News / Two years without a suicide but challenges remain for local mental health service

New clinical nurse manager Graham Laing (left) and head of mental health services Karen Smith (right). Photo: Chris Cope/Shetland News

THERE have been no suicides in Shetland in over two years now, while more men in the isles appear to be coming forward to access mental health support.

Local Choose Life coordinator Karen Smith, who was named on Monday as NHS Shetland’s new head of mental health for the next year, thinks the dramatic slow down in the number of suicides is due to prevention training in the community and reduced stigma.

Graham Laing, meanwhile, is looking to boost the isles’ often-criticised mental health provision after taking up the new role of clinical nurse manager with NHS Shetland at the end of July.

Demand for help locally remains strong, with a new support service from charity Mind Your Head already having over 30 referrals – many of them of men – after only seven weeks.

Today (Tuesday) marks World Mental Health Day and the issue has been a hot topic in the isles over the last few years, with patients previously criticising long waiting times in the NHS.


Smith admits there are challenges ahead for the mental health service as budgets tighten, while NHS Shetland’s problems with recruiting staff is another significant issue.

“We’re looking at resources becoming more and more restricted, so it’s about how you work with less, and how do you do more with less,” she said.

“I think there’s a dedicated team of people, but there’s a real issue with recruitment and retention, and I think that’s not just for mental health, that’s for Shetland.

“Particularly in the mental health service, it’s our most vulnerable in our society, and they need to develop relationships with people. If we can’t maintain them, how do those relationships keep going forward? I don’t have the answer for that, but I think that’s the challenge.”

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Laing, who previously worked in the Borders, praised Shetland’s mental health staff for their dedication to helping their patients.

“The team are extremely committed,” he said. “That is something very eye-opening I would say, across all the services in mental health here.

“It’s quite humbling, and it’s inspiring actually.”

NHS Shetland is currently recruiting for a consultant psychiatrist, while there are also a number of a psychiatric nurses being sourced too.

Smith will continue her Choose Life role and she believes a more pro-active method of suicide prevention awareness work has helped Shetland to reduce a rate which had previously averaged at seven a year.

“I think it’s down to the training and the fact that we say it out loud a lot now,” she said.

“When we do the roadshow we go out with a truck that’s covered in ‘let’s talk about suicide prevention’. It’s in your face. You can’t avoid it.


“For a long time when it was suicide prevention week we’d sit very quietly in the corner of Tesco with a couple of Mind Your Head flags. And then we made a decision that we’d do something really in your face, so people would speak about it.”

Mind Your Head, which was founded in 2005, could take some of the strain off the local NHS with its new support service which focuses on “low level intervention”.

Smith said “early intervention and prevention are the best for mental and physical ill health”, so “lower level stuff will take the pressure off higher-level.”

It provides one-to-one support for up to three months and service manager Anouska Civico said demand has been high.

There is capacity to have about 40 clients at any one time, with waiting times relatively short due to the service’s three-month turnaround.


Civico said a high number of males have been using the new service after the charity ran a video campaign encouraging more men to speak out.

“I suppose we’ve been overwhelmed with the response,” she said.

“A significant proportion of these have been self-referrals. People who have just picked up the phone and rung in to see if they can access the support service, or people who have just walked into the building, and a lot of those have been men.

“A couple of weeks back, 70 per cent of our case load was predominantly men.”

Mind Your Head also runs Grubby Hut sessions encouraging men to open up – and listen to others – in the workplace.

Civico believes an island community like Shetland being more open to talking about mental health and suicide continues to strip back the stigma.


“I think we have come a long way in Shetland and I think that we are more open as a community about talking about mental health, and I really think Mind Your Head has had a big part in it,” she said.

“We’ve still got a long way to go. I’m sure there are hundreds or thousands of people that are struggling that haven’t yet contacted us, but we’re here.”

The theme of this year’s World Mental Health Day is mental health in the workplace. Find out more here.

There are a number of ways people can access help. Breathing Space can be contacted on 0800 83 85 87, while Samaritans is on 116 123. People are also advised to visit their GP, or in an emergency they can go to A&E or dial 999. Mind Your Head can be contacted at 01595 745035.

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