Research, evidence and evaluation

A key objective of Choose Life is to ensure that interventions to reduce suicidal behaviour are informed by evidence from research and evaluated appropriately. Vital pieces of research from NHS Health Scotland, Scottish Government and national and international academics continue to inform the implementation of the Choose Life strategy. This research includes:

Trends in National Suicide Rates for Scotland and for England and Wales 1960 - 2008

This study reveals the widening gap in suicide rates between Scotland, England and Wales.
The research carried out by Manchester University, Edinburgh University and the Medical Research Council/Social and Public Health Sciences Unit in Glasgow, examined patterns of suicides north and south of the border between 1960 and 2008. The team found that the suicide rates in both men and women were lower in Scotland until around 1968 when they overtook England and Wales. Suicides among men continued to rise on both sides of the border until the early 1990s when rates in England and Wales began to fall and the gap between north and south widened markedly.

Guidance on action to reduce suicides at locations of concern (2010) (external link)

Preventing suicide at locations of concern is an important part of a suicide prevention strategy. While the evidence base is slim, there are advantages to a consistent approach to reducing the risk of suicide at locations of concern. This is based on the best practice guide 'Guidance on action to be taken at suicide hotspots' (2006), developed by Dr Christabel Owens and the Research and Development Department of the Devon Partnership NHS Trust, together with the Peninsula Medical School. Health Scotland has supported a working group to review this guide in the Scottish context and further developments in the field.

Evaluation of the second phase of Choose Life (2006-2008) (external link)

The evaluation of Phase 2 of the Choose Life suicide prevention strategy and action plan was published in 2010. The evaluation was commissioned by the Scottish Government and conducted by Patricia Russell & Associates between February and November 2009. The aim of the study was to evaluate the performance and achievements of Phase 2 and to make recommendations for going forward from 2010.

• View the summary of the second evaluation of Choose Life (external link)

Evaluation of the first phase of Choose Life (2003-2006) (external link)

An independent evaluation was published in 2006 to examine the progress of Choose Life in developing a sustainable infrastructure, to measure and review progress towards key milestones during its initial phase (2003-2006), and to make detailed and staged recommendations to guide the next phase of the action plan. The evaluation was conducted by researchers led by Professor Stephen Platt of Edinburgh University.

• A research findings summary, PDF, 243Kb (external link) is available. Within this is a Review of National Strategies for Suicide Prevention.
• Read the Scottish Executive response to the evaluation of phase 1 (August 2006).

Pulling together the evidence base

A three-stage process was launched in 2004 to ensure that service development and the implementation of Choose Life is supported by a reliable, relevant evidence base.

A scoping study was commissioned to identify how to most usefully co-ordinate the evidence base, identify gaps and inform thinking and activity in the prevention of suicide and deliberate self-harm.  'Suicide and Suicidal Behaviour: Establishing the Territory for a Series of Research Reviews' (external link) (McLean, Platt and Woodhouse), published in 2004, is the final report.

Effectiveness of interventions to prevent suicide and suicidal behaviour: a systematic review from 2008 (external link)

The 2008 review provides a comprehensive overview of the known effectiveness of interventions aimed at preventing suicide, suicidal behaviour and suicidal ideation, in key risk groups and the general population. The research team was led by Dr Maria Leitner (InfoTech UK Research) and Dr Wally Barr (University of Liverpool) and included academic researchers, clinicians and service user and carer advisors.

• View the annotated bibliography of the 2008 sytematic review (external link)
• Access the research findings for the 2008 systematic review (external link)

Risk and protective factors for suicide and suicidal behaviour from 2008 (external link)

The review relating to determinants of suicidal behaviour was published in December 2008.

The epidemiology of suicide in Scotland published in 2007 (external link)

This project was commissioned in October 2005, to provide reliable, up-to-date baseline information for monitoring and evaluation of suicide prevention policy implementation at national and local levels. The lead contractor was Professor Stephen Platt of Edinburgh University.

• View the research summary of the epidemiology of suicide (external link)

Evaluations of suicide prevention training

Evaluation of ASIST suicide prevention training including literature review from 2008

ASIST (applied suicide intervention skills training) is a two-day workshop for helping to prevent the immediate risk of suicide. An evaluation of the use and impact of ASIST in Scotland and literature review has being carried out by a consortium of independent contractors, led by Griesbach and Associates.

Evaluation of ASIST in West Dunbartonshire (2007)

Choose Life, West Dunbartonshire commissioned an evaluation of ASIST (Applied Suicide Intervention Skills Training) to inform decisions about how the training should be targeted within this local authority. The 2007 report includes:

• an executive summary
• the questions people were asked (Appendix 1)
• respondents' organisations and job titles (Appendix 2).