Issues in acute psychiatric inpatient services: staff experiences of suicide and risk-assessments:Clinical psychologists' experiences of patient death by suicide in psychiatric inpatient services: An IPA study; The quality of the psychometric properties of risk-to-self assessment tools validated on acute psychiatric inpatient samples: A systematic literature review

This thesis presents four chapters: section one: systematic literature review; section two: empirical research paper; section three: critical appraisal; section four: ethics application. The systematic literature reviews offers a summary of risk-to-self (e.g. self-harm and suicide) risk-assessment tools validated for acute psychiatric inpatient settings. Sixteen reports were included in the review and ten psychometric properties of 15 risk-assessment tools were appraised using a quality rating system. The empirical study qualitatively explores the experiences of clinical psychologists who have had a patient die by suicide whilst working in acute psychiatric inpatient settings. Six participants’ experiences were analysed and interpreted using ‘Interpretative Phenomenological Analysis’ (IPA). The critical appraisal synthesises the finding of the systematic review and empirical study, and offers a deeper exploration of clinical recommendations and limitations of the reports. The final section includes the ethics application for the empirical study, the approval letter and supplementary documentation used to conduct the research

Risk and protective factors for suicidality among lesbian, gay, bisexual, transgender and queer (LGBTQ+) young people, from countries with a high global acceptance index (GAI), within the context of the socio-ecological model: A scoping review

Introduction: Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) young people experience higher prevalence rates of suicidality than their heterosexual and/or cisgender peers. However, there is limited research that can inform suicide prevention efforts. Our aim was to synthesize quantitative, qualitative, and mixed methods research on risk and protective factors among LGBTQ+ young people, from countries with a high Global Acceptance Index.Methods: A scoping review guided by Arksey and O'Malley's five‐stage framework, using the Preferred Reporting Items for Systematic Reviews and Meta‐analysis Extension for Scoping Reviews protocol. Five databases and grey literature were searched for relevant studies. Identified factors were clustered by thematic type, according to the socio‐ecological model to identify empirical trends and knowledge gaps. The mixed methods appraisal tool was used for quality assessment of studies. Results: Sixty‐six studies met our inclusion criteria. Overall, 59 unique risk factors and 37 unique protective factors were identified. Key risk factors include past suicidality, adverse childhood experiences, internalized queerphobia, minority stress, interpersonal violence, bullying, familial conflict, and anti‐LGBTQ+ policies/ legislation. Key protective factors include self‐affirming strategies, adult/peer support, at‐school safety, access to inclusive healthcare, family connectedness, positive coming out experiences, gender‐affirming services and LGBTQ+ inclusive policies and legislation.Conclusions: Overall, our findings affirm that multiple risk and protective factors, at all levels of the socio‐ecological model, interact in complex, unique and diverse ways upon suicidality among LGBTQ+ young people. Implications for suicide prevention are discussed. Further empirical studies are required, particularly at the communities, policies, and societal levels of the socio‐ecological model, and these studies should include a focus on protective factors and significant within‐group differences