Fiona Breaker-Rolfe has the led the suicide bereavement support service for Cambridgeshire and Peterborough since October 2017. Working for the mental health charity Lifecraft, Fiona was responsible for setting up the service from the start and has shared some of her learnings and experiences with us.

Suicide bereavement support was a key part of Cambridgeshire and Peterborough’s suicide prevention strategy, to ensure information and access to support services are available to those bereaved by suicide.  Initially there were a few other services around like AMPARO in Cheshire and Outlook South West in Cornwall to research information on postvention models of delivery.  This helped enable the local Care Commissioning Group and Local Authority to develop a contract to commission a service in the area.

We have a strong, effective partnership, chaired by the Head of Public Health. This has been vital in providing strategic direction and in keeping the key players engaged in the process of postvention work. These include not least the police, Local Authority, coroner, voluntary sector. NHS and Network Rail. With senior decision-makers around the table, the trust was already established between partners to make a real impact on suicide prevention.

Lifecraft was successful in winning the contract for delivery of the service and advertised for a person to come in to develop and deliver the service. As a qualified bereavement counsellor with mental health experience, I was successful in getting the job and funded to work 15 hours (so two days) per week. This has now increased to 18 hours per week.

As this was a brand new service, I built on the original specification from the outset. I researched good practice and spoke to other people doing the same work. I used resources from NSPA, SASP and Public Health England around developing a service and particularly, how to evaluate. Although I looked at other services for models that worked, I had to shape our service to fit the funding we had available and to meet our local need.

The first priority for Lifecraft was to set up a confidentiality agreement with key partners; the police, NHSE, and the Coroner’s Office.

This allowed me to accept referrals immediately. Once the Police report a suicide to the Coroner, I am copied in (where the next of kin agrees to support). This means I am working with ‘real time’ data where I can be in touch with the family within days of a possible suicide.  We are also able to support people who self-refer, however we would expect this to be within the first year of a loss.

I am a mobile worker based from home, with easy access to the office in Cambridge and plenty of autonomy to manage the caseload. I have a line manager at Lifecraft with a wealth of experience in mental health and an independent clinical supervisor. The service at present is managed effectively in the 18 hours allocated, although there is always demand to do more. This does mean having some boundaries and priorities of course.

In addition to case work, I get involved with local partners to meet and provide an ‘on the ground’ view of loved ones’ experiences, and also offer outreach support to schools, NHS, family support staff and voluntary agencies. I have recently set up a suicide bereavement support group for those who have received a service from us and are ready to move to the next steps.

With case work, I make my first contact with families and loved ones within the first week, Sometimes people need time to process what has happened before they can engage with support – once I have made contact the service is open to them.  Early contact is essential in identifying people in crisis and needing medical support. Sometimes one call and some information is enough. Other times, someone will want to meet face to face for coffee and a chat. I can signpost, listen and offer emotional and practical support, whichever that person needs.