Consumer and Carer Perspectives of a Zero Suicide Prevention Program: A Qualitative Study

This study explored the experiences of healthcare consumers who had recently attempted suicide, and their carers, following placement on a Suicide Prevention Pathway based on the Zero Suicide framework. Qualitative interviews were conducted with 10 consumers and 5 carers using a semi-structured interview schedule. Interviews were transcribed and thematic analysis was applied to identify prominent themes and sub-themes. Three interrelated themes were identified. The first theme was ‘Feeling safe and valued’ with the associated sub-theme pertaining to perceived stigmatizing treatment and self-stigma. The second was ‘Intersection of consumer and staff/organizational needs’ with a related sub-theme of time pressure and reduced self-disclosure. The final theme was ‘Importance of the ‘whole picture’, highlighting the relevance of assessing and addressing psychosocial factors when planning for consumer recovery. Overall, consumers and their carers reported a favorable experience of the Suicide Prevention Pathway; however, there were several areas identified for improvement. These included reconciling the time-pressures of a busy health service system, ensuring consumers and carers feel their psychosocial concerns are addressed, and ensuring that adequate rapport is developed. Key to this is ensuring consumers feel cared for and reducing perceptions of stigma.

Species heterogeneity in food webs can reduce the potential for alternative stable states

Overexploitation can lead to a rapid collapse of consumers that is difficult to reverse if ecosystems exhibit alternative stable states. However, support for this phenomenon remains predominantly limited to simple models, whereas food webs might dissipate the feedback loops that create alternative stable states through species-specific demography and interactions. Here we develop a general model of consumer-resource interactions with two types of processes: either specialized feedbacks where individual resources become unpalatable at high abundance or aggregate feedbacks where overall resource abundance reduces consumer recruitment. We then quantify how the degree of interconnectedness and species differences in demography affect the potential for either feedback to produce consumer- or resource-dominated food web states. Our results highlight that such alternative stable states could be more likely to happen when aggregate feedbacks or lower species differences increase redundancy in species contributions to persistence of the consumer guild. Conversely, specialized palatability feedbacks with distinctive species roles in guild persistence reduce the potential for alternative states but increase the likelihood that losing vulnerable consumers cascades into a food web collapse at low stress levels, a fragility absent in few-species models. Altogether, we suggest that species heterogeneity has a greater impact on whether feedbacks prevent consumer recovery than on the presence of many-species collapses.

Influence of change expectancy and recovery processes on depression severity

Consumer recovery processes refer to social Connectedness, Hope, Identity, Meaning in life, and Empowerment (“CHIME”). This study examined if expectations of change in depression could mediate the relationship between CHIME recovery processes and depression severity. Participants were patients who consulted clinical psychologists at primary care clinics. Measures of depression change expectancy, CHIME recovery processes, and depression symptoms were administered. Change expectancy partially mediated the relationship between Hope and depression severity. The same was found for Identity, but Identity also mediated the relationship between change expectancy and depression. Thus, Hope may reduce depression by improving change expectancies, whereas Identity and change expectancy may have reciprocal influences that alter depression. Findings suggest that the CHIME recovery processes may facilitate recovery from depression.