Defining delivery of the ‘Step-by-Step’ intervention for schools: a co-production project

Introduction to this Emerging Minds funded project by the Lead Researcher, Dr Lucy Biddle, University of Bristol:

Approximately 150 school children die by suicide in England and Wales annually. The suicide of a young person has long-term effects on the mental health of peers, teachers and parents, requiring effective postvention support.

Step-by-Step (SBS) is the only UK school postvention service and is provided by Samaritans, the UK suicide prevention charity. SBS aims to enable schools to recover from a suicide/ suicide attempt and to reduce likelihood of further suicides.

This project led by University of Bristol in collaboration with Samaritans aims to identify the best way to measure and define delivery of the SBS intervention. This will include focus groups with Samaritans staff and postvention advisors (PVAs) to understand how SBS is delivered at ground-level, from which processes for data capture will be developed and piloted. This will be followed by telephone interviews with one teacher from 10 schools receiving SBS to better understand their experiences of receiving the service.

At the end of the project, an accurate means of capturing data about the SBS intervention will have been identified, enabling Samaritans to better address the needs of schools, and informing a future large-scale evaluation of SBS.

Key messages

Following the conclusion of the project, Dr Lucy Biddle shared the key messages from the research.

SBS is underpinned by core values. Postvention advisors (PVAs) consider the extent to which these are realised as key to determining whether a good intervention has been delivered.  PVAs resisted categorising schools according to intensity of intervention because core values were considered difficult to quantify, and an intervention tailored to the needs of the school was regarded as more important than intensity or delivery of specific components.  

Core values included: empowering school staff to take control; being available when needed; partnership working; providing intervention as early as possible; tailoring response to specific needs of the setting.  

Contextual factors relating to school culture and approach to mental health shape the extent to which PVAs feel able to deliver SBS successfully. A key challenge is initiating contact at a time when schools are overwhelmed. Challenge also exists around when to end contact to prevent schools becoming too reliant, while allowing re-engagement if needed (e.g. at anniversaries). The service is described as open-ended, meaning there is no clear endpoint.  

Findings from our small sample of schools indicate SBS is well-received and valued as a source of support which increases confidence of the school leadership team to manage the incident.  

The importance placed on early contact highlights a need to raise the profile of SBS among schools, local authority education departments, the police and relevant third-party agencies, and to consider offering pre-crisis planning.  

Feasibility work is needed to consider the best timing and methods for recruiting schools to participate in a future evaluation study. 

Further reading

Information about the project has also been included on the NIHR Applied Research Collaboration (ARC) West website research pages.