A needs assessment for suicide prevention training within community pharmacies

BACKGROUND: Suicide is a leading cause of deaths globally, with over 700,000 deaths by suicide reported annually. In Ireland, numbers of suicides increased by 5.4% from 2015 to 2019. Community pharmacists are one of the most accessible and trusted healthcare professionals, and together with their staff they are well placed to identify those who may be at risk of suicide and guide them towards care pathways. Furthermore, their role in medication management can limit vulnerable patient access to potentially harmful medications. This study aims to explore the experience of community pharmacists and their staff in dealing with patients at risk of suicide and to identify ways of increasing education and support in this area. METHODS: Pharmacists registered with the Pharmaceutical Society of Ireland (PSI) were invited to complete an anonymous online survey via Google Forms in May 2020, and to circulate the online survey link to their community pharmacy staff (CPS). The survey comprised 29 questions across the following categories: interactions with at-risk patients; communication; training and resources. Free text responses to the following question were invited: “Without any identifying information, please tell us briefly about a time when you interacted with a patient who you were concerned may hurt himself or herself”. Data were analysed using descriptive statistics and thematic analysis. RESULTS: Of 219 eligible responses (67% female, 94% pharmacists, 6% other pharmacy staff), 61% percent (n = 134) reported having a patient die by suicide. Forty percent (n = 87) of participants reported feeling either very or moderately uncomfortable communicating with patients that may be at risk of suicide or self-harm. Most respondents (88.5%, n = 194) had not completed any suicide training. Online/webinar style trainings (82.1%, n = 180), and local/regional in-person events (50%, n = 111) were the most preferred education mode. Qualitative themes that emerged were: (i) accessibility; (ii) medication management; (iii) therapeutic relationship; (iv) knowledge and training; and (v) continuum of care pathways. CONCLUSION: This study highlights the high frequency of community pharmacy interactions with those at risk of suicide and the necessity for appropriate training in suicide prevention. Further research-informed action is required to facilitate navigation of such interactions with knowledge and confidence.