Practitioners' experiences of adolescent suicidal behaviour in peer groups

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Accessible summaryWhat is known on the subject?Group suicidal behaviour can be devastating for all concerned.There is an absence of research on adolescent suicidal group behaviour.The perspectives of practitioners’ experiences of these groups are largely lacking from research literature.What this paper adds to existing knowledge?Practitioners work regularly with suicidal behaviour in adolescent peer groups.Practitioners identify peer relationships in groups as complex, including elements that are both suicide encouraging and preventing.Practitioners identify a range of ways in which young people become involved in suicidal behaviour in groups, including indirectly through risk taking and care-seeking as well as directly suicidal or self-harming.What are the implications for practice?Assessments of young people should routinely include a focus on the qualities of peer relations, including those in the online/digital realm.Assessments and interventions need to consider the complexity of group relationships and roles, and the multiplicity of factors that can contribute to suicidal behaviour in groups.Interventions that sustain therapeutic connectedness are helpful for taking dynamic/fluctuating risks into account.Introduction:Group suicidal behaviour by young people can have harmful effects; it may be increasing, influenced by online media and reported increasing self-harm rates; new knowledge and understanding to inform interventions is required.Aim:To explore how practitioners experience group suicidal behaviour amongst adolescents, how they assess risks/needs, and how these insights inform understanding about these groups.Method:Ten practitioners, including Mental Health Nurses, were interviewed in one multidisciplinary CAMHS, in England. Data analysis was by Thematic Analysis (Braun & Clarke 2006).Results:Participants described frequently working with suicidal groups. Roles in groups include suicide encouraging and preventing. Practitioners identify risky and protective connections between young people, online and offline. Clinical tensions include living with suicidal risks, emotional and positional challenges, and getting to grips with digital media.Discussion:Peer groups appear to have a larger role in adolescent suicide than recognized to date. Practitioners need to assess young people's roles in groups, their diverse motivations and to understand constantly changing digital media.Implications for practice:Assessments of suicide risk for young people should routinely include focus on peer relations including the online/digital realm. Maintaining relationships with vulnerable young people facilitates managing fluctuating risks and understanding different group dynamics.

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