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Ee Xuan Ngeyu

Creating an Audit Tool for Suicide Prevention


May 2021- July 2021

Fuse (Teeside University)


Jill Barker, Emma Giles

Undergraduate Degree

Medicine and Surgery MBBS

Ee Xuan's internship outputs

Ee Xuan internship blog

Suicide prevention is an important topic which I regularly come across during my medical training. The need for good quality suicide prevention training is apparent; this includes professionals, volunteers, lay workers, and the public. Ideally, everybody should have the confidence to have an a, informed conversation about suicide with someone who needs help.

The North-East suffers from disproportionately high rates of self-harm and suicide [1]. To combat this, the North East and North Cumbria Suicide Prevention Network commissioned a project at Teesside University with the aim of producing a framework to quality assure suicide prevention training across the region, which lets suicide prevention training providers monitor and improve their services.

I enjoyed the privilege of joining the team at Teesside University during my NIHR Internship, during which I scoped existing literature on the topic, reviewed the Health Education England Self-harm and Suicide Prevention Competence Framework [2], conducted research interviews, and subsequently transcribing, extracting, and performed thematic analysis of the interview data. We drew upon these separate streams of work to inform our prototype of the quality assurance framework for suicide prevention training.

We found, from our scoping review, a lack of explicit evidence of involvement from people who have been affected by self-harm and suicide in the design and delivery of training. We therefore conducted interviews with people with lived experience of suicidality to understand their views on what good quality suicide prevention training should include. We also interviewed Suicide Prevention Training Providers to understand their views on the development of a quality assurance framework to ensure the relevance and usability of our e framework.

In our scoping review and interviews, we found that we cannot make assumptions about healthcare professionals about their comfort, attitudes, skills, and knowledge in dealing with suicide prevention. While a degree of flexibility in suicide prevention training as dictated by the trainee’s job description is welcomed by our interviewees, it is still ultimately paramount that everyone receives training that addresses a minimum level of competence across all levels of suicide prevention training.

Another notable finding from these interviews highlights the importance of having good communication skills in conversations surrounding self-harm and suicide. Our interviewees observe that, while it is important to be informed with knowledge around self-harm and suicide, the role of empathy and good communication skills becomes more apparent when they are talking to someone who needs help. It is important to dispel the myth that bringing up the topic of self-harm and suicide does not predispose someone to suicide.

During our interviews, we discovered that some training providers find the Health Education England Self-harm and Suicide Prevention Competence Framework extremely complicated, which may explain the lack of evidence in our scoping review for the reference to these competences in suicide prevention training. I therefore took the initiative to map this text-heavy document onto a user-friendly Excel tool.

This tool provides trainers with a live overview of how their training programme adheres to the official competences. This lets them effectively identify areas for improvement in between audit cycles, which subsequently encourages targeted corrective actions when making improvements to the delivery of their training.

Over these six weeks, I have explored my interest in public health, developed my set of research skills and, most importantly, contributed to a cause which I deeply care about. This project has been unique in its nature, in which was directly involved with the production of a specific tool to inform and enhance practice, instead of the norm for myself, which is a research paper. Through this, I have gained a fresh perspective on the breadth of Public Health Research. I particularly appreciated the involvement of Experts by Experience in our project, which lends itself to the practice of co-production of research, a process I find very similar to the concept of shared decision making between doctors and patients in Medicine. Despite the remote nature of this internship, I felt well-supported by my supervising team and the NIHR network while achieving my personal and career goals throughout. I would strongly recommend it to anyone who looks to do the same.



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