Mental health care providers talk about their experiences preventing suicide in people with substance use disorders in South Africa: implications for clinical practice

Abstract

Objective: This study explored mental health care providers’ experiences of preventing suicide in people with substance use disorders and their perceptions of factors related to clinical practice that contributed to these experiences.

Methods: In-depth, semistructured interviews were conducted with 18 mental health care providers working in South Africa. Thematic analysis was used to analyse the data inductively with Atlas.ti software.

Results: Participants described feeling hopeless, helpless, powerless and guilty and needed to debrief from their experiences of preventing suicide. They perceived their experiences to be related to the difficulties of treating substance use disorders, the difficulties of assessing and managing suicide risk and how treating substance use might increase suicide risk.

Conclusions: The ways in which mental health care providers think about suicide and make sense of their experiences affects their perceived abilities to prevent suicide. Educating mental health care providers to transcend the limitations of risk factor approaches to suicide prevention and utilise evidence-based strategies for treating substance use disorders and associated problems, may be important to empower them and make them feel competent in suicide prevention. Empowering people with substance use disorders may help prevent suicide and may require collaboration between mental health care providers and allied professionals.

Keywords:

• Suicide prevention
• substance use disorder
• mental health care provider
• South Africa

Acknowledgements

The authors thank Lisa Dannatt (Department of Psychiatry and Mental Health, University of Cape Town) for assisting with study conceptualization, design, and access to research participants.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

The funding for this research was provided by the NRF (Innnovation Scholarship SFH150722129394 - DG), the NIAAA (Research Grant 5R24AA022919-04; awarded to the Partnership for Alcohol and AIDS Intervention Research – DG), Stellenbosch University (Merit Bursary - DG), and the MRC (Career Development Award - JB). The funding sources played no role in study design, data collection, analysis and interpretation, the writing of this article, or the decision to submit it for publication.