Suicide is a global public health problem and is among the leading causes of death worldwide. Over 700,000 people die by suicide globally each year, affecting all ages, genders, and regions. Community pharmacists are easily accessible and trusted frontline healthcare professionals. They provide pharmaceutical care to the community, yet their role is still yet to be fully optimised. With the expanding role of community pharmacists and their constant accessibility to the local population, they could have a potential role in suicide prevention and awareness in Nigeria through restriction of means, signposting to services, and conversations with patients built on trusting relationships. In this commentary, we review the literature on the involvement of community pharmacists in suicide prevention. In addition, we discuss the potential role of community pharmacists in Nigeria through establishing trusting relationships with patients, clinical counselling, and medication gatekeeping, given the existing gaps in knowledge and awareness of suicide prevention within community settings. This commentary also outlines potential barriers and solutions, making suggestions for future research.

Introduction Globally, over 700,000 people die by suicide yearly, and 77% of the suicide global burden is reported in Low middle-income countries, including Nigeria (1). Community pharmacists are often the most visited healthcare providers for locals in Nigeria. However, there is sparse knowledge about their contributory role in suicide prevention (2). Aim To explore key informants’ perspectives on the potential contribution of community pharmacists in Nigeria to suicide prevention and gain insight into the potential barriers and facilitators in incorporating a suicide prevention programme within community pharmacies. Method Online semi-structured interviews were conducted with global key informants. The key informants were recruited based on their expertise in suicide prevention, public health, mental health, and pharmacy practice from low- and high-income countries. In addition, key informants were either author from literature reviews or referred by the informants. All key informants were contacted through emails, agreed informants gave both verbal and written consent. The topic guide questions were modified according to each key informant’;s professional role and country. The recruitment and interviews were done from March 2022 to September 2022. The interviews were audio, and video recorded, transcribed verbatim and thematically analysed using NVivo software.Codes were generated by the lead researcher and reviewed by the study team. Results A total of 22 key informants consisting of 6 pharmacists, 5 researchers, 4 mental health consultants, 2 policy makers, 2 cognitive behavioural therapists, 2 psychiatrists and 1 suicide and self-harm analyst with different geographical background participated in this study. Each key informant presented perspective on how suicide prevention effort is being handled in their country and how the potential community pharmacist’s role in Nigeria could work. The major themes identified are :(i) The need for a suicide prevention programme in community pharmacies, and this includes (ii) Restricting access to means. This could be achieved by (iii) Education and Training, (iv) Pharmacy service reimbursement and (v) a referral system with other health professionals. (vi) stigma and (vii) pharmacy environment were highlighted as barriers. Conclusion Global Key informants were open to the community pharmacist’;s role in suicide prevention, expecting it would help fill the psychiatric professional gap in Nigeria’;s mental health system. However, some expressed concerns about community pharmacists’ lack of knowledge and awareness in this area and where they could distinctively fit in suicide prevention strategies. Perceptions of stigma underpinned much of key informants’ discussion. All key informants indicated the high existence of cultural and professional stigma and its impact on suicide prevention. This is the first study to explore a broad global perspective on community pharmacists’ role in suicide prevention. However, some key informants are registered pharmacists, and others have a particular interest in suicide prevention and training, thus may be biased towards community pharmacists’ role in suicide prevention. To further explore the practical implication of any recommendations about this role, our identified themes will help to develop our Delphi study to determine consensus on the scope of the future contribution of community pharmacists to suicide prevention efforts in Nigeria. References 1. WHO LIVE LIFE: An implementation guide for suicide prevention in countries [Internet]. 2021 [cited 2022 Oct 7]. Available from: https://www.who.int/publications-detail-redirect/9789240026629 2. Chike-Obuekwe S, Gray NJ, Gorton HC. Suicide Prevention in Nigeria: Can Community Pharmacists Have a Role? Pharmacy [Internet]. 2022 Oct [cited 2022 Oct 7];10(5):109. Available from: https://www.mdpi.com/2226-4787/10/5/109