Reasons for living among those with lived experience entering the suicide prevention workforce

A qualitative analysis of self-reported suicide gatekeeper competencies and behaviour within the Australian construction industry

ISSUE ADDRESSED

Construction workers in Australia have suicide rates 84% higher than other workers, with even higher rates for younger and less-skilled workers. Gatekeeper training (GKT) is a suicide prevention strategy that aims to improve knowledge, attitudes and self-efficacy to identify and assist individuals at risk of suicide. However, the impact of GKT on long-term behaviour and suicide prevention is unclear in the construction industry.

METHODS

Researchers conducted 22 semi-structured interviews with trained Bluehats, who provide support to their colleagues in the construction industry experiencing mental health difficulties and suicidal distress.

RESULTS

Participants reported high levels of motivation and capability due to lived experience of mental health problems or suicide, training, satisfaction from helping others and feeling valued in their work environment.

CONCLUSIONS

The study highlighted the importance of physical and social opportunities for participants to support their colleagues. The findings reinforced the need to integrate GKT within comprehensive industry suicide prevention programs that provide a range of interventions for workers and ongoing support to trainees to translate their skills into behaviour. Future GKT should include behaviour change approaches to identify and target contextual and individual-level factors influencing behaviour. SO WHAT?: Understanding the potential and limitations of GKT within the construction industry offers invaluable insights for health promotion. Integrating GKT with holistic prevention programs could lead to more impactful strategies, potentially reducing the high suicide rates and fostering a healthier work environment in the construction sector.

Possible Mental Health Interventions for Family Members of a Close Relative Who Has Suicidal Thoughts or Committed Suicide: A Pilot Project at a Mental Health Center

Background: Suicides are an actual issue, especially in Lithuania, where, despite significant efforts, the number of suicides remains very high. In cases of suicide, society painfully loses its members, and the relatives of the person who committed suicide, engaged in self-harm, or attempted suicide face many negative experiences. Methods: The purpose of this article is to describe the pilot project applied for 2 years in the Mental Health Center (MHC) in the city of Vilnius, Lithuania, in organizing and providing services to people whose relatives committed suicide or attempted suicide or self-harm. This prevention and early intervention program, organized by an interdisciplinary team at an MHC, appeared appropriate, effective, and well-attended. Program clients could participate anonymously and have the opportunity to choose the time and the right services for themselves from the offered program services package. Results: Providing the possibility for family members to receive flexible mental health services at the primary center increased the attractiveness of the program and reduced stigma. Conclusions: The program results demonstrated the applicability of the implementation of such an initiative as a relevant possibility when providing complex help for the relatives of self-harming and/or suicidal people.

Informing and Sustaining Participation of Lived Experience in the Suicide Prevention Workforce

BACKGROUND

Currently, there is no comprehensive study focused on identifying what is needed to support ongoing participation within the suicide prevention lived experience workforce (LEW). It is unclear what specific factors may impede or support ongoing participation in the LEW. The aim of this study was to explore the experiences of suicide prevention LEW in terms of its sustainability.

METHOD

A qualitative interview method was utilised, with a purposive sample of participants who had engaged in the LEW for at least 12 months. The sample comprised 13 individuals (nine females, four males) who engaged in multiple LEW roles, with over half (54%) working in the LEW for more than 5 years. Data were analysed using thematic analysis.

RESULTS

Five main themes were identified: support, passion, personal impact, training, and work diversity. Each theme offers perspectives about the challenges participants face within the suicide prevention LEW.

CONCLUSION

Challenges faced are both similar to those found in the broader MH sector and unique to suicide prevention. Findings suggest that managing expectations of the LEW is important and can inform the creation of guidelines for a supported and sustainable suicide prevention LEW.

Strategies to Stay Alive: Adaptive Toolboxes for Living Well with Suicidal Behavior

Suicidal behavior constitutes a major global problem. Qualitative research utilizing the first-hand experiences of those who have survived attempts to take their own lives can offer much in the way of understanding how to live well despite ongoing suicidal behavior. Given that suicidal intentions and behaviors occur within the person’s subjective construal, the solutions to living—and preferably living well—despite such inclinations must also be subjective and adaptive. The aim of this study was therefore to understand how individuals live with different aspects of their suicidal behavior and their use of effective strategies to protect themselves from future attempts. Thematic analysis of semi-structured, qualitative interviews with 17 participants with lived experience of suicidal behavior from the USA yielded two main themes: (i) the ‘dynamic relationship with suicidal behavior: living with, and through’, and (ii) ‘the toolbox’. Each of these themes had four subthemes. Participants in this study offered important insights into what helped them not just survive ongoing suicidal behavior, but how they created unique toolboxes to continue living, and to live well. These toolboxes contained personalized solutions to dealing with recurring threats to their subjective wellbeing and included diverse solutions from spirituality, pets, peer-support, participating in the arts, through to traditional therapeutic supports. Some participants also discussed the importance of broader social policy and societal changes that help them live. The findings highlight crucial implications for suicide prevention efforts, especially in terms of encouraging collaborations with the lived experience community and furthering a strengths-based approach to mitigating suicidal behaviors. We encourage the clinical community to work in partnership with service-users to enable them to generate effective solutions to living—and living well—through suicidal behavior.

Gatekeeper Training and Minimum Standards of Competency

Gatekeeper training (GKT) is one of the most widely used suicide prevention strategies. It involves training people who are not necessarily clinicians to be able to identify people experiencing suicidality and refer them to appropriate services. While there is a dearth of research that supports the causal link between GKT and reduced suicide rates, this is likely the result of a variety of factors including training design, definitions of "gatekeepers," differing populations in which the gatekeeper (GK) operates, and other variables that may influence suicide rates. Despite this, research suggests that GKT improves people's knowledge, skills, and confidence in helping individuals who experience suicidal ideation and enhances positive beliefs about the efficacy of suicide prevention. However, there is no consensus on GK competencies to allow differences in effectiveness between various training programs to be measured, that is, knowledge, skills and abilities, attitudes, and self-efficacy attributes expected of a person resulting from the training. This paper discusses challenges in developing GK competencies. It uses developments in suicide prevention competencies for clinicians, vocational education, and training sector competencies, as well as empirical work in GKT, to propose minimum GK competencies that may be examined for further research and evaluation of programs.