Sharon McDonnell Centre for Suicide Prevention School of Community Based Medicine
Brief summary of the study funded by the RfPB programme. The RfPB submission process from a junior PI’s perspective. The support received by the NIHR Research Design Service.
“There are boundless opportunities for researchers, practitioners and service users to work together to devise projects for the NIHR Research for Patient Benefit Programme that have the potential to make a real difference to people’s lives.” Professor Davies (2008)
The Development of a Parental Suicide Bereavement Training Pack for Health Professionals Awarded: £242,000 3 years Competition: 12 (Submitted May 2010)
Centre for Suicide Prevention Dr. Sharon McDonnell (PI) Professor Jenny Shaw Professor Nav Kapur Health Sciences Dr. Lis Cordingley Primary Care Professor Carolyn Chew-Graham Pennine Care Trust Dr. Peter Elton (Director of Public Health) Volunteer sector Mr. John Peters (father bereaved by suicide and volunteer for SOBS self-help group).
Suicide prevention is an NHS priority (5,000 suicides in England and Wales). Estimated 6-10 people are affected by each suicide. Between 80-300% more likely to die by suicide than the general population. No specialist services within the NHS. Little is known about the experiences of those bereaved by suicide.
High suicide rate amongst young men under the age of 35 years. Society tends to blame parents when a young person dies by suicide. Parents experience feelings of guilt, shame, self doubt, feel that they have failed their child and failed as parents. Many feel suicidal and have difficulty caring for surviving offspring who may also be suicidal.
Our understanding of how to respond and care for those bereaved by suicide is far behind our understanding of other ‘at risk’ populations. No specialist services within the NHS. Currently no specialised training in suicide bereavement for health professionals. Patient dies by suicide - Health professionals experience similar grief responses as those bereaved by suicide. Many are often anxious and uncertain how to respond to those bereaved by suicide.
To develop a training pack to provide health professionals with knowledge, skills and a framework in which to guide them on how to respond and care for parents bereaved by suicide.
Stage 2 Stage 3 Stage 4 Stage 1 GPs Community A&E staff Bereaved perspective mental health perspective parents teams perspective perspective Synthesis of four stages Development of suicide bereavement training pack for health professionals (DVD)
The RfPB Application Process
1. ‘Generating high quality applied research in health and social care with the potential to improve any area of health, healthcare and health service delivery.’ 2. ‘Ensure service users and public have as effective as possible a voice in the decision process, in the conduct of research and in discussions of the implications of the findings.’ 3. The research designs are strong enough to influence daily practice within five years. NIHR, Prioritising Patients (2008)
Competition 3 Submitted 1 st bid May 2007 Rejected Oct 2007 but invited to submit another application ‘The Committee would like to encourage you to submit a fresh proposal in this field of research for consideration in a future funding round.’ Competition 12 Sought guidance from RDS (workshops) Submitted amended bid May 2010 Awarded funding Dec 2010 Contracts exchanged June 2011
Amended the study e.g. no longer using mixed methods, inclusion criteria amended etc. We responded to every comment made by the peer reviewers in the previous bid. Paid more attention to issues surrounding: 1. Patient and public involvement 2. Dissemination of findings 3. Value for money. Developed stronger links with the Trust involved in the bid.
Need to highlight the importance of the research and demonstrate the level of support from service users, organisations, and professionals who you might be dependent on to conduct the study (e.g. letters of support). Letters of support were submitted from several self help groups. Committee requested confirmation of support from Coroners who will identifying the deceased and contacting the bereaved family.
Demonstrate that you have a team that is well equipped to deal with sensitive issues and a strategy in place if recruitment becomes an issue. Peer Review Comments It was agreed that this proposal addresses an important research area, on a sensitive issue, for which the applicants should be commended. The Committee also acknowledged the strength of the research team.’
Dr. Sharon McDonnell (PI) Specialises in suicide bereavement Dr Lis Cordingley Health Psychologist Prof Carolyn Chew-Graham GP and Primary Care Prof Jenny Shaw Forensic psychiatrist Prof Nav Kapur General Psychiatrist Dr. Peter Elton Director of Public Health, Pennine Care Trust Mr. John Peters Self help group volunteer and father bereaved by suicide .
Collaboration – active on-going partnerships between researchers and members of the public Development of the grant application Design and management of the research Undertaking the research Analysis Dissemination of research findings
Co-applicant is a father bereaved by suicide. National co-ordinator of self help group guiding research team for the duration of the study. Steering committee consisting of health professionals and parents bereaved by suicide. Guidance from self help groups when developing information sheet, interview schedule etc.
‘The Committee requested that the applicants increase the patient and public involvement at the interview stage and provide adjusted project costs to reflect this. The Committee also suggested that the applicants may consider approaching INVOLVE or the Research Design Service for advice on this matter.’ Subsequently Created an additional advisory group which consists of people bereaved by suicide (£4,400)
Guidance Contact NIHR Research Design Service with any queries associated with an RfPB bid. Read RfPB guidance notes, specifically Directors notes which are updated after each competition. Contact INVOLVE for any queries about service user public involvement in the study. Involve finance department at an early stage (costings are scrutinised – numerous queries associated with bid created delays exchanging contracts).
Ensure You have a significant component of public involvement. Pay equal attention to all questions when submitting bid. Your team has relevant methodological, content and context skills to conduct the study. Clarify why YOUR team is best placed to undertake the study. The research design is strong enough to influence daily practice (i.e. positive impact for patients ). Is able to achieve this within 5 years.
Sharon.j.mcdonnell@manchester.ac.uk
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