Vol.:(0123456789) 1 3 Social Psychiatry and Psychiatric Epidemiology https://doi.org/10.1007/s00127-018-1582-2 ORIGINAL PAPER Confidence and attitudes of pharmacy students towards suicidal crises: patient simulation using people with a lived experience Evelyn A. Boukouvalas 1  · Sarira El‑Den 1  · Timothy F. Chen 1  · Rebekah Moles 1  · Bandana Saini 1  · Alison Bell 2  · Claire L. O’Reilly 1 Received: 7 May 2018 / Accepted: 20 August 2018 © Springer-Verlag GmbH Germany, part of Springer Nature 2018 Abstract Purpose Health care professionals, including pharmacists, have the potential to recognise and assist those at risk of suicide. The primary aim of this study was to assess the impact of utilising people with a lived experience of mental illness as simu- lated patients on final year pharmacy students’ attitudes toward and confidence in caring for people at risk of suicide after first receiving Mental Health First Aid (MHFA) training. Methods A parallel group repeated measures design was used. People with a lived experience of mental illness enacted patients experiencing a mental health crisis, including possible suicidal ideation. Following MHFA training, the first group directly participated in the simulation, the second group observed, and the final group had no exposure to the simulation. Validated surveys measuring student attitudes and confidence were conducted at three time points; pre and post MHFA, and then at 2–4 weeks follow-up. Results Full datasets of survey responses were received from 34/40 direct participants (85%), 104/146 observers (71%) and 50/66 comparison students (76%). Mean confidence scores significantly improved for all groups post MHFA training (p < 0.05). At follow-up, all 8 confidence items for the direct participant and observer group maintained significance from baseline to post intervention (p < 0.05). Mixed results in relation to attitudes towards suicide were evident at each time point and among each participant group. Conclusions Utilising people with a lived experience of mental illness as simulated patients has a positive effect on sustaining pharmacy student confidence in discussing suicidal behaviour post MHFA training. The inconsistency in attitudes towards suicide suggests that attitudes are complex in nature, involving multiple dynamic influences. Keywords Suicide · Healthcare personnel · Attitudes · Confidence · Simulated patients Introduction The increasing rate of suicide, death which is highly prevent- able, is a significant global issue. According to the World Health Organisation, suicide was the second leading cause of death globally among 15–29 year olds in 2012 [1]. Within the Australian context, suicide was the leading cause of death among those aged 15–44 years, and the second leading cause of death among those aged 45–54 years, in 2015 [2]. Despite the development of numerous suicide prevention strategies such as awareness campaigns, educational initia- tives and increasing access to services, suicide rates remain high in Australia. In light of this information, it is appar- ent that there are multiple misconceptions regarding the nature of suicide including its preventability, and thus varied approaches to suicide prevention are required [3]. Health care professionals (HCPs), such as community pharmacists are uniquely placed as they may encounter patients experiencing mental health problems and crises such as suicidal thoughts and behaviours [4, 5]. Their acces- sibility potentially allows pharmacists to recognise warn- ing signs of mental health problems, and effectively direct patients to appropriate professional and personal care [6, 7]. However, as with other HCPs and the general public, * Claire L. O’Reilly claire.oreilly@sydney.edu.au 1 The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Pharmacy and Bank Building A15, Sydney, NSW 2006, Australia 2 One Door Mental Health, Gladesville, NSW, Australia