Centre for Rural Health, University of Tasmania, Launceston 7250, Australia.
School of Medicine, Western Sydney University, Penrith 2571, Australia.
Int J Environ Res Public Health. 2023 Feb 1;20(3):2644. doi: 10.3390/ijerph20032644.
Suicide rates in rural communities are higher than in urban areas, and communities play a crucial role in suicide prevention. This study explores community-based suicide prevention using a qualitative research design. Semi-structured interviews and focus groups asked participants to explore community-based suicide prevention in the context of rural Australia. Participants recruited (( = 37; ages 29-72, = 46, = 9.56); female 62.2%; lived experience 48.6%) were self-identified experts, working in rural community-based suicide prevention (community services, program providers, research, and policy development) around Australia. Data were thematically analysed, identifying three themes relating to community-based suicide prevention: (i) Community led initiatives; (ii) Meeting community needs; and (iii) Programs to improve health and suicidality. Implementing community-based suicide prevention needs community-level engagement and partnerships, including with community leaders; gatekeepers; community members; people with lived experience; services; and professionals, to "get stuff done". Available resources and social capital are utilised, with co-created interventions reflecting diverse lifestyles, beliefs, norms, and cultures. The definition of "community", community needs, issues, and solutions need to be identified by communities themselves. Primarily non-clinical programs address determinants of health and suicidality and increase community awareness of suicide and its prevention, and the capacity to recognise and support people at risk. This study shows how community-based suicide prevention presents as a social innovation approach, seeing suicide as a social phenomenon, with community-based programs as the potential driver of social change, equipping communities with the "know how" to implement, monitor, and adjust community-based programs to fit community needs.
农村社区的自杀率高于城市地区，社区在预防自杀方面发挥着至关重要的作用。本研究采用定性研究设计，探讨基于社区的自杀预防。半结构式访谈和焦点小组要求参与者在澳大利亚农村背景下探讨基于社区的自杀预防。参与者（（ = 37; 年龄 29-72， = 46， = 9.56）; 女性 62.2%; 有过相关经历 48.6%) 是自我认定的专家，在澳大利亚各地从事农村社区为基础的自杀预防（社区服务、项目提供者、研究和政策制定）工作。对数据进行主题分析，确定了与基于社区的自杀预防相关的三个主题：（i）社区主导的倡议；（ii）满足社区需求；（iii）改善健康和自杀倾向的项目。实施基于社区的自杀预防需要社区层面的参与和合作，包括与社区领袖；把关人；社区成员；有过相关经历的人；服务提供者；和专业人员合作，以“完成工作”。利用现有资源和社会资本，共同创建的干预措施反映了多样化的生活方式、信仰、规范和文化。“社区”的定义、社区需求、问题和解决方案需要由社区自己确定。主要的非临床项目解决健康和自杀倾向的决定因素，提高社区对自杀及其预防的认识，以及识别和支持处于危险中的人的能力。本研究展示了基于社区的自杀预防如何呈现为一种社会创新方法，将自杀视为一种社会现象，基于社区的项目是社会变革的潜在驱动力，使社区具备实施、监测和调整基于社区的项目以适应社区需求的“实践知识”。
