title: Effective communication in eliciting and responding to suicidal thoughts: a systematic review protocol.
abstract: BACKGROUND
  In the UK, over 6500 people die by suicide each year. In England alone, this is one person every 2 h. Professionals assess risk of suicide in face-to-face contacts with people potentially at risk. The National Confidential Inquiry into Suicide found that most people who took their life were classified as 'low risk' in their final contact with mental health services. Training for front-line staff in reducing suicide is a NHS priority. While there is considerable evidence on what to assess when exploring suicidal ideation, there is little evidence on how to ask sensitive questions to effectively identify suicide risk and how to respond in the treatment encounter to reduce patient distress and suicidal ideation. This is critical for identifying risk and putting appropriate care in place.
  
  
  METHODS
  An electronic search will be conducted using MEDLINE, CINAHL, Cochrane Library, EMBASE and PsycINFO databases. Controlled studies of effectiveness will be identified using a predefined search strategy. The focus will be on suicidal thoughts/feelings rather than self-harm without intent to die. Two authors will independently screen articles using predefined inclusion and exclusion criteria and relevant data will be extracted using the Cochrane Collaboration data extraction form for randomised controlled trials (RCTs). Discrepancies between the two authors will be resolved by consensus or by consulting a third author at all levels of screening. We will assess the quality of evidence as well as risk of bias. A meta-analysis will be conducted if participants, interventions and comparisons are sufficiently similar, and we will perform the meta-analysis using Stata data analysis and statistical software.
  
  
  CONCLUSIONS
  The results of this systematic review will be used to guide training and practice for health care professionals.
  
  
  BACKGROUND
  PROSPERO CRD42015025867.
authors.affiliation: College House, University of Exeter Medical School, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK. r.mccabe@exeter.ac.uk.
authors.forename: Rose
authors.initials: R
authors.lastname: McCabe
authors.affiliation: European Centre for Environment and Human Health, Knowledge Spa, Royal Cornwall Hospital, Truro, TR1 3HD, UK. R.Garside@ex.ac.uk.
authors.forename: Ruth
authors.initials: R
authors.lastname: Garside
authors.affiliation: College House, University of Exeter Medical School, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK. A.Backhouse@exeter.ac.uk.
authors.forename: Amy
authors.initials: A
authors.lastname: Backhouse
authors.affiliation: College House, University of Exeter Medical School, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK. p.d.xanthopoulou@exeter.ac.uk.
authors.forename: Penny
authors.initials: P
authors.lastname: Xanthopoulou
mesh_terms: D003142:Communication; D018849:Controlled Clinical Trials as Topic; D006801:Humans; D011369:Professional-Patient Relations; D018570:Risk Assessment; D012650:Self Disclosure; D059020:Suicidal Ideation; D000078202:Systematic Reviews as Topic