Back to Blog

Building suicide safety in Shetland


Mar 13, 2017

Photo: Karen Smith, center, with members of Shetland’s Fire and Rescue Service. The truck at the left displays a “Let’s talk about suicide prevention” decal to promote awareness and break down stigma.

Located 110 miles north of the Scottish mainland, the Shetland Islands evoke images of rugged hills, rocky coasts, and rolling seas. Over 23,000 people inhabit the island chain, and two dedicated ASIST trainers are working to keep them safe from suicide. Karen Smith, the Choose Life Coordinator for the National Health Service (NHS) of Shetland, and Shona Manson, founder of Shetland’s Mind Your Head mental health charity, have been steadily providing ASIST training for the past several years. “There’s a minimum of three courses run every year and they’re always full,” said Karen.

Choose Life, Scotland’s national suicide prevention strategy, mandates ASIST training to empower community members with intervention skills. Widespread attendance is encouraged in Shetland, and members of the public take ASIST alongside professional caregivers. When it comes to building suicide safety, the island community’s remoteness can be an advantage, said Karen. “The beauty of living on an island, or a chain of islands, is that if you work here, you live here—so even if we just trained professional staff, we’d have trained the community as well.”

ASIST is one part of Karen and Shona’s overarching initiative to promote mental health and break down the stigma around suicide. Working with NHS Shetland and Mind Your Head, they organize awareness events to engage and empower the people of Shetland. Each year during Suicide Prevention Awareness Week, vehicles traveling throughout Shetland display messages of hope as Karen, Shona, and their colleagues reach out to the community. Their efforts have taken them aboard Shetland’s ferries to provide resources to crew members, and to remote communities where they’ve trained shopkeepers to watch for invitations. “In some remote areas, the shopkeeper is the only person you might see on a regular basis, so their involvement can mean a lot,” explained Karen.

Their work is making a difference. Like many trainers, Karen and Shona have heard about successful interventions. “We always do the ASIST training on a Thursday and a Friday so we have the weekend to recover,” said Karen with a laugh. “One day I got an email from one of the participants who’d done an intervention with a family member the following weekend. They thanked me that they’d actually been able to speak with him, and said it was a very different conversation from the ones they’d had previously with him. This time they had been able to convince him to go and get help.”

Slowly but surely, through sustained outreach and training efforts, Karen has witnessed a transformation in Shetland. “I don’t think you can pick one element of it, it’s a number of things,” she said. “I think seeing these events and trainings very publicly makes a difference in the community. Suicide was almost a whispered word before, and now people feel like they can talk about it. I don’t think we’ve reduced all of the stigma, but I think we’re making a difference.” Shona agreed: “Here in Shetland, suicide rates have historically been high, but signs of a sustained drop in numbers are becoming evident.”

We’re inspired by Karen, Shona, and their colleagues, and we congratulate them for all they’ve achieved in bringing awareness and intervention skills to Shetland.