Consumer and Carer Perspectives of a Zero Suicide Prevention Program: A Qualitative Study

Abstract

This study explored the experiences of healthcare consumers who had recently attempted suicide, and their carers, following placement on a Suicide Prevention Pathway based on the Zero Suicide framework. Qualitative interviews were conducted with 10 consumers and 5 carers using a semi-structured interview schedule. Interviews were transcribed and thematic analysis was applied to identify prominent themes and sub-themes. Three interrelated themes were identified. The first theme was ‘Feeling safe and valued’ with the associated sub-theme pertaining to perceived stigmatizing treatment and self-stigma. The second was ‘Intersection of consumer and staff/organizational needs’ with a related sub-theme of time pressure and reduced self-disclosure. The final theme was ‘Importance of the ‘whole picture’, highlighting the relevance of assessing and addressing psychosocial factors when planning for consumer recovery. Overall, consumers and their carers reported a favorable experience of the Suicide Prevention Pathway; however, there were several areas identified for improvement. These included reconciling the time-pressures of a busy health service system, ensuring consumers and carers feel their psychosocial concerns are addressed, and ensuring that adequate rapport is developed. Key to this is ensuring consumers feel cared for and reducing perceptions of stigma.

A Missing Piece in the Puzzle: Exploring the Phenomenon of Suicide Recovery in Developing a Recovery-Focused Suicide Management Program

“…The procedural elements are also crucial in conceptualizing the suicide management and intervention program. Like the Zero Suicide Initiative, the procedural aspects can provide a structure to eventually develop an evidence-based practice, 45 not for suicide prevention but for suicide recovery. To wit, suicide risk appraisal instruments, according to Posner et al 46 and Madan et al 47 include the use of the highly validated Columbia Suicide Severity Rating Scale (C-SSRS) because it explores both lifetime and recent suicidal thoughts and behaviors.…”

The implementation of a zero-suicide framework in a child and youth mental health service in Australia: processes and learnings

“…The SPI includes processes to identify warning signs, internal coping strategies, social contacts to distract from suicidal thoughts, social and professional supports, and strategies to restrict access to lethal means of suicide. There is growing evidence that the SPI improves consumer engagement, helps in resolving suicidal crises ( 25 , 29 ), and reduces repeated self-harm and suicide risk ( 29 , 30 ).…”

“It’s so scary, and you’re so alone with it”: Clinicians’ perspectives on suicide risk management in integrated primary care

“…When applied in health care settings, the Zero Suicide model seeks to better identify, engage, treat, and transition those at risk of suicide by engaging leadership, training, and applying continuous quality improvement (CQI) strategies [28]. There is increasing evidence of this model's effectiveness in preventing subsequent suicide attempts in mental health settings [29], and of its acceptability to a range of stakeholders from clinicians and administrators [30] to patients and family [31]. However, its fit with primary care is yet to be determined.…”