Recognising and responding to suicide risk in a community mental health setting

Despite the number of best practice guidelines for working with those at risk of suicide, there remains a paucity of research pertaining to the realities of clinical practice. The aim of this study was to develop a grounded theory of how clinicians respond to those at risk of suicide in UK community mental health settings. Semi-structured interviews were conducted with eleven members of staff including social workers, nurses, psychologists, psychiatrists and occupational therapists. A theory grounded in the resulting data was developed.
Results: Anxiety, uncertainty and practitioners’ perceived responsibility for preventing suicide influenced their attributions in relation to a client’s distress. Findings indicated that clinicians most often attributed low responsibility to clients for both the cause and the solution. Therefore, clinicians sought solutions to suicidal presentations within services, rather than attending to contextual or environmental ‘triggers’ to offer a resolution, potentially increasing dependency on services.
Feeling supported and an environment of psychological safety enhanced professionals’ capacity to tolerate the uncertainty inherent in this work which allowed professionals to ‘hand the responsibility back’. This highlights the importance of services creating an environment of psychological safety in order for clinicians to tolerate the uncertainty of working with those who present with suicide risk.