Item 6 on the agenda this afternoon is the Member debate under Standing Order 11.21(iv): Suicide Bereavement Support, and I call on Lynne Neagle to move the motion. Lynne. 

Motion NDM7211 Lynne Neagle, Dai Lloyd, David Melding

Supported by Angela Burns, David Rees, Jack Sargeant, Jayne Bryant, Joyce Watson, Mark Isherwood

To propose that the National Assembly for Wales:

1. Recognises that losing someone to suicide is a uniquely devastating loss for families, friends and whole communities.

2. Notes the limited support available in Wales to support those bereaved by suicide.

3. Notes that losing someone to suicide is a major risk factor for dying by suicide and that support for those bereaved is a vital part of suicide prevention.

4. Calls on the Welsh Government to urgently ensure there is support for those bereaved by suicide available across Wales as part of a comprehensive postvention pathway for Wales. In doing so, the Welsh Government must ensure that improvements to services and the new pathway are co-produced by those with lived experience of suicide bereavement. 

Motion moved.

Thank you, Dirprwy Lywydd. I'm really pleased to open this debate on suicide bereavement. I'd like to thank Dai Lloyd AM and David Melding AM for co-submitting the motion with me today, and Dai Lloyd for closing the debate. I'd also like to thank all the Members who have supported the motion.

Today, I want to start by recognising that losing someone to suicide is a uniquely devastating loss. It leaves people in a deeply dark place. Now, I know that grief is a very personal thing, and that everyone experiences it in their own way and copes differently. I do not mean in any way to minimise the impact of other bereavements, but in order to ensure the right support for those bereaved by suicide, we have to recognise the ways in which it is different to other losses and just how uniquely devastating it is. Indeed, it is hard to even put into words. In addition to the heartbreaking loss of someone you love, there's often stigma and isolation, destructive feelings of guilt, and a lifetime of asking, 'What if?', 'If only', and, above all, 'Why?'—a question that some people will never be able to find the answer to. 

The loss of someone to suicide can also have a major impact on those well beyond the deceased's immediate family and friends. I have previously described suicide as like a large rock falling in a pond. The waves ripple outwards and are wide and far-reaching.

Each year in Wales, around 300 to 350 lives are lost through suicide. It used to be claimed that six people are impacted by every suicide, but more recent research has found that, in fact, 135 people are affected. The loss of someone to suicide devastates families, friends and whole communities. We know too that losing someone to suicide is a major risk factor for dying by suicide, especially for young people who are in a high-risk group. So, support for those bereaved by suicide is one of the most effective things we can do to prevent people dying by suicide.

Members will remember that the Health, Social Care and Sport Committee, so ably chaired by Dai Lloyd, undertook a major inquiry into suicide prevention in Wales in 2018 and produced a report called 'Everybody's Business'. As part of that inquiry, we looked carefully at the support available for those bereaved by suicide, including meeting with people living with suicide loss.

I've spoken before in this Chamber about the committee's visit to the Jacob Abraham Foundation in Cardiff where we met a group of relatives, all of whom had lost sons, husbands, fathers, and brothers to suicide. One lady had lost not one but two sons to suicide—an absolutely heartbreaking reminder of the risk that suicide bereavement poses. Shockingly, not one of those families had received any specialist support, apart from the support offered by the foundation. They had not even been able to access 'Help is at hand Cymru', the excellent Welsh Government booklet on suicide bereavement. Now, the Jacob Abraham Foundation receives no statutory funds and has been operating on a hand-to-mouth basis since it was set up by Nicola Abraham following the death of her son Jacob by suicide in 2015. In 'Everybody's Business', the committee said very clearly, and I quote:

'We were staggered to hear of the lack of support available to those bereaved by...suicide.'

That is why the committee went on to make three recommendations on bereavement support. We called for a Wales-wide postvention pathway for suicide to be taken forward as an immediate priority. We called for 'Help is at hand Cymru' to be more actively promoted, and we called for Welsh Government to give active consideration to providing funding for support groups for those bereaved by suicide. We made those recommendations back in November 2018, and now, more than a year on, nowhere near enough has changed.

I welcomed the £500,000 additional funding made available in response to the health committee's report to fund the role of a new national suicide prevention lead in Wales and regional co-ordinators. I recognise that there's been a delay in appointing that person, which has slowed progress, but now that an appointment has been made, we really need to move at pace. I welcome, too, the 1,500 copies of 'Help is at hand Cymru' that the Welsh Government got printed following our report, but I am still meeting people bereaved by suicide who are not being signposted or given this vital resource. And there has been no investment in support groups and, indeed, the final survivors of bereavement by suicide group in Wales has, in fact, closed.

Whenever I have raised my concerns about suicide bereavement in the past year, I've been pointed to Welsh Government's bereavement services review, although I have said time and time again that I don't think we needed a review to tell us that suicide bereavement services are woefully inadequate in Wales. That review has now reported, and I have to say, I am really disappointed with it. I just do not recognise the picture it paints of the support it claims is out there for suicide bereavement. Apparently, there are six services offering suicide bereavement support in Torfaen. Caerphilly, Cardiff, Flintshire, Pembrokeshire, and Rhondda Cynon Taf fare even better with eight each. Who knew? Certainly not the people bereaved by suicide that I have met. To be fair to the report, it is clear that the majority—81 per cent of providers—are offering information and support and signposting to other support services, which, for me, raises many questions about what this suicide support looks like. Is it a flyer, an e-mail, a phone call? And shouldn't the report have been clear about what kind of support was being offered and by whom? We know from the report that specialist support is thin on the ground, but it tells us nothing about who is delivering that support, how long people have to wait for it or anything about the quality of services or, indeed, anything else about it.

The Minister knows that young suicide is a cause very close to my heart. The 2 Wish Upon a Star charity provides bereavement support for families who lose a child or young adult in a sudden and traumatic way, including through suicide. It was set up by Rhian Mannings, following the death of her baby son, George, which was followed by the tragic suicide of her husband, Paul, just five days later. Just like Nicola Abraham, Rhian has used her lived experience of suicide bereavement to try to prevent other families going through what she has done. They are doing really fantastic work across Wales. The memory boxes they provide for families whose child has died in hospital provide a little comfort at a time that is undoubtedly the darkest any parent will ever experience. Their ability to offer support shortly after the bereavement, or whenever that support is needed, is literally, for some families, a life saver. They also provide much needed support for bereaved siblings. Yet, despite taking referrals from every health board in Wales, and providing a service in every A&E department and most critical care departments, 2 Wish Upon a Star receives not a penny of public funding from any of the health boards. That is just wrong. 

The Welsh Government urgently needs to implement the recommendations in 'Everybody's Business' to develop a postvention strategy for suicide. That strategy should be co-produced with those with lived experience of suicide bereavement, and ensure that flexible support is available to people when they need it, whether that be in the immediate aftermath of a suicide, in six weeks, in two, three or 10 years down the line. It must also include timely access to specialist treatment for post-traumatic stress disorder, which is often suffered by those bereaved by suicide, especially those who found their loved one. 

We are behind other parts of the UK on this. England already has a postvention pathway that could help inform ours, and there are fantastic examples of suicide bereavement support in England, many co-produced with bereaved families. But it is not just about supporting individuals; it is also about postvention in organisations where there has been a death by suicide, whether that be a school, a fire service, a hospital, GP practice or a railway station. We in this Assembly should know better than many the crucial importance of a postvention response to the loss of a friend and colleague to suicide. Particularly close to my heart is the need for suicide postvention in every school in Wales. In England, new guidance has been published, stating that a single suicide in a school should be treated as a potential cluster because young people are so vulnerable as a high-risk group for suicide.

I warmly commend the new guidance that the Welsh Government commissioned from Professor Ann John on talking about suicide with young people who are suicidal and self-harming, but it is not enough. We need to ensure that mental health and suicide prevention is embedded in the curriculum in Wales, to reach those young people who nobody knows is suicidal until they tragically take their own lives. We also must ensure that all schools undertake postvention following a suicide. I know that some schools have been quick to use the Samaritans' Step by Step postvention programme, but there are others I know of that, other than some counselling sessions, have done nothing at all. I'm delighted we now have Papyrus with a base in Wales, and we must ensure that schools draw on the organisations of them and the Samaritans. It cannot be an optional extra; it is too late when another young person has died. 

And, yes, this will take additional resources, but to anyone who says we can't afford it, I say we can't afford not to. It has been estimated that every suicide costs the public purse £1.6 million. How much better would it be to do what the Government talks so much about and invest in early intervention and support for those bereaved? We have some brilliant people and organisations working in this field in Wales. I want to pay tribute to Professor Ann John, who chairs the Welsh Government's national advisory group on suicide prevention. Ann works tirelessly, and I thank her for it. But we must ensure that people like Ann have the resources and the full commitment from Welsh Government to do the job that they so want to do. 

Social media gets a bad press a lot of the time, and I'm sure we can all understand this here. However, I have found Twitter a fantastic opportunity to network with like-minded people. Through Twitter, I have come to know a group of mothers who have lost children to suicide. Some of them are from Wales; others are from elsewhere in the UK. They have nicknamed themselves 'The Warrior Mums', and warriors they are, each and every day. 

So, I want to close today by paying a heartfelt tribute to all the warrior mums, the warrior dads, and to the courage of all those who are living with suicide loss every day. Our duty, Minister, is to honour their courage, by working with them to deliver the suicide bereavement support that is so desperately needed in Wales, and, in doing so, to save lives.

David Melding.

Thank you, Deputy Presiding Officer, for calling me in this most important debate. Can I just start by paying tribute to Lynne Neagle, who is an outstanding voice and leader in this field, both as Chair of the committee, and in general in our debates here, and has done so much to hold the Government to account, to commend the Government when it's doing well, but also to remind it when there's still a huge gap that needs to be filled?

I think all of us who have served as Assembly Members for any length of time would have had casework in this area that's tender and very, very painful. I have to say at least two cases come to mind in my own experience, and the complication of the cases, the length of time required in our own efforts to support those affected, was immense, and of some value in terms of improving public services, but of course, by way of direct therapy, of no particular use to the people that we were supporting. And that's when I really did experience this insight that, for some of my constituents, the first time they were really talking to someone outside their immediate family or group of friends about this issue was when they'd come to talk about the difficulties they were having in accessing adequate support.

I have to say, I've also met people who have then spoken out—and Lynne talked about this—and given incredible witness. What an act of generosity it is, to come to a meeting here, perhaps, in the Oriel or the Neuadd, or indeed even in formal committee session, and indeed also in the all-party group that Lynne has established, and to talk about their experiences, to give that witness, so that others may be spared this terrible pain. And you were quite right, Lynne, to pay tribute to all those who have done that.

When suicide afflicts children and young people, it is, I think, overwhelmingly painful. And I do pay tribute here to the work of Swansea University and Public Health Wales for their recently published thematic study, which is a great help I think in giving us a fuller understanding. And this was a study of all those aged between 10 and 17 who probably suffered suicide. Their deaths were rarely due to a single reason, but a complex combination of risk factors, circumstances, and adverse experiences. But families will often blame themselves and suffer appalling guilt, which itself then increases the risk of suicide. And it's at that point, because it is a natural tendency I think for many, to ask the question, 'What could I have done?', or even to say, 'What didn't I do?' These are not justified questions. These circumstances are overwhelming, but they are the thoughts that come to mind, and they are dark and unpleasant thoughts, and thoughts that eat away at people's own resolve very often, unless they can talk them through, and then are supported by people who realise that this is the inevitable response, often, that people who have suffered this trauma will experience.

Clearly, bereavement services can play a crucial part in supporting those affected by suicide. The voluntary sector play a great role here, being highly innovative, and, as Lynne said, 2 Wish Upon a Star is a gold-standard example, in my opinion, of this. But there's also the likes of Cruse Bereavement Care Cymru. It provides support for about 360 people a year bereaved by suicide, providing one-to-one support and group support, but also giving incredible insight into the sorts of services that are required. And Cruse points out that it's critical that the right support is available at the right time, and that will be different for various people. Very structured approaches and therapeutic approaches may not be possible immediately or desired immediately by those affected, but then much needed later. So, you need to look at the whole case and whole pathway. But Cruse has pointed out that there are very limited counselling support services available to those bereaved by suicide, and I do think that that is something that we need to focus on this afternoon in our debate.

I do think it's proper to balance our remarks by commending the work that the Welsh Government has started. And I did notice from the mid-term review, conducted by Swansea University and Health Promotion Wales, that the Welsh Government's five-year suicide prevention strategy has achieved some excellent progress and made developing local suicide prevention action plans a reality, and that they are coming into play. But they all need to be looking at what bereavement services are available. That's a key area in terms of preventing suicide. As we've just heard, those that have had a close friend or relative that has suffered suicide are themselves at risk, but have also given us those insights that are needed to plan effective services. Thank you very much, Deputy Presiding Officer. 

And I'd like to just start by thanking Lynne Neagle and others for tabling this debate this afternoon. However, it is extremely sad that we have to have this and debate this subject today, not just because suicide bereavement support is limited and, frankly, not good enough, but because suicide is still occurring on an enormous scale and is a public health crisis.

Last year, I spoke during the debate on suicide prevention and I set a challenge to all of us. The challenge was for all of us to do better and to understand and accept that suicide is everybody's business. I asked Members and members of the public to do more to support each other and to do more to prevent suicide. Now, I did this, Deputy Llywydd, because I simply do not want another family to go through what mine has gone through and continues to go through. So, let's remember, Deputy Llywydd, that we should never stop trying to help others, especially when it can save lives. 

At the start of the debate, Lynne Neagle mentioned the fact that those bereaved by suicide are at risk of suicide and more at risk from suicide, and that is no surprise to me. I myself, following my experience, am a sufferer of depression and PTSD. So, I want members of the public and Members of the Chamber to understand what life is like for the bereaved and why it is so important that we ourselves do more and also the Governments in Wales and across the United Kingdom do better—do better to support those bereaved when suicide occurs and to support those suffering before it's too late. 

So, what is suicide bereavement? It's the sleepless nights; the nightmares when you do sleep; the not being able to get out of bed to face the world; the flashbacks and anxieties when you do; the knowing that someone's life has ended too soon; the feeling that you'll never go to the football with your best friend again; and it's the realisation that while others may be able to move on, it's that realisation that your life will never be the same again. 

Deputy Llywydd, awareness of behaviour can impact on those that have lost someone has to improve. The reporting of suicide is a particular example and those that seek to inform this type of reporting should answer this very simple question: what effect will my actions have on the bereaved? 

Finally, Deputy Llywydd, I'd like to comment on mental health services as a whole and the role that they can play in suicide prevention. Now, we are very much more open in talking about this issue at the moment, but as I said at the start, suicide and mental health illness is a public health crisis. We always say that mental health should be treated with the same urgency and respect as physical health, well, now it's time to prove that point.

And in closing, if I may, I'd like to say that, in the absence of the adequate support for those bereaved by suicide and those suffering with mental health illness, there is an army, an army of volunteers and members of the public, who step up to the plate each and every day to provide support. And I'd like to finish, Deputy Llywydd, by thanking them, each and every one of them, for changing lives, for saving lives. Diolch.

As chair of the cross-party group on funerals and bereavement, I welcome this debate. We understand that between 300 and 350 people die by suicide each year in Wales, according to Samaritans Cymru, with the male suicide rate almost three times higher than that for females.

Samaritans Cymru reports the figure that Lynne Neagle referred to, that at least six people are deeply affected by each suicide. Lynne indicated, actually, that the multiplier is far, far higher than that, and that a person bereaved by suicide is far more likely to attempt suicide themselves. And they add that many people who are bereaved in this way find it hard to get the help they need and that we must provide better information and support to those bereaved or affected by suicide, and that support for this group must be recognised as a key element of suicide prevention.

Reference was made to Rhian Mannings, the founder of the all-Wales charity 2 Wish Upon a Star, and the charity and Rhian take part in the cross-party group. This charity, as we heard, provides essential bereavement support for families who have suddenly and traumatically lost a child or young adult aged under 25, which may be from suicide or may be through accident or illness. She told me that sudden death is the forgotten death in Wales. And although the charity has effectively become a statutory service in Wales, working, as we heard, with every health board and every police force, they're receiving no statutory support whatsoever, having to raise every penny themselves, despite reducing pressure on mental health teams, helping tackle the unforeseeable trauma of unpredictable death and loss.

Rhian Mannings states that she started her fight after her husband and son were taken from her suddenly—no preparation, no warning and then nothing, she said—and that the lack of support they received directly led to her husband taking his own life.

Cruse Bereavement Care launched their manifesto for bereaved people two months ago. They believe that access to the right support, tailored to the need of each bereaved person, can help them deal with the challenge of grief and build a meaningful life, whilst remembering and celebrating the lives of those they have lost. This, they say, can in turn help improve mental health and reduce the impact on NHS services.

Amongst other things, Cruse is calling for a named Minister with responsibility for bereavement and a cross-departmental strategy, and for local funding for high-quality bereavement support, where they say too many people still lack support after bereavement, where in too many areas, there is no statutory funding for the agencies and charities helping bereaved people. And they call for more compassionate communities where everyone knows enough about grief to play their part in supporting people around a death. 

Marie Curie states that ensuring adequate support for families experiencing bereavement is an important part of the process of death and dying. And 2 Wish Upon a Star notes the correlation between those organisations, funded by Welsh Government, local authority or health boards, which predominantly signpost or refer into organisations and those who provide bereavement services, but receive little or no funding. And they state that services need to be widely known and a multi-agency approach undertaken to ensure support can be delivered Wales-wide and that severe long-term consequences can be reduced.

The cross-party group on hospices and palliative care, which I also chair, proposes four recommendations to improve the care and support of bereaved people in Wales, and thus ensure better outcomes for people following the loss of a loved one. Firstly, to improve data on the need for bereavement support where, due to the lack of robust needs assessment, it is currently very difficult for services to plan for meeting need or to understand what resources they may need to do so. Secondly, to make bereavement a key feature of all relevant policy to be considered and embedded in Welsh Government strategy and policy, including adult mental health and well-being and children's mental health and well-being. Thirdly, to embed bereavement support in schools. And, fourthly, to make the provision of bereavement care sustainable where the lack of strategic and policy prioritisation for bereavement support is evidenced in the very low levels of statutory funding for care for the bereaved.

Lynne Neagle made reference to the publication last month of 'A Scoping Survey of Bereavement Services in Wales: End of Study Report' commissioned by the Welsh Government. This identified that more bereavement services were available in the south-east of Wales, with the least number being available in the north and west of Wales. It said

'Respondents described a number of gaps and challenges in bereavement service provision...Many appeared to relate to the lack of a clear framework for the commissioning and delivery of bereavement services and included non-prioritisation of bereavement care within organisations, lack of access to funding and restricted access to training and appropriate facilities.' 

A key—

Are you winding up, please? Wind up, please.

Yes. A key consideration from the results, therefore, is the development of a national delivery framework for bereavement care. This is urgent and must include support for those bereaved by suicide, co-produced by those with lived experience. Thank you.

I think this is a very important but difficult debate, but what I'd like to do is just use my five minutes to focus on the preventative agenda, because, obviously, the parliamentary review of people aged 13 to 17 that took place—happily, it only affected 33 people. But, obviously, there are a lot more people who might have committed suicide, and we just have to focus on what we can do to endeavour to prevent suicides where at all possible.

We've come quite a long way, historically, since the stigma of suicide at the time when my grandfather took his life in 1928, because, at that point, churches would just simply refuse to even allow the family to bury their loved one in a churchyard. Most people tried to cover up what had happened and pretend that there was some other cause of their death. So, the fact that we can now speak openly about suicide, and Jack, obviously, is absolutely an exemplary example of doing that—.

We have to endeavour to ensure that all public services and, indeed, other stakeholders are engaged in the business of preventing suicide. So, whilst many young people have suicidal thoughts, only a small number die in that way, and that's in that parliamentary review. So, we have to focus on those who might become so desperate that they actually do it, and we know some of the signs and we need to ensure that we tackle them. They are there in the opportunities for prevention that are recommended.

We know that self-harm is a potential sign, and we need to get much better at ensuring that everybody knows who is self-harming and what services we're making available to them, because self-harm is a cry for help until it becomes suicide.

Prevention of alcohol and substance misuse: ongoing action to restrict access of children and young people to alcohol. I went to an excellent drama called Smashed aimed at year 8 pupils in Ysgol Bro Edern in my constituency. It's really important to outline to students who think that toying with alcohol is a cool thing to do, when, actually, they are opening themselves to being exploited by people if they're out of control, don't know what's going on, can't get home safely. These are some of the risk factors that young people need to understand, and it's no use telling people not to drink because it's all over the place. But they need to do it in a controlled and safe way.

Mitigation of adverse childhood experiences: we know that things like adoption, things like a parent in prison, sexual abuse—these are all risk factors. Lynne Neagle and I attended the launch of Papyrus last Friday in Cardiff Central, which the First Minister also attended, which indicates the importance he gives to this matter. It was very humbling to hear the experience of the chair of Papyrus, who explained that he'd had to give up becoming a headteacher when his adopted son killed himself. But it wasn't that it wasn't a perfectly loving family. It was the background, the reasons why this child, then a young adult, had become adopted—that was haunting him. We know that, once people go through puberty, this can become a major issue. The report that we did with the Children and Young People Committee in the fourth Assembly told us how complex that is.

But we need to ensure that all schools are taking this agenda seriously. Some schools do absolutely brilliantly, and other schools think that it is somebody else's problem. I think I'd like to highlight the report that came out from the Samaritans over the summer, which was about exclusion from school in Wales, and the hidden cost. We know that some schools will use every opportunity to dump kids on somebody else and get rid of them because they just don't want them appearing in their exam statistics. This is absolutely not good enough. We need to ensure that all schools are aware of their well-being responsibilities towards young people, and we need to be vigilant that people aren't using covert ways of getting rid of people and making it somebody else's—. Because we know that the people who are living in poverty are bound to have more issues around status, around self-worth, and these are people that we absolutely need to be ensuring that the school is embracing as their second family if their first family is unable to provide that loving home that most of us are happily able to have.

Thank you. Can I now call on the Minister for Health and Social Services, Vaughan Gething?

Thank you, Deputy Presiding Officer. I welcome today's debate on what is a deeply emotive and important issue. The impact of losing someone to suicide is devastating and unquestionably has far-reaching effects on families, friends and communities, as Lynne Neagle set out in opening the debate, and was added to by every other Member in a different way during the course of it.

I recognise, as speakers do, that bereavement by suicide is a unique sense of loss, and that people experience a wide range of emotions. No-one can predict exactly how people will react to such an event, but it is important that support is available in the right places and at the right times for those who need it. I recognise that people who are bereaved by suicide can be at risk themselves, so ensuring that appropriate postvention support is, I recognise, critically important. I am committed to improving postvention support as part of our broader programme of work to prevent suicide and self-harm.

Understanding the complexity of circumstances and risk factors that contribute to suicide is key if we are to prevent future deaths by suicide. The recent review by Public Health Wales, referred to earlier and last week, into the deaths of children and young people by probable suicide is part of helping us to understand this. The review highlighted the significant number of children and young people who were known to public services, for instance health, social services and criminal justice, challenging all public services to consider future opportunities to intervene early to prevent death by suicide. It is clear that no one person or agency can prevent suicide and self-harm. So, partnership and cross-sector working are critical to maximise opportunities for prevention. Creating a culture—as we have taken some steps towards—that encourages people to talk, and taking a public health approach to supporting emotional well-being are also an essential part of improvement.

Our 'Together for Mental Health' strategy is underpinned by meaningful collaboration and partnership, delivered by a range of organisations, from public sector to third sector, and overseen by a multi-agency national partnership board. A recent announcement in the draft budget commits a further £20 million to mental health services, raising the ring fence to £712 million, which demonstrates our continued commitment to improving the services. That builds on the additional £0.5 million announced this year specifically for suicide prevention and support. I've also committed to doubling the funding, together with the education Minister, for the whole-school approach work, and of course that is funding that comes from both the education and health portfolios.

The new 'Together for Mental Health' delivery plan, which will be published on Friday this week, positions preventing suicide and self-harm as a key action, making it a priority for the next three years. Actions include the development and implementation of a bereavement support pathway for suicide, as well as a commitment to further improve access to valuable resources, such as the 'Help is at Hand' resource that has been referred to several times today.

This will build upon the work we've already put in place to improve the emotional well-being of our children and young people. Our recent work included extending the schools in-reach pilot to expand capacity, enabling specialist staff to work with more schools, and publishing new guidance on suicide and self-harm. The guidance aims to support teachers and other professionals on early intervention and self-management of self-harm and suicidal thoughts when they arise. The whole-school approach forms a key element to our focus on prevention and ensuring early access to support. As has been mentioned, last week, the First Minister attended the launch of Papyrus, a particular organisation for the prevention of young suicide in Wales, reaffirming cross-Government support in this area.

Within this financial year, we've also supported a range of regional suicide prevention programmes, including innovative approaches such as working with rugby teams to encourage men to talk about mental health, and providing additional bereavement counselling sessions. At the end of the month, I will update the Health, Social Care and Sport Committee on our actions to deliver our response to their 'Everybody's Business' suicide prevention report, and that will include our work to improve bereavement services in Wales. We know that access to good quality bereavement care is of primary importance. It helps with a healthy grieving process for the bereaved and should include actively following up on all those who have been bereaved, even if support is initially refused.

The bereavement services scoping review taken forward by the end of life care board at Marie Curie in Cardiff University was published in December, and again referred to in the debate, mapping existing support, ranging from signposting through to specialist counselling, and identifying areas where further resourcing is needed. The scope of the report covered the broad range of bereavement support, including suicide. It highlights gaps and challenges in bereavement service provision, and raises a number of considerations for development and improvement. These are centred on the need to develop a national framework for the delivery of bereavement care in Wales. This would then facilitate the prioritisation of bereavement support at organisational and regional levels, and help to provide equity and access to appropriate types and levels of support that are responsive to local need.

A national delivery framework would also support the establishment of clear referral pathways, approaches to risk and need assessment, training for staff and volunteers, and the development of a directory of the available bereavement provision. Finally, a national bereavement framework will support improvements in how services are evaluated and assessed, and standards could then be further developed for use as audit and quality improvement. To take the development of the framework forward, we're in the process of recruiting a dedicated project manager. We have asked the national clinical lead for end of life care, Dr Idris Baker, to establish a national bereavement steering group to support this work. As many of you will know, Dr Baker has considerable knowledge and experience in bereavement care.

As an interim measure, I've recently agreed additional in-year funding to strengthen existing suicide bereavement support provided by the third sector. Five organisations have been supported. In addition, Welsh Government regional funding is being used to create a new bereavement support service for north Wales. I'll make a written statement before the half-term recess to outline our longer-term plans.

I can also confirm that we have now appointed a national suicide prevention co-ordinator for Wales who will be vital in joining up approaches and leading the development and implementation of new action to prevent suicide and self-harm in a much more co-ordinated and effective way. The co-ordinator will be supported by three regional posts to deliver on action plans across Wales. The inclusion of people with lived experience will be fundamental to the development of the postvention pathway. A key focus for the national co-ordinator will be the development of that postvention pathway as part of our broader work to improve bereavement support. The national advisory group on suicide and self-harm are now planning three regional stakeholder workshops to inform that work.

I hope this helps to demonstrate the importance we continue to attach to this agenda, and outline action that we are taking, both to prevent suicide and self-harm, and also to improve bereavement support. I recognise the ambition of Members across the Chamber for further pace in delivering that improvement. I will include more details on timescales for the bereavement pathway in the written statement that I aim to issue before half-term recess.

Thank you. I call on Dai Lloyd to reply to the debate.

Diolch, Dirprwy Lywydd. Can I say, first of all, how proud I am to be able to take part in this debate? Because we've had some powerful, emotive expressions of what are true, deep feelings here from everybody who's contributed. It's been a truly spectacular debate, really. I know it won't get hardly any coverage outside, but it has really been a privilege here to witness what everybody has said. Because, as Lynne Neagle in opening said, this is the utter devastation of bereavement by suicide, and she outlined, in some cases, the paucity of the support available to those uniquely bereavement by suicide.

There were 360 deaths by suicide a couple of years ago in Wales; that's one a day. If anything else was causing one death a day in Wales, people would be out there protesting and stuff, we'd have urgent questions here every other week saying, 'What's happening?' I hear the Minister saying there is a lot of stuff happening, and I commend the approach of the Government, but we need so much more, because there is an opportunity.

There are two different preventative aspects. The first is the prevention of suicide in the first place, and that is about how we deal with people who self-harm—not all of whom go on to do anything else, other than a cry for help. But the challenge for us in primary care is to pick up on who is likely to go on to do something far more devastating. And when we decide as GPs that that person needs to be seen there and then, they need to be seen there and then.

We keep talking about how physical health and mental health should have a parity of esteem, but if somebody's acutely mentally ill, that parity is not obvious to me as a GP. It was 20 years ago when, if somebody said they were suicidal, I would ring up the nearest psychiatric hospital and a doctor would see them there and then; as would happen if you came to see me if you had chest pain, and I would refer you to the nearest physical health department there and then. That no longer happens with acute mental illness. We need to look at how acute mental health emergencies are dealt with.

The current situation is that crisis teams will ring the GP back later that day, the following day, or offer an appointment for the following week. It just does not do it. Because GPs do know a fair amount about psychiatric illness and suicide, which is not always recognised in the secondary care sector. Otherwise, people are left bereft and we are left in these devastating situations so eloquently outlined by Lynne, David, Jack Sargeant—I pay tribute again, Jack, to your unique insight into this—and Mark Isherwood, as well as Jenny.

Yes, there's a primary prevention of suicide in the first place, but important in the context that we're talking about today is the prevention of suicide in those already bereaved by suicide. We always say, and it was obvious in the health committee's report, 'Everybody's Business', that suicide is everybody's business. Can I just say, be kinder to one another, people, all right? As Jack is always saying, 'Be kind to one another.' If somebody looks distressed, ask them how they are. There's a good piece of suicide prevention. You may be the only person that's spoken to them that day.

Talking about suicide, in the first place, does not make it more likely that suicide will happen—that's important to remember. But once suicide has happened in a family, a family member is more likely to have a death by suicide as a result of the devastation of the suicide in that family. And that's where we can have a unique opportunity, through the suicide bereavement support services coming in at that point, to prevent a further suicide in that family. So, that's what's before us.

There needs to be a step change in performance. I welcome all the hard work that's going on, and we've heard about the excellent work in the third sector: Papyrus, 2 Wish Upon A Star, Cruse, Samaritans and, yes, Survivors of Bereavement by Suicide—what a tremendous organisation—and that is people with the lived experience. We need to tap into that. The step change in behaviour needs to keep on stepping and changing. 

To finish, Lynne mentioned there's a load of warrior mums and warrior dads out there in these difficult family situations. I'm looking at a couple of warrior AMs, I have to say, in Lynne, Jack and others. We need in this situation to all be warrior AMs with a warrior Government. Diolch yn fawr. 

Diolch. The proposal is to agree the motion. Does any Member object? [Objection.] Object. Therefore, we will defer voting until voting under voting time. 

Voting deferred until voting time.