The importance of safe spaces and peer support in suicide prevention

As part of Suicide Prevention Australia’s first Knowledge Exchange webinar on safe spaces, Ellie Hodges, Executive Director at the Lived Experience and Advocacy Network (LELAN) shared outcomes from their Learning from Lived Experience (LfLE) Suicide Prevention Project. The Life in Mind team have provided an overview of this research below.

Those with lived experience often express that service responses to a crisis are inadequate and can sometimes even compound their distress. In the current medical model, the care and management of suicidal behaviour is provided in the context of diagnosis/treatment of mental illness, and typically doesn’t consider the assessment and treatment of trauma and situational crisis that are often core to the experience of suicidal distress. Listening to the voices of those who have experienced suicidal crisis and their feedback on services currently available are important to improve care and prevent suicide.

The learnings from the Lived Experience (LfLE) Suicide Prevention Project aimed to highlight the experiences of those who have been through suicidal distress to better inform development of supports and services. The project was funded by the South Australian Suicide Prevention Community Grants Scheme and supported by the South Australian Mental Health Commission. It included the production of a film, and online survey of those with lived experience of suicide. 

The film, Care not Treatment, shares the voices and journeys of 11 people who have lived experience of suicidal crisis. The aim was to answer three questions: what helped, what harmed and what could be done to support those experiencing suicidal crisis better. Their stories, told to camera in their own words, provide powerful insight into how those in crisis experience the current services and supports available.

Over 100 people with lived experience of suicide responded to the LfLE survey, which included questions about past experience with services. Currently, most people are directed to present to the emergency department or call a suicide helpline when in suicidal crisis. 

Key results included:

• Over 80% of survey respondents ‘strongly disagreed’ or ‘disagreed’ that they felt comfortable and safe in the emergency department when experiencing a suicidal crisis
• 76% of respondents ‘strongly disagreed’ or ‘disagreed’ that services and support currently available adequately meets their needs
• 66% stated their opinion of supports changed for the worse after their experience
• 67% of respondents ‘strongly disagreed’ or ‘disagreed’ that they felt validated and heard by helplines (standard helplines that are not peer run)
• Over 90% of respondents ‘strongly agreed’ or ‘agreed’ that they felt ‘alone and like they had to work it out themselves’. 

The survey also asked respondents for attributes that they would like to see in a support service for those in suicidal crisis. 

Key themes identified were:

• Non-clinical, with a home-like feel
• Non-judgemental, compassionate, welcoming and inclusive.

Safe spaces are non-clinical alternatives to the emergency department. Survey respondents were asked what features they would like in a safe space, and the responses included:

• Opportunities for connection, distraction and self-regulation, for example with games, therapy animals and sensory tools
• Pathways to other services
• Peer support workers who also have lived experience of suicide were identified as the most important aspect.

Ms Hodges said, “The wisdom and stories of those in the film allow the broader voice, influence and leadership of people with lived experience to be heard and drive the changes we so desperately need. The results of the survey have provided a strong advocacy platform for change that LELAN is pursuing.”

Using the findings from the LfLE project, LELAN has been advocating for peer-led community-based responses to suicide distress to be more available, particularly the Alternatives to Suicide approach. They have also been working with governments, PHNs, NGOs and community groups, sharing lived experience insights and contributing to the design of safe spaces that are emerging in South Australia. 

You can view a snapshot of the survey results via the LELEAN website.