Podcast Episode 044: Suicide Risk Factors

TheStrengthsRevolution_albumart_2-2In this episode I maintain a focus on suicide risk by reviewing risk factors and the importance of counter-balancing these with a focus on protective factors and strengths.

A specific program in Detroit has generated debate and pilot sites in the UK to develop a zero tolerance to suicide risk, and while aiming for zero suicides is an excellent ideal, it raises several important questions. Firstly, some people have made a clear and final decision to take their own lives for their own complex and personal reasons, so how will choice be respected within a zero tolerance approach? Will services be recognised for reductions in suicide rates or will the blame culture still focus on the diminishing few completed cases? Should any practitioners or advocates seriously question the ethos and intentions behind a zero tolerance approach?

Suicide risk factors from the known research are outlined, and the more personalised reflection of protective factors are highlighted. The emphasis on assessing and working with suicide risk is placed on the quality information through narrative approaches, not the more frequent bureaucratic requirement for ticking boxes.

For the full content of this episode click on the links for iTunes and Sound Cloud (or go to Stitcher Radio):

https://itunes.apple.com/gb/podcast/strengths-revolution-steve/id867043694

https://itunes.apple.com/gb/podcast/044-suicide-risk-factors/id867043694?i=334338377&mt=2

“Suicide is a permanent solution to a temporary problem.” [Phil Donahue].

Values-Based Practice

TheStrengthsRevolution_albumart_1In 2013 Oxleas NHS Foundation Trust, in south-east London, commissioned a piece of work from Practice Based Evidence and the Mental Health Foundation to explore ways in which ‘values-based practice’ can be practiced and evidenced more in the day-to-day work with service users and carers within the Adult Mental Health Directorate. So far, the programme has engaged with six pilot teams and produced a set of draft guidelines. In 2014 the programme explore innovative ways of implementing the ideas, and spreading ideas to staff in other directorates.

Now in 2015 the programme draws to a close with a focus on a specific group of people, explored elsewhere in a few podcast episodes, the team and ward managers. These are seen by the programme developers as the key people for embodying and promoting the culture change needed within teams in order to implement refined approaches to the day-to-day challenges of working with peoples strengths and focusing on person-centred values in practice rather than just words in policies and mission statements.

WHY FOCUS ON VALUES-BASED PRACTICE?

They influence everything we think, decide and do in day-to-day practice, though often in a more sub-conscious way rather than overt statements and discussions. Good practice is not about adhering to one set of right values, we should respect and embrace values diversity. Values can be very personal, professional or organisational statements, but the focus here is on the values that underpin the day-to-day language of focusing on the needs and priorities of the individual service user. Practitioners need to be supported to be able to work where values of the service user, organisation, or professional may differ or conflict.  A recent high profile report in the UK highlights the need to put this approach to values-based practice into context:

Francis Report into Stafford Hospital “People must always come before numbers. Individual patients and their treatment are what really matters. Statistics, benchmarks and action plans are tools not ends in themselves. They should not come before patients and their experiences. This is what must be remembered by all those who design and implement policy for the NHS.” Excerpt from press release statement by Robert Francis QC in Stafford (5/2/13).

One product of the overall programme has been the development of brief practical guidelines linking together values and principles, working with strengths, positive risk-taking, and the role of person-centred care planning. A modified version of these can be accessed on request through The Strengths Revolution blog.

Podcast Episode 043: Suicide Risk [2]

IMAG1511What role does positive risk-taking have to play when someone is experiencing and expressing serious suicidal thoughts? Firstly, we have a duty to take such expressions very seriously, but the language of suicide risk can often appear overwhelming to others, and generate great fears of what might be.

Do we respond in a way that manages the other person, manages the situation, and ultimately takes over through assuming control over and for the person? Do we really take that step backwards, and give ourselves whatever time is available to listen to the person and help them explore their options in a supported relationship? We cannot eliminate risk, but do we become overwhelmed by a fear of engaging in the real conversation?

There is no such thing as a risk-free option, and in this episode I outline a case example from my own practice that illustrates how positive risk-taking was put in place through listening and acting on what the individual has to say, identifying alternatives, and exploring strengths and potential protective factors alongside the serious expression of risk.

For the full content of this episode click on the links for iTunes and Sound Cloud (or go to Stitcher Radio):

https://itunes.apple.com/gb/podcast/strengths-revolution-steve/id867043694

https://itunes.apple.com/gb/podcast/043-suicide-risk-2/id867043694?i=333467695&mt=2

“If it wasn’t for the possibility of suicide I would have killed myself a long time ago.” [Unknown source].

Podcast Episode 042: Suicide Risk (Interview case example)

TheStrengthsRevolution_albumart_2-2This episode is an interview with Satsanga (Lawrence Borish) reflecting on a case example of Alice, who he worked with whilst on a family counselling placement in his Masters Degree Social Work training in the US back in 1968. The placement was focused on cultural awareness, and the specific referral emerged through neighbourly concern for a woman whose behaviour and appearance was deteriorating. However, on engaging Alice, Satsanga discusses how, as a young inexperienced social worker, he is suddenly presented with an expression of suicidal ideas.

How we respond to these immediate circumstances can have a heavy bearing on the future life of another person. The interview explores issues of engagement of trusting working relationships, working with instinct, exploration of genuine alternatives to suicide, genuine collaboration between a person and a worker… all of which are important components of the process of ‘positive risk-taking’. The discussion raises thoughts about how we are supported, or not, to make difficult decisions; and could a decision-making process from a bygone era remain relevant today?

For the full content of this episode click on iTunes or Sound Cloud (or go to Stitcher Radio):

https://itunes.apple.com/gb/podcast/strengths-revolution-steve/id867043694

https://itunes.apple.com/gb/podcast/042-suicide-risk/id867043694?i=331833222&mt=2

Strengths-Based Practice

OMOpen Mind was a fabulous social care focused magazine for which I published a number of articles between 2000-2012. The following article was first published in OpenMind 126, Mar/Apr 2004) and was reproduced with their kind permission on my website at Practice Based Evidence.

It remains just as pertinent to practice today as it ever was, so I provide the link here to the strengths-based article. It focuses on the importance of principles, and the need to change the focus of our language in health and social care services to ‘go beyond  the alphabet of negativity’…

Click to access OpenMind-StrengthsBasedPractise.pdf

Podcast Episode 041: Juno’s View

Full faceIn this episode Steve Morgan reflects on the brief life of his cat, Juno, and the strength we derive from our pets, not just what we offer to them.

Juno’s sudden and unexpected death prompts reflection not just on the life she brought to Steve’s home; no, this was a cat that provided the inspiration for a blog… Juno’s View at http://cardiffcoolcat.com/ offering a creative option as to how to view a local city. All pet owners and lovers are challenged to take a long look at your pet(s) and identify the source of strength they provide for you.

For the full content of this episode click on the links to iTunes or Sound Cloud (or go to Stitcher Radio):

https://itunes.apple.com/gb/podcast/strengths-revolution-steve/id867043694

https://itunes.apple.com/gb/podcast/041-junos-view/id867043694?i=330253170&mt=2