Suicide and Self-Harm: Samaritans 'Listener Scheme' Case Study

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    • 00:09

      ELIZABETH SCOWCROFT: My name is Liz Scowcroft.I am the research manager at Samaritans.And this film's going to be about the listenerscheme, which is a service that Samaritans runsin prison in over 100 prisons in the UK and Republic of Ireland.And the purpose of the scheme is to support prisonerswho are struggling to cope, and provide a peer supportservice-- so prisoners supporting

    • 00:29

      ELIZABETH SCOWCROFT [continued]: other prisoners in the same way that that Samaritansvolunteers would help support any memberof the general public, on the phone or in any other way.

    • 00:42

      JIM SANDERS: I'm Jim Sanders.I've been a Samaritan volunteer for about six or seven yearsnow.So that means that I regularly-- a couple of times a month--come and spend some time on the phonesand listen to callers who need our support,either they may be suicidal or just actually feeling very low.As well as providing that support to callers,I also got involved in doing prison work

    • 01:05

      JIM SANDERS [continued]: and going in with Samaritans into prisonsand supporting prisoners.So I originally did that because I'mvery interested in doing the training and trainingprisoners up to become what we call listener volunteers.So we take what we do with Samaritansand we transpose it into the prison context.

    • 01:26

      JIM SANDERS [continued]: We identify people who we think are suitable,try and encourage them to come forward.Some people volunteer themselves.We do a selection day in which we take our listenersthrough a set of exercises to seewhether they would be suitable to be trained up as volunteers.We then train them over eight different modules, whichtalks about suicide, talks about howyou have a conversation with somebody, how we listen,

    • 01:48

      JIM SANDERS [continued]: how you're just there for people in distress,and taking people through that process-- supporting them,training them, allowing them to learn and askquestions and discover what it means to actuallybe able to be there for somebody is possiblyone of the most rewarding things I'vedone for Samaritans in total.

    • 02:09

      JIM SANDERS [continued]: And through that work, I got very involvedin how Samaritan supports prisons more generally.So I started doing a regional prison supportrole, in which I looked after the London region and allthe prisons in the London region.In that role, essentially, I was the liaison pointbetween the regional prison service and Samaritans.

    • 02:33

      JIM SANDERS [continued]: So each Samaritan branch has a prison teamwhich will go into their local prisonand support the listeners to provide that service.So I started off by doing the training,then getting into doing the regional prison support role.I enjoyed that so much that I moved on and started

    • 02:54

      JIM SANDERS [continued]: doing the functional lead of prison support role, whichis a role which works across the entire organizationand looks at liaising with the seven different prisonservices, which we support, whichwe have prisons which we support in across the organization.It's really fascinating, understanding

    • 03:14

      JIM SANDERS [continued]: how we can grow and evolve the service,but also understand how important actually beinga listener is for the listeners themselves,but also about how important it is to make sure that there arepeople in prisons who callers from prisoncan see face to face and can relate to,because they're in a very similar situation to them.

    • 03:37

      JIM SANDERS [continued]: So the listener scheme, like Samaritans' workmore generally, is based upon four core principles.The first one is being available all the time, 24 hours.Since Samaritans launched, we've alwayshad somebody manning phones so you can call us.And if we're available, we can answer the call

    • 03:57

      JIM SANDERS [continued]: and provide that support.It's exactly the same with the listener service, as well.Listeners should be available in prisons 24 hours a day.The second key one is confidentiality.We don't believe that people would trust uswith the depth and difficulty of some of the emotions whichthey talk about.

    • 04:18

      JIM SANDERS [continued]: So keeping that to ourselves-- not telling anyone, nottelling prison officers, if we're in prison,not telling the police-- about what's saidis very, very important.So confidentiality is the second one.Being non-judgmental is the third key principleof Samaritans.And this is it allowing our callersto really say anything which they feel they need to to us.

    • 04:39

      JIM SANDERS [continued]: Outside, in society, when you're talkingto your friends or families or colleagues,there's a lot of judgemental behaviorwhich we see all the time.We want to create a safe space in which, actually, it'sOK to talk about all of those really difficult things--all those things you've been worrying about allof these things which really concern you.So being non-judgemental is very, very important.

    • 05:02

      JIM SANDERS [continued]: And that leads on to, actually, the final one, whichis about self-determination.So we believe it's actually everybody's rightto choose what they do with their lives.We hope that, by being there and listening to people,that they're less likely to take their own lives.But we ultimately believe it's their right.We'll not try and influence a caller to not take their lives.

    • 05:27

      JIM SANDERS [continued]: We hope by talking that they won't.But ultimately, it's their decision.So ensuring that people who feel like theyhave that right to self-determine, to choosewhat happens to them, is an important partof what Samaritans do.

    • 05:51

      KAREN SLADE: My name is Karen Slade.I'm a forensic psychologist by profession.I currently work at Nottingham Trent University.But I used to work, for around 15 years,for Her Majesty's Prison Service as a forensic psychologist.I first became aware and working with the listener schemeand the Samaritans some years ago, around 15 years ago,

    • 06:16

      KAREN SLADE [continued]: when I started to work with prisonerswho used to self-harm.And then I became much more involved a few years later,when I used to be the head of safe custody--so with responsibility on behalf of the prison for suicideprevention.And then I'd work much more directlywith the Samaritans and the listeners,

    • 06:36

      KAREN SLADE [continued]: working together, across all the servicesthat were involved, with prisoners to try and preventself-harm and suicide within that population,both within prison, but also on release, after they left.I started to research in the area just a few years ago,

    • 06:60

      KAREN SLADE [continued]: really-- about eight years ago-- when it became clearthat we really didn't know enough about howto really support people in crisisin prison, why people were becoming so distressed,why the rate of suicide, self-harm, is so high.And so I started to research in the area.

    • 07:22

      KAREN SLADE [continued]: And I work alongside, now, the Samaritans,who are also looking into evaluating the listenerscheme-- understanding why and how it works, and for whom.The research that I'm undertakingalongside Liz Scowcroft from the Samaritansis going to be evaluating the listener scheme in relation

    • 07:44

      KAREN SLADE [continued]: to a psychological model.The Integrated Motivational-Volitional Model,by Professor O'Connor, is a modelwhich tries to explain the process that people go throughtoward suicidal behavior.And it captures some really key conceptsthat help to explain why it is that people

    • 08:06

      KAREN SLADE [continued]: go from being vulnerable initially-- solife events, background that they have.That might be some trauma in their background, childhoodabuse.It could be substance use-- thingsthat make people vulnerable to findingdistress in stressful situations,more difficult to deal with.

    • 08:28

      KAREN SLADE [continued]: And the model suggests that peoplego through essentially three key stagestowards suicidal behavior, the first of whichis a concept called defeat-- feeling that they have loststanding in the world, that they will feel defeated and maybeworthless within the world around them.

    • 08:52

      KAREN SLADE [continued]: And then the second concept is feeling trapped,feeling entrapped by their situation.They feel trapped within themselves.They feel trapped in their situations,their external situations.And if they come together, those two concepts,alongside thinking around suicide-- so having

    • 09:14

      KAREN SLADE [continued]: suicidal ideation-- they may thengo on to actually act in a way that is harmful.So they'll have not just thoughts, but also behaviors.Now, the model is a bit more complex than that.And there's a number of things that

    • 09:35

      KAREN SLADE [continued]: are suggested in the model which will speed up or slow downthat process.And those are the things like whether peoplefeel able to cope, whether they have social support in place,people to talk to, whether they feel emotionallyable to deal with situations.And what the research we're doing with the listener schemeis looking at is whether the listener scheme can actually

    • 09:60

      KAREN SLADE [continued]: help to slow down that process.So by providing social support, helpingpeople solve their problems, be able to copewith their emotional situations--whether that then can slow down the processand then mean that people don't go on to thinking aboutor behaving in a way that is harmful to themselves.

    • 10:22

      KAREN SLADE [continued]: So this research is really vital and reallyimportant as a way within prisonswhere suicide risk and suicide behavior is so high,but to help to understand what we can doto help slow down that process.

    • 10:42

      ELIZABETH SCOWCROFT: We just completeda pilot study of this research in one male prison in London.The purpose of the pilot was to find outwhether the questions and the measures that we were includingin a questionnaire for the full studyare reliable and valid with the prisoner population.So we asked prisoners who aren't listeners,but who may or may not have used the listener

    • 11:03

      ELIZABETH SCOWCROFT [continued]: scheme, to complete some questionnaires, answerquestions about themselves and possiblytheir history of suicidal feelings,and validated measures that relateto the psychological model that we'reusing to conduct this research.And them we analyzed the results using statistical reliability

    • 11:24

      ELIZABETH SCOWCROFT [continued]: tests, and looked at whether the measures had to be changed,and whether there were different questions that were maybemore appropriate to use with a prisoner populationso that we could refine the questionnaireand take it into the full study, knowing that it'sa good measure of the model, and that prisoners can fill it out

    • 11:44

      ELIZABETH SCOWCROFT [continued]: easily so that we get some good robust resultsin the full study.

    • 11:49

      KAREN SLADE: The research like we're doinghas such importance in terms of how we move forwardwith addressing this issue in prison.Without doing research, we wouldn'tknow what we're doing well, but also what we're doing poorly--

    • 12:12

      KAREN SLADE [continued]: which bits should we spend more time doing?Which bits should we spend less time doing?And research like this provides really concrete evidenceof what works, what doesn't work,and where we should spend our ever limited resources,in terms of trying to make the best use of specialists,

    • 12:37

      KAREN SLADE [continued]: better use of time, money.But also, the buildings that we have in the prison are limited.We can't provide one to one treatment for everybody.We have to use a range of resources to support people.

    • 12:58

      KAREN SLADE [continued]: In terms of how research is used generally,the prison service very much uses researchin guiding its policies, its procedures, its practices.It will directly inform how we do our day to day jobs.It will directly inform how services

    • 13:19

      KAREN SLADE [continued]: should be set up, how they shouldbe run within the prisons.But also, continuing research-- it's not a one off thing.It's not something you do once and then 20 years later, it'snever done again.It's a constant process of understanding and the changing

    • 13:41

      KAREN SLADE [continued]: environment, the changing world that we live in.The Samaritan scheme's been running nearly 25 years nowin prisons.We have lots of information.It's time to now look at it again and lookabout how we want it to go forward in the next 25 years.

    • 14:05

      JIM SANDERS: So in essence, the role of the listener in prisonand the role of the Samaritan on the phones is the same.We provide the same type of supportto people who are in distress.There are some important differencesabout being in prison and providingthat support in prison to when you're on the phones.So they themselves are also in prison.So they have their own challenges,

    • 14:27

      JIM SANDERS [continued]: personal circumstances going on, which obviously, they'recarrying around and they're dealingwith on a day to day basis.So some of our listeners will have their own challengeswhich they'll need to, whenever they're sitting downin front of a caller, put aside and be there with that person.And putting those things aside in that type of an environmentis not necessarily an easy thing to do.

    • 14:49

      JIM SANDERS [continued]: But we've got lots of very dedicated listenerswho do manage to do that on a daily basis--to be there for callers.So not only do they have their own challenges.The people who they're supportinghave perhaps more challenges, often,than some of the people who we get phoning up.Certainly, it's our experience that everybody in prison

    • 15:10

      JIM SANDERS [continued]: has got all of the challenges of the peoplewho we talked to on the phones, and they'rein prison, which makes all sorts of additional barriersto repairing broken relationships,just because you can't get contactwith your family or your loved ones.Having the freedom to do what you want, to go about-- there's

    • 15:31

      JIM SANDERS [continued]: a very strict timetable in prison,which means that a lot of prisonersaren't afforded some of the things which they wouldneed to do to get peace of mind, to eat how and when they want.All of these things add up and, I think, makepeople's personal circumstances and the challengeswhich they're dealing with far more difficult.

    • 15:52

      JIM SANDERS [continued]: A great loss of a sense of control, I think,comes with, often, being in prison.And we often talk to a lot of people who feel quite hopeless.And so there are important differencesaround the people who we actually supportand some of the challenges which they present.So there will be lots of people expressing fears

    • 16:15

      JIM SANDERS [continued]: about being in prison, guilt, regret,broken relationships-- all the thingswhich are on top of all of the other challenges which theymay have.The prison regime itself-- actually justoperating in a prison can be challenging.You could be there with a caller, supporting a caller,and an alarm will go off, which means

    • 16:37

      JIM SANDERS [continued]: they're in the middle of talking to you about--perhaps for the first time in their life,telling somebody that they're feeling suicidal.And then suddenly, an alarm goes off.And you want to be there and you want to support them,but you know, right now, you've got an officer telling youit's on lockdown or whatever may have happened.So there's a real practical challenge around that.

    • 17:01

      JIM SANDERS [continued]: The prison services that we work with are really aware of thatand do a very good job of minimizing that.But that doesn't mean that it doesn't happen.And so there's a practical challenge around it.And I suppose the fourth thing to my mindis the fact that our listeners livewith the people they support.

    • 17:22

      JIM SANDERS [continued]: So you may be walking around the prison,having seen somebody who you spenttwo hours with last night, talking about someof the deepest and darkest fears.And they may not want to really even acknowledgethat they had that conversation.They may not want other people to know.

    • 17:42

      JIM SANDERS [continued]: Confidentiality is very, very important to Samaritans.Being a listener can be challenging in different ways.There is often an impact on deciding to take that badge,put that t-shirt on which says, I'm a listener,

    • 18:03

      JIM SANDERS [continued]: and be there for people.It really varies from prison to prison.In some prisons, listeners will begiven an enhanced status, which means that they can reallymove around the prison.In others, they won't.Mostly, most prisoners who talk to themgive them respect and time, because they're

    • 18:24

      JIM SANDERS [continued]: giving-- they're not paid for what they do.It's totally voluntary.And they're giving their time to be there for callers,for anybody who's in distress.So most of the time, there aren't many negative impacts.Obviously, sometimes, there are.There will always be somebody whodoesn't understand what you're doingor who wants to have a go.But most of the time, in prison, most of the impact is positive.

    • 18:49

      JIM SANDERS [continued]: The real impact having a listener has on peopleis the personal impact that it has, though.When you go through that training,when you first start to try to understandhow to have a conversation about somebody who's feeling suicidalor how-- people feel suicidal in different ways.And we're privileged enough to be there

    • 19:09

      JIM SANDERS [continued]: when people are talking about some of those hardest feelings.It's that personal impact that actuallyhas a transformative effect on so many prisonerswho choose to become listeners.I know a number of prisoners myself, who I've trained,who feel that it has fundamentallyturned around their lives.The skills that it gives you-- enables you to listen better,

    • 19:33

      JIM SANDERS [continued]: relate to people better.I've spoken to listeners who told meyou know before they became a listener,somebody would say something which angered them,and they'd just blurt something out.Now, they stop.They pause.They think about what they want to say.And they'll attribute their livesturning round down to having joined the listener scheme

    • 19:53

      JIM SANDERS [continued]: and deciding to become a listener,to go through the training, and actuallycommit to support people.So the real impact that I think it's worth notingis the personal, the individual impactthat actually has on listeners themselves, which reallyhas a transformative effect.And I can't talk about that enough, because it's

    • 20:14

      JIM SANDERS [continued]: such a pleasure to see somebody who maybe came alongthe first time to be a listener to the training--they didn't really know what the training was about,and maybe they were bored and wantedto get out of their cell.There could be 1,000 reasons.Maybe just an officer said, why don't yougo along to the training, and they thought, why not?They didn't really know what it was about.

    • 20:35

      JIM SANDERS [continued]: And watching them over that journey,over those eight modules, and thenwatching them grow over the next six months,year, however long it is that they'rea listener, into that role, a role of responsibility,a role which sees them mature in different ways,is an absolute privilege for us, and really demonstratesthe value that it has on a personal level for listeners.

Suicide and Self-Harm: Samaritans 'Listener Scheme' Case Study

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The listener scheme, ran by the Samaritans, is a service to help support people who are struggling to cope with prison life. The Samaritans train prisoners to become "listener volunteers" and provide peer support within prisons. That support can help reduce suicide risk and self-harm within prisons by providing a confidential outlet for prisoners.

SAGE Video In Practice
Suicide and Self-Harm: Samaritans 'Listener Scheme' Case Study

The listener scheme, ran by the Samaritans, is a service to help support people who are struggling to cope with prison life. The Samaritans train prisoners to become "listener volunteers" and provide peer support within prisons. That support can help reduce suicide risk and self-harm within prisons by providing a confidential outlet for prisoners.

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