18/138 Suicide prevention in high risk groups
Please note: The Public Health Research (PHR) Programme would like to draw researchers’ attention to the commissioning brief below, which was first advertised in Autumn 2018. This is a brief that we have previously advertised as a commissioned funding opportunity. We are still interested in receiving applications in this research area, as it remains a priority in our portfolio. However, please note that the commissioning brief, along with the underpinning literature searches, has not been updated since originally written.
• Which interventions, aimed at people at high risk of suicide, are effective* in reducing the rate of suicide and suicide attempts?
In the UK approximately 6,000 people take their own life each year, and for every suicide there are many more people who attempt suicide. Certain factors are known to be associated with increased risk of suicide, these include: drug and alcohol misuse, history of traumatic life events or abuse, self-harm, unemployment, social isolation, poverty, poor social conditions, imprisonment, learning disabilities, violence and family breakdown. Evidence also suggests that there is a significant association between socioeconomic disadvantage and suicidal behaviour.
Certain population groups are known to be at higher risk of suicide. Risk of suicide attempt, suicidal ideation and self-harm are high among young people, and suicide is the leading cause of death among people in the UK aged 20-34 years. The highest suicide rate in the UK is for men aged 40–44 years. Other high risk groups include people: who are economically disadvantaged, who have attempted suicide, in certain occupations, in contact with the criminal justice system, in contact or have been in contact with mental health services, LGBT teens and young adults, and in some cultural and ethnic groups. There is growing evidence of the impact of online and social media on suicide risk.
The Public Health Research programme wishes to commission research to identify which interventions, aimed at people at high risk of suicide, are effective* in reducing the rate of suicide attempts and suicide. Interventions could come from the statutory or voluntary sectors. Examples may include:
- Interventions to prevent suicide in high risk groups, which may be defined by gender, age, ethnicity, occupation and/or other factor(s)
- Interventions to prevent suicide in those in contact with the criminal justice system (a single setting or a range of custodial settings may be considered)
- Interventions to prevent suicide in those in contact or who have been in contact with mental health services, including in secondary, primary and community care settings
- Interventions to prevent suicide by restricting access to the means of suicide
- Interventions to increase levels of support to those in different forms of crisis
Outcomes of interest may include suicide, attempted suicide, or suicidal ideation. Growing the evidence in specific sectors such as the transport (road network) or other social factors such as gambling addiction. Researchers are encouraged to consider other outcome measures, which should be specified and justified.
Studies should generate evidence to inform the implementation of single or multi-component interventions. Studies may include evidence syntheses, studies evaluating interventions, including trials, quasi- and natural experimental evaluations, and feasibility and pilot studies for these. We welcome applications for linked studies (e.g. pilot + main evaluation). Secondary analyses of existing epidemiological data and/or impact modelling studies may also be funded. We encourage the adoption of a systems perspective where appropriate to the study context. In all cases a strong justification for the chosen design and methods must be made.
The primary outcome measure of the research, if not necessarily the intervention itself, must be health-related. The positive or negative impacts of the intervention, including inequitable outcomes should be considered. Researchers are asked to indicate how long-term impacts will be assessed. All applications should identify underlying theory and include a logic model (or equivalent) to help explain underlying context, theory and mechanisms. Proposals should ensure adequate public involvement in the research.
The impacts of public health interventions are often complex and wide-reaching. Studies should acknowledge this by adopting a broad perspective, taking account of costs and benefits to all relevant sectors of society. An appropriate health economic analysis to inform cost effectiveness, affordability or return on investment should be included where appropriate.
For all proposals, applicants should clearly state the public health utility of the outcomes and the mechanisms by which they will inform future public health policy and practice. Details about the potential pathway to impact and scalability of interventions, if shown to have an effect, should be provided, including an indication of which organisation(s) might fund the relevant intervention(s) if widely implemented.
** ‘Effectiveness’ in this context relates not only to the size of the effect, but it also takes into account any harmful or negative side effects, including inequitable outcomes.
Remit of Call
All proposals submitted under this call must fall within the remit of the NIHR Public Health Research (PHR) Programme. For the evaluation of time sensitive, policy driven, interventions applicants may wish to consider the fast-track work stream.
Notes about NIHR and the PHR Programme
The PHR Programme funds research to generate evidence to inform the delivery of non-NHS interventions intended to improve the health of the public and reduce inequalities in health. Our scope is multi-disciplinary and broad, covering a wide range of interventions that improve public health.
The primary aim of the programme is the evaluation of practical interventions. We will fund both primary research (mainly evaluative, but also some preparatory research) and secondary research (evidence synthesis); precise methods will need to be appropriate to the question being asked and the feasibility of the research.
Our research serves a variety of key stakeholders including: decision-makers in local government; primary care organisations and other local public services; third sector organisations; relevant national agencies (e.g. NICE) concerned with improving public health and reducing health inequalities; researchers; public health practitioners and the public.
Applicants should consider how their findings will impact upon decision making in public health practice, whether results are generalisable to other populations and affordable, setting out a clear pathway to impact. The NIHR PHR Programme recognises that there is a need for an evidence base for disinvestment and that the removal of an intervention from a population can be worthy of evaluation.
The affordability of the intervention, and at least an indication of the stakeholder(s) willing to fund the intervention, should be referenced within the stage 1 application. At the stage 2 application point, statements of support confirming stakeholder commitments to funding will be required. Applicants should be aware that the NIHR PHR programme is unable to fund intervention costs.
The NIHR PHR Programme is open to the joint funding of research projects with other organisations such as those in the third sector. If you would like to explore the potential for joint funding, please contact us at firstname.lastname@example.org with details of your proposal and the other funder prior to submission.
All of our funded projects are eligible for publication in the NIHR Journals Library. This open access resource is freely available online, and provides a full and permanent record of NIHR-funded research.
Notes to applicants
The NIHR PHR Programme is funded by the NIHR, with contributions from the CSO in Scotland, Health and Care Research Wales, and HSC R&D, Public Health Agency, Northern Ireland. Researchers in England, Scotland, Wales and Northern Ireland are eligible to apply for funding under this programme.
Applicants are recommended to seek advice from suitable methodological support services, at an early stage in the development of their research idea and application. The NIHR Research Design Service can advise on appropriate NIHR programme choice, and developing and designing high quality research grant applications.
The NIHR Clinical Research Network (CRN) supports health and social care research taking place in NHS and non-NHS settings. The CRN provides expert advice and support to plan, set up and deliver research efficiently.
Clinical Trials Units are regarded as an important component of many trial applications however, they are not essential for all types of studies to the PHR Programme. The CTUs can advise and participate throughout the process from initial idea development through to project delivery and reporting. NIHR CTU Support Funding provides information on units receiving funding from the NIHR to collaborate on research applications to NIHR programmes and funded projects. In addition, the UKCRC CTU Network provides a searchable information resource on all registered units in the UK, and lists key interest areas and contact information.
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