Practitioners’ experiences of adolescent suicidal behaviour in peer groups

Aim: To explore the experiences of mental health practitioners working with young people who engage in suicidal behaviour in their peer groups. Background: Group suicidal behaviour by young people can have devastating effects for young people, families and communities, and there are concerns that it may be increasing, influenced by online media and reported increasing rates of self-harm (ref). There is very little research to date on how professionals engage with adolescent suicide groups nor an exploration of the insights practitioners can provide about these groups. Design: Semi-structured interviews with practitioners in one mental health service Methods: We interviewed 10 practitioners, between May and July 2015, in one CAMHS multidisciplinary service. Data was analysed using thematic analysis. Findings: Participants described frequently needing to work with suicidal groups. Assessment of suicide risks is inevitably imprecise; young people have multiple motives for involvement, including risk-taking and care-seeking, and roles change within groups. Practitioners focus on identifying risky and protective connections between young people, in clinical services, schools and online. Clinical tensions include living with risks, emotional and positional challenges, and getting to grips with digital media. Conclusion: Peer groups appear to have a larger role in adolescent suicide than has been recognised to date, and should be a routine focus for assessments of suicide risks. Assessing risks is complex and emotionally demanding, and is assisted by understanding young people’s diverse motivations and roles in these groups. Further research is indicated to test transferability of findings