| Abstract | Introduction
Globally, at least 700,000 people die by suicide each year. Rates of suicide mortality fluctuate geographically, with low-and middle-income countries representing 77% of the world's suicides. Suicide-related behaviours and individual risk factors vary between ethnicities and across cultural affiliations. To make matters more complex, additional differences are apparent when people undergo geographical relocation. People forcibly displaced by violence and conflict, such as those from asylum-seeking and refugee backgrounds, are likely to encounter stressors that can increase their risk of suicide. Despite rapidly increasing rates of conflict-induced migration, there is a scarcity of research into evidenced-based suicide prevention strategies to support people from these groups. Current Investigation
This research proposes that a contextually-responsive gatekeeper training (GKT) program named Suicide Intervention First Aid (SIFA), is be an appropriate strategy to enhance the identification and support for people from asylum-seeking and refugee backgrounds. Methods
A mixed-method approach was incorporated into an action research framework to validate and refine SIFA training as a contextually relevant intervention to support people from asylum-seeking and refugee backgrounds. The GKT constructs – knowledge about suicide in multicultural contexts, attitudes towards suicide and suicide prevention, and self-efficacy to intervene were measured quantitatively, adopting a pre- and post-training procedure similar to those used in previous GKT evaluations. Statistical comparisons were made between three identical self-report surveys completed across three consecutive time points – pre-training, immediately post-training, and three months following training – referred to as time-point zero (T0), time-point one (T1), and time-point two (T2). In addition, focus group discussions were used to retrieve participants’ feedback regarding areas of SIFA that were most helpful and how the program could be modified to enhance suicide prevention efforts in this particular socio-cultural context. Lastly, during the T2 follow-up, additional open-ended questions were included to retrieve information concerning participants’ post-training intervention experiences, including which areas of SIFA they feel prepared them effectively and how SIFA could have better prepared them to intervene. Results
A total of 28 participants took part in the study. Quantitative analysis indicated SIFA's capacity to exert a significant favourable influence on knowledge about suicide and self-efficacy to intervene, which remained above baseline scores three months after training. Thematic analysis performed on focus group transcripts and narrative follow-up survey items identified three main themes: ‘The Acquisition of Knowledge’, ‘Perceived Ability to Make a Difference’, and ‘Factors Promoting and Impeding Suicide Prevention Behaviour’. The results illustrate that the program was appropriate for its target socio-cultural context and demonstrated the application of SIFA content and resources in real-life suicide prevention efforts. Further, the findings provided insight into how SIFA could be modified to support knowledge and self-efficacy further. Most prominently, perhaps, was the identification that gatekeepers who provide support in these contexts may be prone to compassion fatigue. This led to the assertion that future GKT should include evidence-based information on mitigating compassion fatigue's adverse impact on help-giving behaviours. |
|---|