Conference Agenda

Although suicide theories acknowledge the role of social context, the links between specific community experiences and suicidality remain insufficiently examined. This study aimed to examine how community experiences identified as relevant by individuals with lived experience of a suicidal crisis are associated with suicidal ideation and related psychological constructs.

Methods. A sample of 1,412 Lithuanian adults (age M = 42.75, SD = 13.72, 68% female) was used. An online survey included items from the Availability/Rejection Experiences Scale, created following a qualitative study with individuals who had a recent lived experience of a suicidal crisis. Presence of suicidal ideation over the last month was determined using the first item of SIDAS. The Suicidal Behaviors Questionnaire–Revised, Interpersonal Needs Questionnaire, Entrapment Scale–Short Form, and Self-hate Scale were also used in the network analysis.

Results. Feeling inadequate in the family and having had experiences of bullying by friends showed the strongest direct edges with suicidal ideation. Support from friends and the wish to be seen by the family when experiencing difficulties demonstrated the highest expected influence on the network of individual scale items linked to presence of suicidal ideation. In the full network, family availability and thwarted belongingness had the largest bridge expected influence between community experiences and other variables. However, self-hate had the largest expected influence over the overall network.

Conclusions. The findings highlight the importance of specific interpersonal experiences in understanding suicidal ideation. Enhancing experiences of family members’ availability for support may have potential to influence psychological processes related to suicidality. Self-hate likely represents a key clinical target through which change in both community experiences and psychological processes related to suicide may occur.

Funding: Lithuanian Research Council (LMTLT), contract no. S-MIP-24-77

Introduction Supporters (family and significant others) of individuals experiencing suicidal ideation or behaviour (SIB) are key partners in suicide prevention. They provide emotional support, share essential information, and help ensure safety. However, supporting someone with SIB can entail a high emotional burden, negatively affecting supporters’ mental and physical health. To develop effective interventions, it is crucial to understand their needs, both in caring for the person at risk as in safeguarding their own well-being. This study explores these needs and experiences.

Methods An online survey was conducted among persons aged 16 and older who had supported someone with SIB in the past three years. The survey assessed: (1) needs for information and support and experiences obtaining them; (2) involvement in professional mental health care; (3) awareness and use of existing resources; and (4) caregiver burden, psychological distress, and respondents’ own SIB.

Results A total of 1,147 respondents participated, representing diverse relationships (e.g., parent, partner, friend, sibling, child). Among them, 32.8% reported the supported person had suicidal thoughts for over two years, 35.1% reported that the person had attempted suicide, and 34.7% reported that the person had died by suicide. Nearly half (45.4%) were in daily contact with the person at risk. Overall, respondents reported substantial levels of unmet needs for information (58.8%) and support (54.9%), limited awareness of available resources, and elevated psychological distress, including suicidal ideation.

Conclusions Family and significant others of individuals with SIB face substantial emotional burden and often lack adequate support. Improving access to tailored information and resources is essential to reduce distress and strengthen their role in suicide prevention. These findings highlight an urgent need for interventions that address both the well-being of family and significant others and their involvement in care.

Roots of Hope is a made-in-Canada suicide prevention model designed to be locally adapted and community driven. Evaluating a diverse multi-site model calls for an approach that balances rigor with flexibility and empowers communities to assess their own progress. This presentation describes the development of a community-based evaluation toolkit for Roots of Hope.

The Roots of Hope model is grounded on five pillars: public awareness, means safety, training and networks, specialized supports, and research and evaluation. Community-led initiatives (e.g., awareness campaigns, safe storage programs, training for service providers, and enhanced clinical supports) are implemented under these pillars to ensure a comprehensive approach to suicide prevention. While this model has attracted tremendous engagement and support across the country, there is a need to document its impact, at both community and national levels.

To advance a Roots of Hope evaluation framework we undertook iterative steps to develop and refine the framework that included 1) a literature review and environmental scan of approaches to implementation and evaluation relevant to community-based suicide prevention; 2) Expert consultation with experts in suicide prevention/ intervention; 3) A strengths-based community-based consultation using the Strengths, Opportunities, Aspirations, Results Framework; 4) Lived experience engagement.

The resulting Roots of Hope evaluation framework is guided by the model’s Theory of Change, and maps outcomes across pillars at levels of implementation and systems development; learning and capacity building; reductions in suicide and distress; and equity.

In this presentation, we will share the Roots of Hope evaluation framework and toolkit that was developed, along with key lessons from this collaborative process and invite discussion on how community-driven evaluation can advance public health practices and inform broader suicide prevention strategies.

Background

Little is known about whether community mental health service (MHS) use is associated with reduced suicidality in adolescents and whether distress could explain these effects.

Methods

We used MYRIAD, a nationally representative dataset of 11-14-year-olds, with three waves collected in 2016-2019. MHS consisted of past 3-month self-reported contact with MH specialists, counsellors, or psychiatric medication. Participants self-reported self-harm, suicidal ideation, and transdiagnostic distress. In those with any probable mental disorder, inverse probability of treatment weighting using propensity scores of MHS at T1 and T2 respectively mimicked randomisation and accounted for participants’ continuing treatment engagement. Effect sizes and heterogeneity were evaluated in subgroup analyses by mental health problem, service type, socioeconomic disadvantage, and ethnicity. Distress was tested as a mediator of MHS on suicidality outcomes. Adolescents with relevant lived experience gave insight into potential moderators.

Outcomes

In 2746 adolescents with probable mental disorder, 21.4% reported past 3-month MHS use at T1. Following propensity weighting, T1 MHS predicted a 29% reduced risk of self-harm after one year compared with non-use. These effects were seen in depressed adolescents, those from more advantaged neighbourhoods, and of White ethnicity, but were non-significant in disadvantaged and non-white groups due to increased variability. In the more homogenous depressed and White subgroups, precision increased such that MHS also significantly reduced distress after six months, and distress mediated 57-73% of MHS effects on subsequent self-harm. In the White depressed subsample, MHS reduced risk of suicidal ideation by 17% after one year and distress significantly mediated this effect. Service type moderated effectiveness, with specialist services reducing risk of self-harm by 56% in the depressed subsample.

Interpretation

Results support the role of MHS in decreasing self-harm in adolescents, but non-specialist services need improvement. MHS appear to need tailoring to increase effectiveness in more marginalised groups.

Understanding Patient Perspectives on Family Involvement in Suicide Care
A qualitative phenomenological study on how patients view the involvement of family members in the treatment of suicidality

Background
Joiner’s Interpersonal Theory of Suicide identifies perceived burdensomeness and social disconnection as central risk factors for suicidality. Clinical guidelines increasingly emphasize involving family members or significant others in suicide prevention, as relational connectedness may offer long‑term support that professional care cannot always provide. Given that suicide risk often intensifies during care transitions—when contact with professionals may decrease—the stable presence of loved ones can be crucial. Despite these benefits, motivating suicidal patients to involve family members in their treatment remains challenging.

Aim
This study seeks to examine how suicidal patients consider and decide whether to involve family members in their treatment. By exploring the underlying reasoning, expectations, and experiences shaping these decisions, the study aims to generate insights that can inform interventions to strengthen collaboration within the patient–family–clinician triad.

Method
A qualitative phenomenological design was employed. In‑depth interviews were conducted with 11 adult patients receiving treatment for suicidality at a mental health institution. Participants were recruited via clinicians from Intensive Home Treatment (IHT) teams and an outpatient geriatric psychiatry service. Data were analyzed using Colaizzi’s method, providing a systematic and rigorous phenomenological approach.

Results, Conclusion, and Discussion

Patients evaluate the anticipated costs and benefits of involving family, shaped by expectations about relatives’ responses, informed by prior experiences, and grounded in beliefs about themselves and others. Considerations of autonomy, connectedness, and perceived competencies further influence this assessment. Patients move through a sequence beginning with loneliness, followed by disclosure of suicidality, and subsequently deliberation on family involvement. Outcomes vary: some refrain from involvement, others choose to inform relatives, and a subset actively engages them in the treatment process.