TY - JOUR
PY - 2024//
TI - Improving assessment and management of suicide risk among people who inject drugs: a mixed methods study conducted at the Medically Supervised Injecting Centre, Sydney
JO - Drug and alcohol review
A1 - Hocknull, Kate
A1 - Geiger, Brennan
A1 - Bartlett, Mark
A1 - Colledge-Frisby, Samantha
A1 - Shand, Fiona
A1 - Day, Carolyn A.
A1 - Jauncey, Marianne
A1 - Roxburgh, Amanda
SP - ePub
EP - ePub
VL - ePub
IS - ePub
N2 - INTRODUCTION: People who inject drugs are 13 times more likely to die by suicide than the general population. Guidelines for responding to risk in this population are limited. Harm reduction services attended by people who inject drugs require targeted strategies to address the complexities of suicide risk among this population.
METHODS: Co-design, engaging health professionals and people with lived experience informed the study. Mixed methods were used to understand the experience of managing suicide risk among clients attending the Medically Supervised Injecting Centre (MSIC) in Sydney. A survey was administered to assess staff confidence in managing risk. Focus groups were conducted with health professionals and MSIC clients to explore experiences of suicide management, response and opportunities for improvement.
RESULTS: Half (N = 17) the MSIC staff surveyed reported over 10 years' experience working with this population. Confidence in managing suicide risk was low. Three key themes emerged from focus groups (N = 17): (i) Autonomy and the need to involve clients in the assessment process; (ii) Trust between clients and health professionals, and transparency in decision-making; and (iii) System barriers, described by health professionals as inadequate referral pathways for clients in distress, and by clients as negative experiences of care, including involuntary admission and not receiving medication (e.g. methadone).
DISCUSSION AND CONCLUSIONS: Revised assessment guidelines and a tailored safety plan were developed. These resources are also suitable for other alcohol and other drug services. The challenge in managing suicide risk in harm reduction services is balancing duty of care with staff-client relationships and client engagement.
Language: en
LA - en SN - 0959-5236 UR - http://dx.doi.org/10.1111/dar.13900 ID - ref1 ER -