Australian psychologists' attitudes towards suicide and self‐harm

Abstract

An exploratory study of 81 Australian psychologists' attitudes towards suicide and self‐harm was undertaken. Two attitudinal measures, one knowledge measure and demographic information, were used to assess the relationships between attitudes, knowledge, gender, age, years of professional experience, and previous experience with suicidal and self‐harming clients. Among this sample, attitudes towards suicide and self‐harm were generally positive and participants displayed high levels of knowledge of self‐harm. Age and years of experience were related to participants' attitudes, with younger psychologists reporting greater confidence in working with these clients and believing in the right of an individual to decide when to die. Future research is needed to determine the impact of psychologists' attitudes on their behaviour towards suicidal and self‐harming clients.

Key words:

• attitudes
• self‐harm
• suicide

Suicide and self‐harm are of great concern to Australian health professionals; suicide was the 14th leading cause of death in Australia in 2008, with 2,191 deaths being classified as completed suicides (Australian Bureau of Statistics, 2010). During the 2003–2004 year more than 24,000 self‐harming clients were hospitalised for their injuries (Berry & Harrison, 2007), and there are indications that the rate of self‐harm is increasing (Shapiro, 2008). While professionals are entrusted to treat all clients, caring for those who harm themselves can evoke strong emotions that may interfere with this duty (Wilstrand, Lindgren, Gilje, & Olofsson, 2007) and affect the professional's behaviour towards their clients (McKinlay, Couston, & Cowan, 2001). Further, perceived stigma and negative attitudes, towards suicide generally, and suicidal behaviour in particular, held by health professionals contribute to a lack of help‐seeking among those who self‐harm (Hurry & Storey, 2000).

Attitudes towards suicide became of interest to researchers in the 1980s (Domino, Gibson, Poling, & Westlake, 1980; Domino, Moore, Westlake, & Gibson, 1982); however, the related area of attitudes towards self‐harm (defined as excluding conscious suicidal intent) has been largely ignored by researchers until the last decade (Anderson & Standen, 2007; Friedman et al., 2006; Mackay & Barrowclough, 2005; McKinlay, Couston, & Cowan, 2001). To date, the majority of research into these attitudes has focused on nurses and doctors, in particular those who are employed in hospital emergency departments (Anderson, 1997; Botega et al., 2007; Herron, Ticehurst, Appleby, Perry, & Cordingley, 2001; Holdsworth, Belshaw, & Murray, 2001). As attitudes have the potential to impact upon practitioners' behaviour, an understanding of the attitudes held by other health professionals involved in the care of suicidal and self‐harming clients is essential if these clients are to obtain the best treatment outcomes (McKinlay et al., 2001).

Positive attitudes about both suicide and self‐harming behaviours among health professionals have been demonstrated through rejection of myth‐based and negative statements about suicide and self‐harm, such as the belief that clients who engage in these behaviours are seeking attention (McCann, Clark, McConnachie, & Harvey, 2007). Nurses recognise the severity of suicidal and self‐harming behaviour (McCann et al., 2007), yet nurses employed in emergency departments hold more positive attitudes towards the behaviours than those employed in community mental health services (Anderson 1997). Crawford, Geraghty, Street, and Simonoff (2003) studied health professionals who worked with self‐harming adolescents and found that practitioners' attitudes are generally positive.

In contrast, Anderson and Standen (2007) observed that while medical doctors and nurses had generally favourable attitudes towards suicide (as demonstrated by rejection of negative statements about suicide), doctors were more likely than nurses to attribute suicidal behaviour to mental illness. Mackay and Barrowclough (2005) found that medical staff displayed higher levels of irritation towards self‐harming clients and indicated a lower level of helping behaviour than nurses. This study also demonstrated gender effects on attitudes towards self‐harm behaviour, with male employees reporting higher levels of irritation than their female colleagues. Strong feelings of anger and frustration towards these clients have been reported, with these feelings sometimes leading to verbal and physical confrontation (Wilstrand, Lindgren, Gilje, & Olofsson, 2007).

Friedman et al. (2006) demonstrated that professionals who had worked with suicidal and self‐harming clients for a long period expressed more negative attitudes towards the clients than professionals with less experience in this area, evidenced by high levels of anger towards the clients as well as higher feelings of inadequacy. Anderson (1997) also found that age and length of experience had an effect on attitudes. The older and experienced community mental health nurses (more than 10 years of practice experience) in his study reported more negative attitudes towards suicidal behaviour than their colleagues (with less than 5 years experience).

The majority of previous research has focused on nurses and doctors; however, other professionals also work closely with these clients. Hammond and Deluty (1992) reported that psychologists were more accepting of suicide (under particular circumstances such as terminal illness) than other health professionals examined, and professionals with specialist mental health training hold more positive attitudes towards suicide and self‐harm than professionals without this training (Botega et al., 2007; Herron et al., 2001). However, no study has specifically examined attitudes held by psychologists towards suicide and self‐harm.

The present study aimed to examine the attitudes held by Australian psychologists towards suicide and self‐harm. From the literature examined, it was anticipated that psychologists would display generally positive attitudes towards suicide and self‐harm. Of interest were the effects of age, gender, and length of professional experience on the reported attitudes, as these were shown to be related to attitudes in studies of other health professionals (Anderson, 1997; Friedman et al., 2006). Participants' personal concepts of ‘suicidal behaviour’ and ‘self‐harm behaviour’ were also examined. This was of particular importance, as the studies in the current literature have examined attitudes towards either self‐harm or suicide in isolation of the other behaviour. As the two behaviours have been shown to be inextricably connected, it was important that an understanding of how psychologists distinguished the two behaviours was developed.

METHOD

Participants and procedure

After obtaining ethical approval for the project, the study was advertised on the Australian Psychological Society (APS) website. As such, participation in the study was open to all APS members in Australia (approximately 18,000 members). A brief description outlining the purpose of the study was displayed in the advertisement. Participants were able to access further information and the questionnaire through a URL link at the end of the advertisement. The online questionnaire took approximately 30-min to complete. Participation in the study was anonymous and no incentives were offered as compensation.

A total of 81 participants (69 females, 11 males, 1 unspecified) participated in the study. Participants' ages ranged from 22 to 71 years with a mean age of 42.38 years (SD = 10.75). All participants were working as psychologists in Australia at the time of the study. Years employed as a psychologist ranged from 2 months to 36 years with a mean employment length of 9.95 years (SD = 8.51). Participants reported their primary specialisation/area of work as: clinical (n = 36), counselling (n = 15), forensic (n = 12), and child and adolescent mental health (n = 10). Twenty‐two participants (27.16%) primarily worked in private practice, six (7.41%) worked in a hospital setting, and five (6.17%) worked primarily at a university. Generally, the geographic location of participants matched the distribution of APS members across states. The majority of participants (34.57%) worked in NSW, Victoria (18.52%), Western Australia (18.52%), or Queensland (14.81%).

The majority (n = 54) indicated that they had received formal training in suicide risk assessment, although the source and extent of this training varied greatly (from a lecture during postgraduate studies to intensive week‐long workshops, or on the job training). Of the participants, 23.5% of participants reported never having worked with a suicidal client (range 0–30 clients), while 17.3% reported no experience with clients who self‐harm (range 0–60 clients). Those with experience working with these clients reported seeing an average of 3.94 (SD = 5.36; range 1–30) suicidal clients in the last month and 12.05 (SD = 24.09; range 1–180) in the last 6 months. Similarly, they reported seeing an average of 5.43 (SD = 8.83; range 1–60) self‐harm clients in the last month and 12.85 (SD = 25.79; range 1–180) in the last year.

Materials

Participants completed online questionnaires assessing the following variables.

Demographic data

Using a custom‐designed questionnaire, participants provided information regarding their age, gender, current qualifications, years of professional experience, and number of clients they had seen in the last 6 months who displayed suicidal or self‐harm behaviours. In addition, participants were asked to briefly define ‘self‐harm’ and ‘suicide’ as they understood the terms.

Knowledge of self‐harm

A 20‐item knowledge of self‐harm scale was constructed by Warm, Murray, and Fox (2003) as a brief measure for determining participants' ability to distinguish self‐harm fact from fiction. Ten items in the instrument were fact‐based statements about self‐harm (e.g., ‘Self‐harm is a release for anger.’) while the remaining ten items were myth‐based statements (e.g., ‘Self‐harm is attention seeking’). Using data from clients who engaged in self‐harm, a principal component analysis confirmed that the classifications of items as ‘truth’ or ‘myth’ were congruent with the views of clients who self‐harmed (Warm et al., 2003). All items included a forced‐choice (true/false) response scale. Participants were allocated 1 point if they correctly identified a myth or truth, or 0 points when they were not able to identify the truth or myth. The maximum possible score a participant could achieve was 20, with higher scores indicating higher levels of knowledge of self‐harm behaviour.

Attitudes to self‐harm

The Attitudes Towards Deliberate Self‐Harm Questionnaire (ATDSHQ; McAllister, Creedy, Moyle, & Farrugia, 2002) is composed of 33 statements about self‐harm. Participants were required to indicate the extent of their agreement with each statement using a 4‐point Likert scale (strongly disagree to strongly agree). This instrument has been found to support four distinct factors: perceived confidence in assessment and referral of deliberate self‐harm clients, dealing effectively with deliberate self‐harm clients, empathetic approach, and ability to cope effectively with legal and hospital regulations that guide practice. Initial validation of the measure revealed relatively sound internal consistency for most of the four scales (perceived confidence α = 0.71; dealing effectively with clients α = 0.74; empathy α = 0.67; and ability to cope with legal and hospital regulations α = 0.57). High scores indicate strong agreement with the construct measured (e.g., empathetic approach to clients who self‐harm).

Opinions regarding suicide

The Suicide Opinion Questionnaire (Domino et al., 1980) comprised 100 statements about suicide. Typical statements on the instrument included ‘A large percentage of suicide victims come from broken homes’ and ‘Suicide attempters are typically trying to get even with someone’. Participants were required to respond on a 5‐point Likert scale ranging from strongly disagree to strongly agree (and including an undecided option at the midpoint). Items in this instrument have been shown to support eight clinical scales: suicide reflects mental illness, suicide threats are ‘not real’, the right to die, importance of religion, impulsivity, suicide is normal, suicide reflects anger/aggression, and suicide is morally bad (Domino, MacGregor, & Hannah, 1988). All eight of these scales obtained test–retest reliability estimates above 0.70 (Domino, 1996). As the Suicide Opinion Questionnaire was written for use with American participants, five items were amended on the authors' recommendation. These amendments included changing ‘USA’ to read ‘Australia’ as well as amending two items that used American expressions (e.g., minority groups were changed from ‘Chicano’ and ‘American Indian’ to ‘non‐Caucasian’).

RESULTS

Definitions of self‐harm and suicide

In an effort to determine whether psychologists distinguished between suicidal behaviour and self‐harm, participants were asked to briefly define the terms as they understood them. Of the total sample, 76 provided a definition of suicidal behaviour and 75 provided a definition of self‐harm. Responses indicated that participants tended to distinguish the behaviours through the intent, thoughts, specific behaviours, and emotions associated with suicidal behaviour and self‐harm as well as the underlying motives for the behaviour (see Table-1). Sixty‐four participants mentioned intent when defining suicidal behaviour, while only 33 mentioned intent when defining self‐harm. A significant difference was observed in the expressed intent of suicide and self‐harm, χ² (df = 3) = 79.46, p < .001. The majority of participants clearly indicated that suicidal behaviour indicated an intent to die (n = 26) or a desire to end one's life (n = 31). However, no participants described self‐harm as indicating intent to die. Rather, nine participants specified that self‐harm may not necessarily reflect suicidal intent, while 24 clearly indicated that suicidal intent was not a feature of self‐harm.

Table 1 Distinctions between suicidal behaviour and self‐harm

	Suicidal behaviour		Self‐harm
	n = 76		n = 75
Intent	n = 64	%	n = 33	%
Intent to die	26	40.63
Desire to end life	31	51.56
Not necessarily intent	7	10.94	9	27.28
No suicidal intent			24	72.72
Acts	n = 74	%^a	n = 70	%
Behaviours	73	98.65	70	100.00
Cognitions	34	45.95	8	11.43
Affect	7	9.46	3	4.29
High‐risk behaviour			11	15.71
Behaviour + cognition	30	40.54	6	8.57
Behaviour + affect	3	4.05	1	1.43
Behaviour + cognition + affect	4	5.41	2	2.86
Motives	n = 9	%	n = 25	%
Emotion regulation/coping			16	64.00
Hopelessness	3	33.33
Relief from psych distress/pain	6	66.67	7	28.00
Dissociation			2	8.00
Change environment/communication			3	12.00

a Frequencies do not sum to 100% as some participants provided more than one response.

In providing their descriptions, 74 participants described active behaviours, cognitions, or affect comprising suicidal behaviour, while 70 made mention of acts comprising self‐harm. A difference was observed in the number of people who assigned specific acts (e.g., deliberate behaviours that might result in death; cutting arm with a razor blade), cognitions (e.g., any thought that involves terminating one's life) or emotions (e.g., feelings of deep despair) to suicidal behaviour and self‐harm, χ² (df = 2) = 12.53, p < .01, with fewer participants indicating that self‐harm might include thoughts of hurting oneself. In most cases, participants used language that indicated an overt act on the part of the person who was engaged in suicidal behaviour (n = 73) or self‐harm (n = 70). Just less than half the participants also indicated that suicidal behaviour also includes suicidal thoughts. Few participants recorded that either suicidal behaviour or self‐harm might include an emotional component. Those that did, described emotions such as feeling depressed, flat affect, and feelings of hopelessness. Eleven participants also mentioned high‐risk behaviour, such as substance abuse or reckless behaviour that is potentially life‐threatening, in their descriptions of self‐harm, while such behaviours were absent from the descriptions of suicidal behaviour.

Finally, nine participants provided views on the motives that may underlie suicidal behaviour and 25 suggested motives underlying self‐harm. Again, differences in reported motives for suicidal behaviour and self‐harm were observed, χ² (df = 4) = 19.45, p < .001. Sixteen participants specified that self‐harm served the purpose of emotional regulation or as a coping strategy. Those that suggested motives for suicidal behaviour indicated that it may result as an attempt to relieve hopelessness or as a relief from psychological distress or pain.

Knowledge of self‐harm

Participants generally demonstrated high levels of knowledge about self‐harm (M = 17.16, SD = 1.67). No participant scored below 14 on this measure (see Table-2). Knowledge of self‐harm was positively related to experience with clients who self‐harm, r = 0.26, p = .048, and experience with suicidal clients, r = 0.26, p = .046. Participants who had experience with self‐harming clients (M = 17.29, SD = 1.71) achieved significantly higher knowledge scores than those who had no recent experience with these clients (M = 15.83, SD = 1.17); t (56) = −2.03, p = .048.

Table 2 Knowledge of self‐harm

Item	True (n)	False (n)	% correct
1. Self‐harm is a form of communication	62	6	91.18
2. Self‐harm is a manipulative act	24	43	64.18
3. Self‐harm is a coping strategy	66	1	98.51
4. Self‐harm is a sign of madness	0	67	100.00
5. People who self‐harm will ‘grow out of it’ eventually	8	59	88.06
6. Self‐harm can obtain feelings of euphoria	64	3	95.52
7. Self‐harm is a release for anger	61	5	92.42
8. Self‐harm is a ‘woman's problem	0	68	100.00
9. Self‐harm helps to deal with problems	38	30	55.88
10. Self‐harm is a response to sexual abuse	19	47	28.79
11. Self‐harm provides a way of staying in control	58	9	86.57
12. Self‐harm is a failed suicide attempt	0	68	100.00
13. Self‐harm is attention‐seeking	14	54	79.41
14. Everybody who self‐harms suffers from Munchausen's disease	0	68	100.00
15. Self‐harm provides a distraction from thinking	59	8	88.06
16. Self‐harm is an expression of emotional pain	67	0	100.00
17. People who self‐harm should be kept in psychiatric hospitals	1	66	98.51
18. Self‐harm helps a person maintain a sense of identity	42	25	62.69
19. Self‐harm provides an escape from depression	47	21	69.12
20. The best way to deal with people who self‐harm is to make them stop	2	66	97.06

Attitudes to self‐harm and suicide

The same generally positive attitudes were found with the ATDSHQ; participants achieved a mean score of 74.90 (SD = 5.57). Similarly, results of the factor scores on the Suicide Opinion Questionnaire demonstrate that participants held generally positive attitudes towards suicide (see Table-3).

Table 3 Descriptive statistics and correlations between attitudes towards suicide and self‐harm

	Mean (SD)	1	2	3	4	5	6	7	8	9	10	11	12	13	14
1. Age	43.28(10.75)
2. DSH knowledge	17.16(1.67)	−0.10
3. Years of experience	9.95(8.51)	0.60***	−0.01
4. SOQ: mental illness	39.47(4.81)	−0.07	0.04	0.02
5. SOQ: not real	39.48(3.54)	−0.16	0.24*	−0.24	0.18
6. SOQ: right to die	21.98(4.39)	−0.34**	−0.02	−0.26*	−0.04	−0.03
7. SOQ: religion	25.84(3.42)	−0.19	0.12	−0.05	0.27*	0.31**	−0.13
8. SOQ: impulsivity	21.22(2.30)	0.03	0.03	0.01	0.04	0.16	0.14	0.15
9. SOQ: normal	20.31(2.96)	−0.23	−0.16	−0.24	−0.17	−0.09	0.65***	−0.11	0.12
10. SOQ: anger	20.59(3.15)	−0.19	−0.00	−0.18	0.28*	0.24*	0.27*	0.23*	0.20	0.17
11. SOQ: morally bad	17.03(1.92)	0.01	0.16	0.07	0.05	0.33**	−0.26*	0.47***	0.00	−0.23*	0.14
12. Confidence	22.5(2.11)	−0.30*	0.14	−0.32*	−0.24*	−0.03	−0.02	0.17	−0.16	0.14	0.10	0.08
13. Effectiveness	18.51(3.03)	−0.02	0.13	0.16	0.03	0.21	0.10	0.14	−0.14	−0.11	0.12	0.21	−0.07
14. Empathy	16.56(1.64)	−0.01	0.07	0.02	−0.04	0.24*	0.17	−0.06	−0.12	0.12	0.08	0.26*	0.06	0.47***
15. Regulations	17.05(2.21)	0.20	0.10	0.23	−0.19	0.12	0.14	0.04	−0.01	0.03	0.03	0.11	−0.06	0.38***	0.38***

Note. DSH = deliberate self‐harm; SOQ = Suicide Opinion Questionnaire.

* p < .10,

** p < .05,

*** p < .01.

Relationship between clinical experience and attitudes

Contrary to expectations, age and years of professional experience were not related to total scores reflecting attitudes to self‐harm, attitudes to suicide, or knowledge of self‐harm. However, both age and years of experience were related to perceived confidence in assessment and referral of self‐harm clients (attitude to self‐harm) and the right to die (attitude to suicide). Overall, younger, less experienced psychologists were more confident in their assessment and referral of self‐harming clients than their older, more experienced counterparts. This younger, less experienced group were also more likely to support the idea of a client having the right to choose when to die than older, more experienced practitioners were. Attitudes towards suicide and self‐harm appeared unrelated to each other.

The number of clients psychologists saw in the last month who were exhibiting suicidal behaviour was positively associated with perceived effectiveness in treating self‐harm, r = 0.31, p = 0.02, while the number of clients exhibiting self‐harm over the previous 6 months was associated with a general empathic approach to such clients, r = 0.27, p = 0.03. The number of previous clients was not related to any other attitude or knowledge variable.

DISCUSSION

This study was designed to measure the general attitudes towards suicide and self‐harm held by Australian psychologists. It was also intended to determine if variables such as age, years of professional experience, and experience with suicidal and/or self‐harming clients were related to knowledge of and attitudes towards suicide and self‐harm. As attitudes have been shown to affect practitioners' behaviour towards suicidal and self‐harming clients, it was essential that a clear understanding of the attitudes held by Australian psychologists be developed. The current study found that younger, less experienced psychologists were more confident in their ability to treat someone who self‐harms and were also more favourably inclined to an individual's right to die. Conversely, experience with a larger number of clients exhibiting these behaviours was related to greater confidence in treatment and a more empathic attitude towards these clients.

A secondary aim was to explore how psychologists viewed suicidal behaviour and self‐harm and the basis on which they distinguished these behaviours. It was clear from the responses that the majority of participants did differentiate between suicidal behaviour, which involves intent to die, and self‐harm, in which suicidal intent is often absent. Participants were clear to make this distinction, with the vast majority of participants explicitly stating that self‐harm did not involve suicidal intent. In addition, participants were more likely to include suicidal thoughts as an aspect of suicidal behaviour, while this was rarely mentioned in relation to self‐harm.

That psychologists in this sample made a clear distinction between suicidal behaviour and self‐harm bodes well for future research in this area. Traditionally confusion regarding the definition and measurement of these behaviours has confounded the literature, making comparisons across studies and assessment of accurate prevalence rates difficult (DeLeo, Burgis, Bertolote, Kerkhof, & Bille‐Brahe, 2006). The current results suggest that clinicians are aware of distinct motives underlying these behaviours and presumably tailor their treatment accordingly. However, despite making the distinction between suicidal behaviour and self‐harm, participants' perceived effectiveness in treating self‐harm was related to their experience with suicidal clients. It was unfortunate that actual treatment response was not assessed in the current study in order to confirm this. Future research would benefit from examination of whether treatment practices are related the conceptualisation psychologists have of these behaviours.

In both the present and previous research (Crawford et al., 2003; McCann et al., 2007), health professionals were found to agree with concepts such as the normalcy and acceptability of suicide, as well as clients being able to choose when to die. As research in this area has shown that health professionals who have training in mental health display more positive attitudes than practitioners without this training, it was anticipated that psychologists would have high scores on both attitudinal measures. Participants' responses also indicated that while they agreed with the client's right to die, suicide could be an impulsive act and one that was a reflection of the person's own aggression or anger.

A caution must be made that negative attitudes towards suicide, suicidal behaviour, and self‐harm must not automatically be labelled as ‘wrong’ or ‘incorrect’; likewise, positive attitudes are not necessarily ‘correct’. It is the influence of these attitudes on a practitioner's behaviour that is of concern. If negative attitudes lead to mismanagement of clients or an underestimation of suicide risk, then they are of great concern and must be addressed quickly (Herron et al., 2001). Similarly, negative attitudes and stigma reduce help‐seeking among people who self‐harm (Hurry & Storey, 2000), limiting opportunities for early intervention. Regardless of whether practitioners hold favourable attitudes towards suicide and self‐harm, a positive attitude towards the client is paramount to ensuring effective and empathic care.

Results obtained by this study have shown that the variables related to attitudes held by psychologists (e.g., length of experience, experience with self‐harming/suicidal clients) are similar to the variables that influence the attitudes of practitioners from other health professions (Anderson, 1997; Friedman et al., 2006). The finding that younger practitioners perceived themselves as more confident in assessment and referral of clients is of particular interest. It is a little concerning that less experienced psychologists appear more confident, as this may indicate an inflated sense of efficacy. An overestimation of clinical skills or ability to treat high‐risk clients could arguably lead to a greater number of errors or oversight of important clinical information. When dealing with clients who engage in suicidal behaviour and self‐harm this is particularly concerning.

One explanation for this finding may be related to more recent training received by more junior clinicians. With more recent training, suicide risk assessment and treatment strategies may more readily come to mind and thus result in increased confidence in how to treat these clients. This accords with the finding that psychologists with more direct experience working with suicidal and self‐harming clients felt more confident in their ability to do so. It is also possible that as self‐harm is apparently increasing in prevalence (De Leo & Heller, 2004; Klonsky, Oltmanns, & Turkheimer, 2003), more junior psychologists are seeing more clients who self‐harm, although in the current study length of time working in the profession and number of suicidal or self‐harm clients were not related. Further study of attitudes towards suicide and self‐harm held by psychologists could assist in developing more comprehensive vocational training for both psychologists and other health professionals (e.g., nurses working in emergency departments; Botega et al., 2007), particularly those working with suicidal and self‐harming clients.

One limitation of the current study was the small sample size obtained. While the overall sample size was sufficient for the analyses performed here, further investigation with a larger, more representative sample would confirm the findings reported. Of note, the sample comprised an extremely small percentage of APS members, perhaps reflecting a response bias in this sample. Similarly, although we aimed to minimise bias with the use of an anonymous questionnaire, it is possible that participants felt compelled to respond in a socially desirable fashion. The high rate of practitioners who had experience with suicidal and self‐harming clients also indicates that those who chose to participate were particularly interested in this area of research. Further research with a more representative group of psychologists, as well as other allied health professionals, is clearly warranted. As noted above we were unable to examine the way in which psychologists interact with clients who exhibit suicidal or self‐harming behaviour, or to explore their treatment responses. As such we are unable to determine whether attitudes relate to behaviour.

The study presented here focused exclusively on Australian psychologists' knowledge of and attitudes towards suicide and self‐harm. While the link between attitudes and behaviour has been shown both theoretically and empirically for other professions, the current study does not attempt to make any such connection for psychologists. The need for future research to address the attitude–behaviour link in the psychological profession is strong, as any aspect of a practitioner that impacts upon a client's recovery process must be thoroughly understood.