Translating Learning from Patient Deaths by Suicide into Practice

In this course, Colette Ramsey, research assistant at Ulster University, observes that, while some “good work” is occurring to implement recommendations from the Serious Adverse Incident (SAI) reviews completed after patient deaths by suicide in Northern Ireland, there are problems with the recommendations being implemented – and also with the evaluations of those recommendations which are implemented. Ramsey’s Ph.D. research examines how such recommendations can contribute to reducing deaths by suicide of people in the care of mental health services. Her Phase 1, a systematic literature review, turned up four overarching themes which are discussed throughout the talk. While recommendations abound, few studies examine how implementation and evaluation of them have gone, limiting the translational value of the recommendations. Phase 2 of the research was a data analysis of SAI reports, with Phase 3 being comprised of focus groups, whose meetings yielded five themes. Ramsey discusses the recommendations that emerged within each of the themes.