Identification of key messages for a national suicide prevention media campaign

Abstract

The suicide rate in Australia has increased over recent years, indicating a need for novel suicide prevention interventions. A large proportion of people at risk of suicide do not seek professional help, but rather express their suicidal thoughts to close friends and family members. However, expressions of suicidal thoughts to family and friends can be indirect and ambiguous, and consequently can be missed or misunderstand, leading to dismissive response and missed opportunities for suicide prevention. A suicide prevention media campaign aimed at family members and friends may be one useful population-level suicide prevention strategy to encourage greater recognition of suicide risk and appropriate helping actions in response to suicidal communications. Current evidence for what messages would be acceptable and appropriate for inclusion in such as campaign, however, is limited. The research described in this thesis was undertaken to develop suicide prevention messages to include in an Australian suicide prevention campaign aimed at family and friends of adults at risk of suicide. To understand what messages would be most important to include, five studies were undertaken and are described in this thesis. Study 1 was an expert consensus study involving suicide prevention professionals and people with lived experience of suicide risk. This study established which suicide prevention actions these experts believe are the most important to encourage in a suicide prevention campaign aimed at family and friends. Study 2 was an online survey study involving people with lived experience of suicide risk that aimed to assess the most and least helpful actions taken by others in response to their suicidal communications. Studies 3 to 5 used data from a nationally representative telephone survey conducted with Australian adults. Study 3 examined Australian adults’ confidence and intentions to help a person close to them at risk of suicide. Study 4 examined helping actions given and received in response to suicidal communications. Study 5 assessed the relationships between beliefs in suicide ‘myths’ and helping intentions and actions. Overall, the findings from these studies show that Australian adults are confident and willing to assist a person close to them at risk of suicide. They intend to undertake, and indeed do undertake, a number of appropriate helping actions toward people close to them who are at risk of suicide. These appropriate actions include listening and talking to the person at risk and encouraging them to seek professional help. However, Australian adults also largely fail to ask important risk assessment questions, and commonly undertake actions that do not conform to best practice in suicide prevention. Such non-recommended actions include telling the person at risk ‘what they have going for them’ and telling them that their suicide would hurt their family and friends. A substantial minority of Australian adults also believe in suicide myths, including those related to encouraging suicidal thoughts by talking about suicide. The combined results of these studies have been utilised to make recommendations regarding the most useful messages to include in an Australian suicide prevention campaign aimed at family members and friends at people at risk of suicide.