Lifeline: on the line
Public Health Agency proposals to reform the Lifeline crisis helpline will risk the lives of suicidal people, according to Contact which operates the service.
The PHA’s ongoing consultation on Lifeline's future stands accused of plans to “fragment and downgrade the Lifeline service”,
Lifeline is Northern Ireland’s 24/7 freephone suicide prevention and crisis helpline, available for people of all ages. Contact Managing Director Fergus Cumiskey is scathing about the proposed changes.
“It is… vital the public respond to the public consultation which ends on 19th November, as the proposed changes for Lifeline will dismantle an independent trusted service, which provides a bridge of hope at times of crisis and support to the right service at the right time when people are at their most vulnerable.”
The group has outlined a number of “key concerns” about the new proposed model, which include:
- A “downgrading” of the crisis helpine, with professional counselling, advocacy and referral with a “listening and signposting” service staffed by call operators – with focus on the concern that the new proposals will place a greater emphasis on service users to seek their own follow-up help, which flies in the face of research into the behaviour of people at risk of suicide.
- Concern at the separation of the Lifeline crisis helpline from its follow-on support services which risk fragmenting the care pathway – which, as above, is known to be particularly crucial in relation to these specific health issues.
- Placing more focus on those at immediate risk of suicide, with less provision for those low- or medium-risk – this might sound sensible but ultimately the majority of suicides come from that latter cohort, so this also requires full attention.
- Splitting up the Lifeline follow-on psychological therapies from a single regional provider to a minimum of five locally-based providers will risk undermining expertise and consistency, according to the group.
A defining local issue
It is well known that Northern Ireland, as is the case in post-conflict societies generally, has an extremely high rate of suicide.
Any cursory look at the prevalence of suicide locally will show just how important it is to get our crisis services right.
Contact, in its media release slamming the proposals, featured testimony to the service from other notable people.
Dr John Kyle, GP East Belfast said: “As a GP working in a busy East Belfast surgery, I have witnessed first-hand how my patients have benefited from Lifeline, having made many referrals over the nine years the service has been available. The current service model has earned community confidence, ensuring every caller is provided with expert, professional and compassionate support, tailored to their particular needs.
“Lifeline is a non-stigmatising independent service lobbied hard for by communities most affected by suicide, linking concerned families and distressed individuals with the right support at the most difficult times. We know through NI studies that breaking down barriers for men in particular requires service choice - this is what Lifeline delivers.
“I cannot understand the rationale behind removing one of the most important elements of the current model – ensuring patients get the right care at the right time with dedicated follow up until safety and stabilisation are secured.”
Caitriona Cassidy, who previously benefitted from Lifeline and now speaks on its behalf, said:
“When I read about the proposed changes to the Lifeline service in the public consultation, I was very disappointed that this vital service could potentially, be radically changed. I am not convinced that the needs of vulnerable people in crisis are at the heart of the proposals.
“What seems to be missing entirely is an appreciation of the sense of isolation and burden a person in crisis feels - to expect someone in crisis to reach out for support first to a crisis line and then find the courage to do this again when signposted to community based services will risk lives.
“Certainly, the idea of bringing this service within a statutory body would not fill me with great confidence as a service user.”
The other side
The PHA yesterday released a long statement on its proposed reforms and its priorities, saying:
“The Lifeline crisis response service is highly valued by the Public Health Agency (PHA) and is a key priority as it provides essential support to people at a time when they are at their most vulnerable.
“The consultation proposals would maintain the 24 hour, seven days a week telephone helpline provided by staff who are skilled and qualified in talking to people in crisis. The telephone helpline operators would require professional skills and qualifications in listening and in assessing the risk of suicide. They will also have knowledge of the range of support services available to ensure that callers are directed to the most appropriate service for their needs. For callers at higher risk, the helpline staff would directly arrange further care through to emergency mental health services. For some lower risk patients, follow up through primary care, or community support may be more appropriate.
They said further that the proposal to move the “telephone helpline element of the Lifeline service” under the management of NIAS was designed to strengthen links between different aspects of provision and is an arrangement that “could prove vital in saving lives”.
Sinn Féin’s Maeve McLaughlin however, the Health Committee chair, has come out fighting against the proposed reforms – saying there should be no cuts to such a vital service
“These changes will fragment the service Lifeline offers and shift its focus to high risk callers which would have a negative knock-on effect on callers who are regarded as being at low or moderate risk.
“This organisation provides an excellent service, including follow up contacts for a range of callers and has literally saved the lives of many people.
“Research has shown that the majority of people who take their own lives have experienced mental health difficulties so the heath service should be investing in services instead of cutting them.”
The outcome of the consultation will be extremely interesting.
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