Caring for a friend or family member who has experienced suicidal behaviour: A systematic review and qualitative synthesis

Abstract

Friends and family members can be important sources of support for people who are or have been suicidal. This review aimed to synthesise qualitative evidence regarding carers' perspectives of supporting someone who has experienced suicidal behaviour. Methods: Five electronic databases (Web of Science, CINAHL, PsychINFO, MEDLINE, and SocINDEX) were searched from inception to May 2022. Eligible qualitative studies were published in English and investigated the caring experiences of friends or family members of people who had experienced suicidal behaviour, defined as any form of suicidal ideation and/or attempts. Studies focused on non-suicidal self-injury or suicide bereavement were excluded. Data from 19 eligible studies were analysed using thematic synthesis. Results: Initial carer reactions to suicidal behaviour included profound anxiety and intensive monitoring for signs of increased suicide risk amongst those they supported. Carers also reported significant challenges with understanding how to provide effective interpersonal support following suicidal crises. Professional support was perceived to be most effective when provided in a timely, interpersonally sensitive and safety-focused manner. However, several studies detailed carers' difficulties accessing appropriate support and challenges managing their own distress. Conclusions: Carers face significant challenges with knowing how to respond to suicidal behaviour, where to find appropriate help, and how to manage their own distress.

Brief admission by self-referral for individuals with self-harm and suicidal ideation: a qualitative study based on focus groups exploring relatives’ experiences

“…Relatives shared experiences of how their loved ones had been able to use BA not only for themselves but also to unburden them as relatives, who were otherwise 24/7 standbys with tremendous distress and need for rest, recognized from other research on relatives to individuals with self-harm and suicidal behaviour (Lantto et al, 2023 ; Marshall et al, 2023 ; Mughal et al, 2022 ). BA helped directly by fulfilling both parties’ personal needs for recovery and indirectly; when the relative felt better, the loved one with access to BA also felt better—and the other way around.…”

“…A recent systematic review points to suicidal behaviour as inducing anxiety among relatives. According to the review, relatives to those suffering from suicidal behaviour perceived access to timely professional support as most effective (Marshall et al, 2023 ), which is the very aim of BA.…”

Stronger Together: A case study exploring the development and piloting of an intervention facilitating family and informal carers to support adults at risk of suicide and serious self-harm

“…Caregiving in the context of suicidal behaviour is particularly demanding, and is associated with poorer carer psychological, psychosomatic and physical health as well as increased caregiver burden (Marshall et al, 2023), defined as "the emotional, social, and financial stress that illnesses impose on caregivers" (Chessick et al, 2007, p. 483). Carers describe feelings of grief, helplessness, distress, overwhelm, guilt, fear, and anger (Acres et al, 2022;Izon et al, 2020;Lee et al, 2018;Spillane et al, 2020).…”

“…(5) focused on carers bereaved by suicide, as the experience of bereavement differs markedly from the focus of this project report (Marshall et al, 2023). thoroughly reviewed.…”

co-production of an intervention facilitating informal caregivers to support adults at risk of suicide and serious self-harm: a brief report

“…Although attitudes toward carers are crucial, the primary reason for their exclusion relates to patient confidentiality, consent, and information-sharing procedures, which hinder involvement and transparent communication. 20,25,[29][30][31] ST: This co-learning model of Workshop Two fosters collaboration and has positively influenced both healthcare professionals who have found personal testimonies persuasive and carers who have felt empowered by lived experience input. A greater understanding between carers and professionals has emerged from this workshop.…”