Developing recommendations to improve identification, prevention, and response to suicide thoughts and behaviours among post-secondary students: A mixed methods study

Abstract

Objective: This study aimed to generate recommendations regarding how to identify, prevent and respond to suicide thoughts and behaviors among post-secondary students. Methods: A convergent mixed-methods design with Nominal Groups Technique (NGT) was used. Post-secondary and high-school students and their caregivers generated and ranked recommendations. A Codebook Thematic Analysis approach guided analysis of the NGT-discussions and extended understanding of recommendations. Results: 88 individuals participated in 21 panels. Five key recommendations were identified: (1) increase student and staff education regarding suicide identification, prevention, and awareness of existing supports; (2) enhance rapid access to supports for those experiencing a crisis; (3) improve institutional academic supports for students following crisis; (4) reduce stigma; (5) improve communication regarding on-campus suicide. Common themes included perceived impact of attitudes, institutional barriers, and peer-support on suicide thoughts and behaviors. Conclusions: These recommendations can inform the development of student-centred interventions for improving mental health supports.

Keywords:

• Post-secondary students
• mental health
• suicide
• prevention
• nominal group technique

Acknowledgement

We would like to thank the student volunteers (Emily Bernier, Hibah Faheem, Sabrina Tseng, Sujeev Chohan) who helped with focus groups (note taking and transcribing). As well, we would like to thank the participants for sharing their perspectives and experiences with us.

Authors’ contribution

GD conceptualized and designed the study, conducted qualitative data collection and analysis, and contributed to manuscript writing and revision. ACHS conceptualized and co-designed the study, conducted quantitative data analysis, and contributed to manuscript writing and revision. JHG contributed to qualitative and quantitative data analysis, co-wrote the first draft of the manuscript, and conducted manuscript revisions. RDL assisted with data collection and management, contributed to conceptualization and study design, conducted quantitative data analysis, contributed to the first draft of the manuscript and revision. AYS contributed to conceptualization and study design, assisted with data collection and management, conducted qualitative data collection and analysis, contributed to the first draft of the manuscript and to manuscript revisions. ARP, HKS, AT & CM contributed to qualitative data analysis. SP contributed to study design and manuscript writing and revision.

Conflict of interest disclosure

The authors have no conflicts of interest to report. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of Canada and received approval from the University of Calgary’s Conjoint Faculties Research Ethics Board.

Ethics approval and consent

This study, and all methods performed within are in accordance with guidelines mentioned in the University of Calgary’s Research Ethics Board. This study, and all methods performed within, were approved by the University of Calgary’s Research Ethics Board (CFREB). Verbal and written informed consent was obtained from all the participants, as all NGT groups were conducted via zoom; this process was approved by the Research Ethics Board of the University of Calgary.

Data availability statement

Due to the personal nature of the NGT groups, data is not publicly available. However, data may be made available from the corresponding author on reasonable request.

Additional information

Funding

This study was funded by a grant from The Children’s Hospital Aid Society and the friends and family of Josephine Wearmouth.