Peer specialists in suicide prevention: Possibilities and pitfalls.

Abstract

The emergence of peer specialists with histories of suicidality in mental health care services is a recent but scarcely researched societal phenomenon. The current study aimed to explore how peer specialists who have experienced suicidality (either attempted suicide or suicidal ideation) use their experiences to contribute to suicide prevention in mental health care services. Qualitative interviews with 20 peer specialists who have personally dealt with suicidality in their past were conducted. Interviewees perceived their work to have unique value in terms of their approach to making contact with suicidal care consumers on an emotional level, which was perceived to lead to less reluctance on the part of suicidal care consumers to talk about suicidality, as well as affect feelings of being acknowledged and heard. However, the lack of professional distance was perceived to carry several risks, including burdening clients with the peer specialists' own suicidal experiences, perceived reluctance of coworkers to let peer specialists work with suicidal clients, and the burden of working with suicidal clients for the peer specialists. Specific conditions that were perceived to be needed in order to work with suicidal clients consisted of personal distance to own process of recovery and suicidality, establishing boundaries with the team or colleagues for the peer specialists' work concerning suicide risk assessment, safety, privacy, and sharing responsibility. Further discussion between mental health care clinicians and peer specialists regarding the role of the peer specialist in suicide prevention is needed to further clarify and optimize their role.

Preventing suicide, promoting resilience: Is this achievable from a global perspective?

“…The role of peers has also been researched with mixed findings. Peers are people with a previous history of suicidal thoughts, ideas, or acts of deliberate self‐harm, and some of the challenges to using this approach are lack of professional distance, poorly defined boundaries, where each individual peer is on their personal recovery journey, and their past experience of mental health services (Huisman & van Bergen, ). If peers are being used as part of a suicide prevention strategy, they should receive mentoring and support individually or, in a group, they should be fully integrated into the wider clinical team, and their previous experiences in their own recovery journey should be taken when allocating people for them to support.…”

“…A Canadian study showed that mothers who have had their children taken into state care by child protection services have a significantly rate of suicidal thoughts and completed suicide than their sisters who have not had their children removed from their care by the state and mothers receiving services, even when other social factors predicting suicide have been adjusted for. The authors suggest that emerging mental health problems could be identified and suicide prevented if they are provided with psychosocial support during the child protection process and after (Wall‐Wieler et al, ).…”

Veteran peer suicide prevention: A community‐based peer prevention model

“…Public health and community‐based approaches to preventing veteran suicide are needed in addition to clinic‐based interventions. Peer support strategies are one promising approach to suicide prevention (Huisman & van Bergen, 2019; Pfeiffer et al, 2019). Pfeiffer et al (2019) described a randomized control pilot study wherein veterans admitted to psychiatric inpatient units for suicidal ideations in the treatment arm of the study met with peer specialists in addition to the usual care.…”

Contact between patients with suicidal ideation and nurses in mental health wards: Development and psychometric evaluation of a questionnaire

“…Starting out with a systematic review (Vandewalle et al 2020) and conducting cognitive interviews ensured that patients' perspectives were prioritized. However, peer specialists with lived experience of suicidal ideation (Huisman & van Bergen 2019) were not involved in the Delphi procedure. This decision was pragmatic in nature to preserve the study timeframe, partly because the ethical committee requested a lengthy patient approval process for involving peer specialists.…”