How suicide lived experience motivates patient screening and helping: a vignette study in the Australian community pharmacy context.

Background: Lived experience with suicide - none, vicarious, or personal - may help explain how pharmacists respond to a person at risk of suicide. Leveraging self-determination theory, we explore the motivational pathways of identified, introjected, and amotivation through which lived experience informed pharmacists' intentions to engage in suicide screening, as well as both recommended and unrecommended mental health support.

Methods: An anonymous online cross-sectional vignette study was distributed to registered pharmacists (n = 291), interns, and students (n = 281) in Australia. The vignette describes a patient in a community pharmacy expressing signs of a potential suicide-related issue or crisis. Following on, participants responded to validated measures assessing their motivation to help, intentions to suicide screen, and use both recommended and unrecommended support. Participant demographics, including their lived experience with suicide, was collected. Analyses were performed using SPSS 28.0.1 with the PROCESS macro (Model 4; Hayes, 2022).

Results: Those with no lived experience of suicide were more likely to screen patients for suicide but also more likely to use unrecommended helping compared to those with vicarious and personal experience. Vicarious, relative to no lived experience, was positively associated with suicide screening and recommended helping through identified motivation. Personal lived experience, relative to vicarious, was positively associated with more amotivation that increased both suicide screening as well as unrecommended helping.

Conclusion: Overall, our findings highlight the need to consider pharmacists' lived experience with suicide, as it shapes their motivations to intervene and carries important implications for patient care. Our findings suggest key implications for pharmacy practice, including the importance of self-awareness and reflection on lived experience, integrating pharmacists with vicarious experience into training, and strengthening support for suicide prevention training.