Clinicians Perspectives on Effective Suicide Prevention in Secondary Care Adult Mental Health Services: An Appreciative Inquiry Approach

Suicide is a major health issue with devastating consequences for individuals, families and communities. In New Zealand, the latest confirmed suicide rates show an increase, with young adults, males and members of the indigenous Māori and LGBTQIA+ communities particularly affected. Until recently, most of the suicide research in New Zealand focused on the general population, rather than clinical populations such as those accessing mental health services. This evidence gap is especially important in New Zealand where almost half of those who die by suicide have known involvement with mental health services. The present qualitative study explored the question: What strategies and approaches do clinicians consider effective for preventing suicide in people accessing adult secondary care community mental health services? Eleven clinicians from a large metropolitan service were interviewed individually and in a focus group. Appreciative inquiry and thematic analysis were used. This report is adherent with COREQ. Four themes were identified for suicide prevention: Understanding who the person is, and for Indigenous Māori, this included use of cultural practices; providing a range of evidence-based prevention strategies; having an effective service structure that is part of a wider system; and suicide prevention work is important and staff need effective support. Clinicians identified strategies at the individual, family and service level for preventing suicide, most of which aligned with those recommended in the literature. There is a need for more suicide prevention research in secondary care mental health services and the effectiveness of suicide prevention in high-rate groups such as Māori and LGBTQIA+.