Please see the NHS England » Staying safe from suicide: Best practice guidance for safety assessment, formulation and management. (published 4.4.25). This suicide prevention guidance will help clinicians provide more personalised care for patients struggling with suicidal feelings. This approach means mental health practitioners will work with all patients where there is a concern about suicide safety to co-produce a personal risk formulation and safety plan. The guidance applies to all mental health practitioners in England.
For adults at crisis point, refer to PCLS immediately (also known in Bristol as Referral & Triage Team)
For children in crisis then please consider obtaining urgent advice from CAMHS - see the CAMHS Remedy page for further information
Suicide Risk Red Flags (non-exhaustive list)
Red flags are significant risk factors that alert us to a person being at increased risk of attempting suicide at time of assessment.
This risk will require a clinically appropriate intervention and a Safety Plan put in place. This may also include discussion with and/or referral to the Mental Health Services.
Demographic and social
Personal background
Clinical factors in history
Mental state examination and suicidal thoughts
Source: Royal College of Psychiatrists (2020) Self-Harm and Suicide in Adults: Final Report of Patient Safety Group.
A safety plan is a tool that can help to set out how a person can support themselves or seek support from others if they are experiencing thoughts of self-harming or suicide.
Depending on the level of risk, you may use this in conjunction with onward referral to the AWP Crisis Team or Assessment and Recovery Team, VitaHealth NHS Talking therapies or other local support such as Off The Record (OTR) for young people, Self Injury Support, Second Step, Changes Bristol, and CASS for culturally diverse services. For more information call CASS on 0117 304 1400 or email info@cassbristol.org).
A safety plan can include:
How to create a safety plan, and its potential value to patients: Staying Safe
Paper safety plan: https://stayingsafe.net/sites/default/files/BlankSafetyPlan.pdf
Electronic safety plan: Staying Safe | from suicidal thoughts (the electronic version contains prompts).
Stay Alive free app: https://www.prevent-suicide.org.uk/find-help-now/stay-alive-app/ The Stay Alive app contains an online safety plan that the user can customise. The app is a pocket suicide prevention resource for the UK, with useful information to help people stay safe. It can be used by someone having thoughts of suicide or those concerned about someone else who may be considering suicide.
DistrACT free app: distrACT app - Expert Self Care. The distrACT app gives easy, quick and discreet access to information and advice about self-harm and suicidal thoughts. It contains links to local services and ideas that could also be used in a safety plan.
NHS Talking therapies and courses are available across BNSSG. Please see the Talking Therapies page. However, this is not suitable for those at high risk to themselves and/or at crisis point.
Student counselling is available from individual colleges and universities.
Please also see Mental Health Resources for Children and Young People
The Hope Project provides short-term emotional and practical support for men aged 30-64, who are in psychological distress because of issues with their housing, finances, or employment. Our aim is to prevent suicide among this high-risk group.
Our experienced project workers work with men across Bristol, North Somerset and South Gloucestershire over a twelve-week period, services. We know that 62% of all suicides are by people who aren’t known or connected to any services.
The Hope Project accept professional & self referrals. However, we request that professionals refer patients into the service with a copy of any assessment notes or summery of GP appt.
Client Paul says our work is life-saving:
"Through my torment, being able to speak to Hannah and make a plan for my life, has been a game-changer."
Contact the Hope Project on hope.project@nhs.net
Hope Project | Mental Health Charity | Second Step Bristol
The Beside Project is here to support you when you have lost a loved one to suicide. We offer emotional and practical support to people aged over 16, whether you are a family member, next of kin or a loved one.
We work across Bristol, North Somerset, South Gloucestershire, Bath and North East Somerset. We are sadly unable to offer support to those who have experienced a historical bereavement by suicide.
What you can expect from us
Find out more
You can contact the team by emailing beside.project@nhs.net.
You can also call Second Step reception on 0117 909 6630 and ask for a call back from the Beside Project.
"We're here for you. It’s natural to feel all sorts of emotions at a time like this. We want you to know that we’re here for you, and that you’re not alone."
AWP provide a Mental Health 24/7 phone service providing support for people worried about their own, or someone else's mental health.
The telephone line offers out-of-hours care for adults and children in crisis 24 hours a day, 7 days a week, 365 days a year.
Telephone: 0800 953 1919
Open: 24 hours per day, 7 days per week
Tel: 116 123 Email: jo@samaritans.org
HOPELINEUK is a specialist telephone service staffed by trained professionals who give non-judgemental support, practical advice and information to;
Open: Mon-Fri: 10am-10pm, weekends: 2pm-10pm & bank holidays: 2pm-10pm
Call: 0800 068 41 41 Text: 07786 209697 Email: pat@papyrus-uk.org
CALM, is a registered charity, which exists to prevent male suicide in the UK. Suicide is the biggest killer in males under 50.
The helpline is for men who are down or have hit a wall for any reason, who need to talk or find information and support. Calls are taken by trained staff who are there to listen, support, inform and signpost. Because calls are confidential and anonymous we don’t and can’t offer a counselling service.
Open: 5pm - midnight, 365 days per year
Call: 0800 58 58 58 Webchat & WhatsApp option available on the website
Calls are anonymous & confidential and won’t show up on phone bills. Calls are free from landlines, payphones and all mobiles
Offer a crisis messenger text service which provides free, 24/7 crisis support across the UK. This support is free and for any issue. They provide in-the-moment support and problem solving. If aged 25 or under, text THEMIX to 85258.
"We know that finding the right support is important, especially if you need someone to talk to right now. We aim to connect every texter to a trained volunteer in less than five minutes to provide crisis help. They will listen to you and help you think more clearly, enabling you to know that you can take the next step to feeling better."
Can also offer up to 8 counselling sessions for a range of issues via telephone or webchat for 11-25 year olds.
Web support and signposting to other help
The Zero Suicide Alliance offer free online training that is aimed at everyone and gives a basic understanding of how to support people who are showing signs of depression or crisis and offers guidance on how you can deal with such situations.
You can access the training presentation online, with the training taking approximately 20 minutes. The training is excellent for both clinical and non-clinical staff. A mass undertaking of this training would have a huge impact in reducing stigma and increasing support.
If you would like further information regarding the work being undertaken by the Zero Suicide Alliance please see their website
Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.
Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.