title: Public involvement in suicide prevention: understanding and strengthening lay responses to distress.
abstract: BACKGROUND
  The slogan "Suicide prevention is everyone's business" has been used in a number of campaigns worldwide in recent years, but most research into suicide prevention has focused on the role of medical professionals in identifying and managing risk. Little consideration has been given to the role that lay people can play in suicide prevention, or to the resources they need in order to do so.The majority of people who take their own lives are not under the care of specialist mental health services, and around half have not had recent contact with their general practitioner. These individuals are not known to be 'at risk' and there is little or no opportunity for clinical intervention. Family members and friends may be the only ones to know that a person is troubled or distressed, and their capacity to recognise, assess and respond to that distress is therefore vitally important. This study aims to discover what the suicidal process looks like from the point of view of relatives and friends and to gain insight into the complex and difficult judgements that people have to make when trying to support a distressed individual.
  
  
  METHODS
  The study uses qualitative methods to build up a detailed picture of 15-20 completed suicides, aged 18-34. Data are gathered by means of in-depth interviews with relatives, friends and others who knew the deceased well. In each case, as many informants as possible are sought using a purposive snowballing technique. Interviews focus on the family and social network of the deceased, the ways in which relatives and friends interpreted and responded to his/her distress, the potential for intervention that may have existed within the lay network and the knowledge, skills and other resources that would have helped members to support the distressed individual more effectively.
  
  
  CONCLUSIONS
  The study will inform interventions to promote public mental health awareness and will provide a basis on which to develop community-focussed suicide prevention strategies.
authors.affiliation: Peninsula Medical School (Universities of Exeter & Plymouth), Wonford House, Dryden Road, Exeter, Devon, EX2 5AF, UK. christabel.owens@pms.ac.uk
authors.forename: Christabel
authors.initials: C
authors.lastname: Owens
authors.forename: Gareth
authors.initials: G
authors.lastname: Owen
authors.forename: Helen
authors.initials: H
authors.lastname: Lambert
authors.forename: Jenny
authors.initials: J
authors.lastname: Donovan
authors.forename: Judith
authors.initials: J
authors.lastname: Belam
authors.forename: Frances
authors.initials: F
authors.lastname: Rapport
authors.forename: Keith
authors.initials: K
authors.lastname: Lloyd
mesh_terms: D000293:Adolescent; D000328:Adult; D006801:Humans; D008131:London / Q000453:epidemiology; D017150:Public Sector; D013315:Stress, Psychological; D014852:Wales / Q000453:epidemiology; D055815:Young Adult; D000092864:Suicide Prevention
references.citation: Br J Psychiatry. 1995 Dec;167(6):747-53
references.pmid: 8829741
references.citation: BMJ. 1999 May 8;318(7193):1235-9
references.pmid: 10231250
references.citation: Br J Gen Pract. 2005 Jul;55(516):503-9
references.pmid: 16004734
references.citation: Sociol Health Illn. 2008 Mar;30(2):237-54
references.pmid: 18290934
references.citation: J R Coll Gen Pract. 1973 Apr;23(129):255-64
references.pmid: 4737186
references.citation: Br J Gen Pract. 2004 Apr;54(501):279-81
references.pmid: 15113495
references.citation: Soc Sci Med. 2003 May;56(10):2191-200
references.pmid: 12697207
references.citation: Crisis. 2009;30(1):20-4
references.pmid: 19261564
references.citation: Suicide Life Threat Behav. 1987 Summer;17(2):133-50
references.pmid: 3303464
references.citation: J Adv Nurs. 1997 Oct;26(4):790-7
references.pmid: 9354993
references.citation: J Adv Nurs. 2001 Feb;33(3):350-6
references.pmid: 11251722
references.citation: J Clin Nurs. 1999 Jul;8(4):467-75
references.pmid: 10624264
references.citation: Suicide Life Threat Behav. 1990 Winter;20(4):307-23
references.pmid: 2087767
references.citation: J Affect Disord. 1998 Sep;50(2-3):269-76
references.pmid: 9858086
references.citation: Qual Health Res. 2003 Jul;13(6):871-83
references.pmid: 12891720
references.citation: Br Med Bull. 2001;57:207-19
references.pmid: 11719919
references.citation: Suicide Life Threat Behav. 2000 Summer;30(2):145-62
references.pmid: 10888055
references.citation: BMJ. 1993 Jul 31;307(6899):300-1
references.pmid: 8374378
references.citation: Psychol Med. 2003 Apr;33(3):395-405
references.pmid: 12701661
references.citation: Am J Psychiatry. 2002 Jun;159(6):909-16
references.pmid: 12042175
references.citation: BMJ. 2002 Jul 27;325(7357):210-3
references.pmid: 12142313
references.citation: Suicide Life Threat Behav. 1980 Spring;10(1):10-23
references.pmid: 7361340
references.citation: Soc Sci Med (1967). 1973 Sep;7(9):677-89
references.pmid: 4749058
references.citation: J R Coll Gen Pract. 1981 Dec;31(233):746-50
references.pmid: 7338870
references.citation: Br J Gen Pract. 2004 Apr;54(501):248-53
references.pmid: 15113490
references.citation: Suicide Life Threat Behav. 2000 Summer;30(2):163-76
references.pmid: 10888056
references.citation: Crisis. 2003;24(3):113-21
references.pmid: 14518644
references.citation: Soc Sci Med. 2003 Mar;56(5):1033-45
references.pmid: 12593876