to work alongside those individuals.

There are many reasons why someone can experience suicidal thoughts and that can be caused by psychological, social and cultural factors, sometimes combined with experiences of trauma and loss. Every person who experiences those thoughts is different and the factors that can lead someone to that mental distress can affect anyone.

Our community Liaison and Diversion Team includes Peer Support Volunteers and Community Link Workers. The peer supporters and CLWs work alongside individuals throughout the criminal justice pathway to help them engage or re-engage with relevant services to tackle issues like housing, addictions or debt, as well as supporting their mental wellbeing. By helping people tackle the underlying causes of their offending, the likelihood of reoffending can be significantly reduced. The team is there to bridge the gap, not to replace existing support someone may have.

An example of a person the Community Liaison and Diversion Team has worked with would be David (name has been changed to provide anonymity for the service user), a young black British male who worked with the team for several months. David had received one conviction as a teenager and was sentenced to four and a half years in prison. He was referred to Together Community Link Worker, Paul Richardson by his probation officer (PO) for mental health and housing support and had been released from prison with no discharge plan and was homeless. David had experienced mental distress previously was considered to be vulnerable by the mental health team who had assessed him and the situation he found himself in put a great deal of strain on him. Paul provides further details of David’s experience and the support he provided below:

When I started working with David, alongside my colleagues in the community team, he was living in temporary shared accommodation provided by the local council. The PO raised concerns with social services and the local Community Mental Health Team (CMHT) as she felt David was vulnerable and needed further support to be able to live independently. Unfortunately both agencies responded by stating he did not meet their thresholds for them to take on his case and that’s when I got involved.

Initially David was reluctant to work with me as he hadn’t had a good experience of working with people linked with the criminal justice system. He experienced paranoia and often isolated himself. He had been prescribed anti-depressants and felt his wellbeing had deteriorated since being released from prison. This meant he found it difficult to cope in the community. When I worked alongside David I ensured the decisions about the support he would receive were led by him and this made him more open to engaging with me.

The priority for David was his accommodation. He told me he felt I had listened and engaged with him about this as I made an appointment with the local council to try and secure him a permanent tenancy in our first session. An important consideration in that for David was to find a property that did not require him to share with other people as he found this distressing.

The housing department at the council told us David would only be entitled to shared accommodation. This was because he did not have a formal mental or physical health diagnosis and so he would not be considered a priority. Despite this, I was able to be an advocate on David’s behalf and continued to liaise with housing services highlighting the concerns he and his PO had. Following this I liaised with several health professionals from different agencies linked to David’s case and he was offered a one bed flat to himself.

Later one day I received a call from David to say he was in crisis and was on a ledge looking to end his life although he didn’t state where he was. I immediately contacted the police and his PO providing his address details. Because of the relationship I had built with David and what I knew about him I told the emergency services he didn’t like to travel much and was likely to be either at his own address or close by.

The police negotiator returned the call to me whilst they were with David. He had stated that he wanted to speak to me and the negotiator felt due to the immediate danger it was the best course of action to resolve the situation safely. I spoke to David and our conversation resulted in him agreeing to comply with the emergency services to avert the danger to himself that had been posed so he could be supported by the relevant teams around him. David was assessed by the mental health team and detained under the Mental Health Act.

While the experience was a traumatic one for everyone involved the intervention meant David had improved access to healthcare and support services to meet his identified needs. Whilst in hospital, family members David had lost contact with visited him, and they started to rebuild their relationships. David felt this family support improved his quality of life. His family, the PO and the crisis team reported that Together’s support and intervention had been invaluable to David.

For a Community Link Worker like me, the average time I would usually work with someone is around 3 months. With David though his wellbeing deteriorated during a time when services working closely with him were closing his case. I’ve found continuity in the people providing support is really important so I organised with my managers to continue working with David for a bit longer.

That extra time allowed me to liaise with the other agencies involved and support David to gain access to supported accommodation with appropriate safeguards. I also put together a budget plan with the view to him staying in this accommodation for 2 years which was approved by the local council. I linked David with a social worker from the local crisis team and secured an additional support package with support from other health professionals including access to a psychiatrist, floating support and talking therapy.

As I closed David’s case I felt we had been on a journey and that David had appropriate support in place to maintain his mental wellbeing. There were a lot of other people involved in providing the support that helped David through this really difficult time from others in Together to the agencies we worked with. It felt like one of the main lessons we’d learned was the importance of taking the time to listen to David’s experience and engage with him to build that relationship which he noticed in our first meeting. In commenting about the case the PO said that Together’s input was instrumental and without my support the outcome would have been completely different.

(Prior to publishing this story Paul reached out again to the Parole Officer he worked with to support David and was pleased to hear that David is doing really well today and has a good relationship with the support team Paul linked him with. As a result of the call the PO suggested he may have some other referrals for Paul to work with meaning the contact may also lead to the team providing support to more people.)