Glenn Alexander Melvin

Objective: Many individuals who die by suicide have contact with healthcare services in the months preceding their death, making these interactions critical opportunities for identification, intervention, and support. However, little is known about how individuals experiencing suicidal thoughts and behaviours (STBs) perceive recent clinical encounters, including how these experiences are discussed and managed.Method: Australian adults (N = 266; Mage = 32.9; range = 18-71 years) who had experienced STBs and consulted with a mental health professional within the past two weeks completed an online survey examining suicide-related enquiry, disclosure experiences, clinician responses, and satisfaction.Results: Psychologists were the most commonly consulted clinicians (49.2%), and 90.8% reported having seen the same clinician previously. Although 95.7% of participants considered discussing their STBs at least somewhat important, only 67.9% reported discussing these experiences with clinicians. Among those who did not discuss STBs, 50.0% reported that they had not been asked. Participants also reported that clinicians more frequently enquired about general emotional wellbeing (80.6%) than directly about STBs (55.3%). Among participants who did discuss STBs, 52.1% reported withholding information, while 46.2% reported feeling hesitant to disclose. Safety planning (36.9%) and follow-up (37.4%) were reported infrequently despite being viewed as important and helpful. Nevertheless, 75.4% reported being satisfied with their recent interactions.Conclusions: Despite generally positive experiences with these interactions, the findings highlight opportunities to strengthen suicide prevention by creating opportunities to discuss STBs beyond initial clinical encounters, supporting disclosure through compassionate care, and ensuring that suicide-specific care is provided where appropriate following identification.Key words: suicide; suicidal ideation; suicidal behaviour; disclosure; non-disclosure; clinician-patient communication

Worldwide, it is estimated that one in ten people will experience thoughts of suicide in their lifetime (Haregu et al., 2023). Around one-quarter of these will attempt suicide at some point, with 8...

Objective: To explore care recipients (patients' and their caregivers) and care providers (healthcare providers' and law enforcement officers') perspectives on paediatric mental health presentations to emergency departments, to identify challenges to care. Methods: Secondary qualitative analysis of free‐text responses from a Delphi study conducted within the Paediatric Research in Emergency Departments International Collaborative (PREDICT) network in 2022. The original Delphi process aimed to identify research themes and key data points for child and adolescent mental health ED presentations; however, a large number of additional free‐text responses were received. The primary aim of this specific study was to identify major categories using the General Inductive Approach (GIA) of these free‐text responses to explore the experiences, service delivery and perceived challenges of care recipients and care providers. Patients were recruited from 12 EDs across three Australian states, and pre‐hospital services (two police and three ambulance departments) across four Australian states. Results: A total of 184 participants provided responses (36 care recipients and 148 care providers). Three main categories are described: (1) care continuity and communication gaps, (2) challenges in the ED environment and (3) need for improved training and education and behavioural support. Conclusions: Care recipients and care providers identified challenges in service coordination, clinician readiness and the ED environment. Strengthening communication, expanding training, reducing sensory overload and improving privacy in physical EDs and improving links to community care could enhance patient experiences and outcomes.

School absenteeism is a multifaceted and widespread issue during adolescence, often associated with psychological maladjustment, academic failure, and social difficulties. According to Self-Determination Theory, the frustration of basic psychological needs (autonomy, competence and relatedness) can undermine motivation and engagement. However, few studies have explored how these psychological needs relate to distinct profiles of school absenteeism based on multidimensional frameworks such as the Assessing Reasons for School Non-Attendance (ARSNA; Havik et al., 2015). This study aimed (1) to identify latent profiles of school absenteeism based on the four ARSNA dimensions (somatic symptoms, subjective health complaints, truancy, and school refusal), and (2) to examine whether these profiles differ in students’ perceived autonomy and competence across general, academic, interpersonal, and leisure life domains. A sample of 1,130 Spanish adolescents ( M _age = 14.85, SD = 1.83) completed the Assessing Reasons for School Non-Attendance , the Perceived Autonomy in Life Domains Scale , and the Perception of Competence in Life Domains Scale . Latent Profile Analysis and Multivariate Analysis of Variance (MANOVA) were conducted to identify school absenteeism profiles and examine intergroup differences. Three profiles emerged: Non-School Absenteeism , Moderate School Absenteeism , and High School Absenteeism . The High School Absenteeism profile reported significantly lower levels of perceived autonomy and competence across all domains, particularly in academic and leisure contexts. The High School Absenteeism profile showed significantly lower levels of perceived autonomy and competence across all domains compared to the other profiles, with the largest differences observed in academic and leisure domains.

Suicide is a substantial contributor to global mortality, with suicidal ideation (SI) a significant predictor of suicide. Research has demonstrated relationships between dispositional coping styles and SI. This study aimed to advance this research by examining the specific coping strategies people use when experiencing SI. Further, it assessed predicted use of coping strategies of people with a history of SI would differ from the actual coping strategies employed by people have experienced SI. Seventy-seven help-seeking adults (Mage = 31.6, SD = 10.4) with (n = 49) or without (n = 28) history of SI completed the Brief Coping Orientations to Problems Experienced (Brief COPE) adapted to SI-related coping and current emotional distress measured by the 21-item version of the Depression Anxiety Stress Scale (DASS-21). An ANCOVA, while controlling for current emotional distress levels, showed a greater predicted Problem-Focused coping use than actual use reported by participants with SI history. Facet-level ANCOVAs attributed this to differences in Active Coping, Use of Informational Support, and Planning strategies. There were no group differences in emotion-focused or avoidant coping. The preliminary findings suggest individuals without a history of SI may prognosticate more frequent use adaptive coping strategies, relative to how frequently people actually employ them during these times. Future research may examine the factors explaining these differences to help inform programs related to SI and coping.

Standardised, routine use of suicide risk measures may function not only as assessment, but in fostering the disclosure, discussion, and management of risk. However, very few studies have examined client perceptions, and if they perceive them as mechanisms of disclosure and engagement. The current study provides preliminary evidence of this from Australian-based psychology services. Help-seeking individuals commencing therapy (N = 83, Mage = 32.3, SD = 12, 60.2% men) were surveyed on their perceptions of a brief, standardised, online-administered suicide risk measure after the first session/use of the measure, and a subsample (n = 24) were surveyed again at a six-week follow-up. The measure was perceived generally as being acceptable, helpful, easy to use, and low burden. Among participants with current suicidal ideation there was evidence of it having perceived utility in talking about, understanding, and managing suicidal thoughts. Positive previous experiences of disclosure were related to more positive perceptions of the measure. Over time, the perceptions of the measure remained positive. In the context of limitations such as a small sample, this study provides initial evidence of the feasibility and client perceptions of administering standardised, routine suicide risk measures. Future research may supplement these finding by investigating clinician perceptions and practices regarding routine measurement of suicide ideation and investigate the clinical outcomes of routine measurement on suicide risk.

Background: Given their modifiable nature, understanding the intrapersonal factors involved in the cessation of non‐suicidal self‐injury (NSSI) is needed to inform existing therapeutic approaches and explore novel avenues for supporting individuals with NSSI. This study aimed to examine the relative contributions of and interactions among intrapersonal factors (self‐concept, emotion regulation, and cognitive flexibility) in distinguishing between ceased and current NSSI. Methods: Two hundred and two adults aged 18–71 years ( M = 31.50, SD = 11.23; 74.75% female) were surveyed to compare facets of self‐concept, emotion regulation, and cognitive flexibility that contributed most to discriminating those who had ceased NSSI for at least 1 year from those who continued. These intrapersonal factors were also explored as potential indirect pathways between identity and NSSI status. Results: Significant differences between ceased and current NSSI groups were observed across all intrapersonal factors, with moderate to large effects. Most differences persisted after accounting for psychological distress. Less identity fragmentation, greater emotional clarity, internal locus of control, self‐liking, access to emotion regulation strategies, and impulse control contributed most to discriminating NSSI cessation after accounting for psychological distress. The relationship between lack of identity and NSSI status operated indirectly through lack of emotional clarity and self‐liking. Conclusions: Having a coherent sense of identity, emotional clarity, internal locus of control, self‐liking, access to emotion regulation strategies, and managing impulsivity relate to NSSI cessation. These modifiable factors denote several promising intervention opportunities and should be considered in the design of NSSI‐specific treatments.

Suicidal ideation and behaviours are common among adolescents. Parents play a fundamental protective role in the prevention of adolescent suicide, but many describe feeling ill-equipped in their caretaking role. This is despite prior research indicating that it is important for these parents to feel empowered to emotionally support their adolescent if they are experiencing suicidality. An online parenting program could offer parents flexible access to evidence-based parenting strategies. However, there are limited digital resources for these parents and, further, very little is known about how an intervention could be designed to support the empowerment of these parents. Therefore, the aim of the current study is to explore how an existing evidence-based, digital parenting intervention, Partners in Parenting (PiP+), could be adapted through co-design to empower parents. Four parents who have lived experience of caring for a suicidal adolescent, four young people who experienced suicidality during adolescence, and four experts in youth mental health/suicide prevention participated in four sets of co-design workshops to innovate adaptations to PiP+ to empower parents of suicidal adolescents. Affinity mapping was used to analyse and interpret findings. Three key themes highlight how a digital intervention could be innovated and adapted to empower parents caring for a suicidal adolescent. Specifically, for parents to feel empowered to parent a suicidal adolescent, a digital intervention should support them to (1) “deal with the now”; (2) “acknowledge needs and understand their role”, and (3) “hold hope for the future”. Further, ten sub-themes were developed illustrating different concepts related to these themes. Findings highlight how technological features could support parents to feel more empowered when caring for a suicidal adolescent. In conclusion, the proposed technological features illustrate how digital interventions can be adapted to empower parents in their role of emotionally supporting and managing the suicide risk of their adolescent.