Dr Katie McGill

© 2019 Objective: This study aimed to identify the information that people who have attempted suicide and those who support them believed to be helpful to receive after an attempt. Methods: Thirty-seven people with lived experience of suicide attempt(s) (suicide attempt survivors and family members/friends of survivors) were recruited through two national lived experience community groups in Australia. Participants completed a semi-structured telephone interview that included questions about the types of information they believed important to receive after an attempt. Results: Using thematic analysis, the key information participants identified was helpful to receive following a suicide attempt was that which could challenge stigma and address negative community attitudes towards suicide. Participants spoke of a need for practical information and information that provided hope. Personal stories of recovery were identified as an important way of communicating this sort of health information. Conclusions: People who have attempted suicide and their family members and friends want information that challenges stigma and supports recovery expectations. Practice implications: Providing people with accurate information about recovery and using personal stories to communicate health information is one way people affected by suicide attempt identify can challenge stigma, and address information needs after a suicide attempt.

© The Royal College of Psychiatrists 2017. Background Prediction of suicidal behaviour is an aspirational goal for clinicians and policy makers; with patients classified as 'high risk' to be preferentially allocated treatment. Clinical usefulness requires an adequate positive predictive value (PPV). Aims To identify studies of predictive instruments and to calculate PPV estimates for suicidal behaviours. Method A systematic review identified studies of predictive instruments. A series of meta-analyses produced pooled estimates of PPV for suicidal behaviours. Results For all scales combined, the pooled PPVs were: suicide 5.5% (95% CI 3.9-7.9%), self-harm 26.3% (95% CI 21.8-31.3%) and self-harm plus suicide 35.9% (95% CI 25.8-47.4%). Subanalyses on self-harm found pooled PPVs of 16.1% (95% CI 11.3-22.3%) for high-quality studies, 32.5% (95% CI 26.1-39.6%) for hospital-treated self-harm and 26.8% (95% CI 19.5-35.6%) for psychiatric in-patients. Conclusions No 'high-risk' classification was clinically useful. Prevalence imposes a ceiling on PPV. Treatment should reduce exposure to modifiable risk factors and offer effective interventions for selected subpopulations and unselected clinical populations.