(PS9-B27) Helpful or Harmful? Examining Perceptions of Suicide Intervention Strategies Among Appalachian College Students Who Have Experienced a Suicidal Crisis

Introduction: Suicide is among the leading causes of death in the United States. In Central Appalachia, the suicide rate is roughly 25% higher than the national average. In a nationally representative survey from 2020, 78% of respondents expressed interest in learning how to help someone who may be feeling suicidal. The intervention strategies people use when trying to provide help for suicidal crises vary. Evaluating how various strategies are experienced by people in crisis could help inform suicide prevention and intervention efforts. This study aims to identify what responses are typically perceived as helpful or harmful by people who have experienced a suicidal crisis.

Method: Data were taken from an ongoing mixed methods study examining college students’ help-seeking experiences for suicidal crises. The current sample (n = 17) includes college students from a mid-size university in South Central Appalachia (M_age = 19.1, SD = 1.2, 76.5% female, 70.6% White, 52.9% LGBTQ+) who endorsed having at least one prior suicidal crisis (64.7% experienced active suicidal ideation with plan and intent, 41.2% attempted suicide). Participants responded to open-ended questions about perceived helpfulness of different responses to their suicidal crisis, as well as one question about what should be done to make it easier for individuals with suicidal ideation to talk about it. Following this interview, participants completed a series of self-report measures, including one measure created by the research team that asked participants to rate the helpfulness or harmfulness of 24 typical suicide intervention responses on a 5-point Likert scale (1 = very harmful, and 5 = very helpful). Descriptive statistics and thematic analysis were used to explore participants’ perceptions of each response.

Results: Responses that participants consistently rated as the most helpful included: not being judged for the way they felt (M = 4.94, SD = 0.24), being listened to respectfully (M = 4.82, SD = 0.39, and being supported during a difficult time (M = 4.82, SD = 0.39). Responses that participants consistently rated as harmful included: being told suicide is a sin (M = 1.24, SD = 0.75), being told to think about something else (M = 1.24, SD = 0.56), and being told suicide is a selfish act (M = 1.41, SD = 1.00). As this study is still ongoing, final results including thematic analysis will be reported at the time of presentation.

Discussion: Our participants’ ratings of helpful and harmful responses to suicidal crises are consistent with the current literature. Many strategies promoted in suicide prevention resources (e.g., listening and providing support) were identified as helpful, while strategies typically discouraged in the literature (e.g., no suicide contracts) were identified by our participants as harmful. A notable strength of this study is that we asked members of a high-risk group that is underrepresented in the current literature (i.e., young adults in Central Appalachia, many with LGBTQ+ identities) who had lived experience with suicidality about their perceptions. Future research should investigate particular contexts (e.g., formal vs. informal sources of support) that contribute to whether intervention strategies are experienced as helpful or unhelpful.