Taking the Next Step: A Qualitative Study Examining Processes of Change in a Suicide Prevention Program Incorporating Peer-Workers

Suicide is a leading preventable cause of death (Centers for Disease Control and Prevention, 2018). Recent research identifies the time following hospital discharge after a suicide attempt as a critical window whereby suicide risk is heightened. As a result, suicide aftercare services that emphasize timely follow-up intervention are increasingly popular. There is a lack of research exploring the role of peer-workers in the context of suicide prevention aftercare. This is surprising given that peer-work has been hypothesized to promote belongingness, engagement, and hope; all factors theorized as critical to suicide ideation and behavior. This project aimed to address this research gap by exploring the perspectives of six peer-workers and five clinicians (n = 11) employed in a suicide prevention aftercare program. Qualitative data were collected via an online survey and telephone interviews. Interviews explored what processes were perceived by peer-workers and clinicians as critical in facilitating change within the context of a suicide prevention service. Thematic analysis identified four themes encapsulating factors that promote change: (1) utilizing lived experience; (2) emotional availability of peers; (3) building lives worth living; and (4) consumer driven care. Our analysis also identified an additional, but less direct, mechanism of change: Consultation in the context of risk. Our findings show that peer-work in suicide prevention is regarded as largely positive by both peer-workers and clinicians. Peer-workers and clinicians highlighted the importance of collaboration and consultation to facilitate effective management of risk and supervision given the complex nature of suicide prevention work. Finally, workers emphasized the importance of promoting agency amongst service-users, which they viewed as particularly important within the context of suicide prevention. Implications for suicide prevention services are discussed.