"Speaking through crisis": experiences of suicidal ideation and emergency care help-seeking among Irish Traveller women.

Abstract

Background: Women from ethnic minorities experience disproportionately high rates of self-harm and suicide. In Ireland, Irish Travellers have an indigenous presence on the island dating back centuries. Although Traveller women are known to be at increased suicide risk, little is understood about their experiences with healthcare during suicidal crisis.

Aims: This study sought to explore how Traveller women make sense of their experiences when presenting to emergency departments (EDs) in suicidal crisis, and how they perceive their interactions with clinicians.

Methods: Interpretative Phenomenological Analysis (IPA) was employed to capture culturally specific meaning-making around a highly sensitive topic. Two Traveller women were purposively sampled from a deliberately homogeneous subgroup. Each case was analysed independently, followed by a cautious cross-case synthesis to identify shared experiential themes.

Results: Two central themes emerged: (1) "Making sense of Suicidal Behaviours" captured the women's attempts to understand their actions, the overwhelming emotional pain they endured, and the internal struggle between life and death. (2) "Impact of Clinicians" reflected a profound loss of autonomy, with participants feeling controlled and monitored during their care. While some clinicians demonstrated empathy and provided support, others offered limited engagement, leaving participants feeling isolated and frustrated.

Conclusion: While idiographic in scope (two cases), the study reflects well-recognised challenges recruiting from acute hospital settings and the impact of limited culturally safe services for Traveller communities. Findings underscore the importance of lived experience-informed, culturally safe, person-centred approaches that recognise the distinct challenges faced by Traveller women during suicidal crisis.