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An exploration of policy and practice in relation to addressing suicidality in children aged 15 years and under in Scotland. Phase I and III

Aim(s):

This PhD seeks to explore what is known about children (aged <16) in Scotland who are considering suicide. It will explore current policy and health service responses to children referred for suicidal ideation, or attempted suicide, and establish whether there is a gap in service response/provision. Concerned with capturing the experiences and documenting the journey of these children, it will inform best practice in this field.

Research Questions:

  1. How do current policy and practice address the issue of suicidality in children (aged<16)?
  2. What are the current pathways of care for children who are identified as expressing suicidal behaviours?
  3. What is the experience and outcomes for children referred to CAMHS in Scotland for help with suicidal ideation/behaviours?

What do specific responses, and interventions this research tell us children presenting with suicidal behaviours (including ideation) need?

Summary:

This study will involve mixed methods and the following linked studies:

Narrative Literature Review using research questions as a framework for analysis.

Purpose: Identity, assess and interpret what is known about children and suicide, service provisions and responses in Scotland, and internationally. Identify gaps in policy and research. Use findings to inform the development of research tools; structured interviews, questionnaires etc.

Data Source: Web and bibliographic databases: Google Scholar, TRIP database, Applied Social Science Index and Abstracts, International Bibliography of Social Sciences, Science Direct, Medline, PubMed, PsychInfo.

Study 1. Longitudinal Study of CAMHS referrals for suicidality:

Purpose: Map care pathways and experiences of children referred to CAMH's where there is suicidal ideation and/or suicidal behaviours.

Data Source: Two different NHS board CAMH's teams.

Track referrals to CAMHS over 6 months where the main reason for referral is suicidal ideation or DSH. Record referral outcome (e.g. treatments initiated, no treatment, signposting to other services).

Study 2. Exploration of: attitudes, beliefs and opinions of practitioners, policymakers and social researchers towards suicidality in children; CAMHS perspectives on the management of these referrals.

a) Semi-structured interviews:

Data Source: CAMHS professionals and those working with children at risk of suicide outwith CAMHS; policymakers and leading suicidality researchers in Scotland (n=12-15).

b) On-line questionnaires:

Data Source: CAMH's practitioners across all 12 NHS boards (n=4x staff per CAMHs team=48)

Study 3. Exploration of perspectives of children who have considered and or attempted suicide, regards their suicidality and care.

  • Semi-Structured interviews; by telephone, online via Skype or face to face (n=10-15)
  • Online survey/questionnaire; utilise websites such as Childline / Mood Juice (n=50 approx)

Purpose: Document views of children who were referred to CAMH's following attempted suicide or suicidal ideation.

Data Source: With the consent of the family, follow-up after 6 months; 10 children who had treatment initiated; 10 where no CAMHS interventions offered.

Purpose: Document perspective of the wider population of children where suicidality is an issue who may/may not have contact with services.

Data Source: Self-selected users of support websites. (82% of Childline counselling about suicide occurs online).

Principal Investigator: Professor Margaret Maxwell

External Collaborators: Gilmour L - University of Stirling

Funder: ESRC Pathway Studentship

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