Suicidal ideation, homicidal ideation, and self-harm in parent carers.

Background Emerging research suggests family carers are a high-risk group for suicide, homicide, and self-harm. Only three studies, however, have focused on parent carers and none were conducted in the UK.

More than 800,000 children in the UK have disabilities and long-term illnesses and the majority are cared for by their parents.

Aims and Objectives Aim: Conduct the first UK study of suicidal ideation, homicidal ideation, and self-harm in parent carers. Objectives: Estimate the rate of suicidal ideation, suicide attempts, and self-harm. Identify risk and protective factors for suicidal ideation, suicide attempts, and self-harm.

Explore the lived experience of suicidal ideation and attempts, homicidal ideation and attempts, and self-harm. Identify carers recommendations for research, practice, and policy.

Provide a foundation for sensitive, evidence-based initiatives for at-risk carers and the social care professionals who support them. Methods The study has a sequential explanatory mixed-methods design, with two interrelated stages. It was co-created with parent carers and social care professionals.

Four carers are co-investigators. Stage One: A cross-sectional survey of 1,000 parent carers.

The survey will include questions on parent and child demographics, the nature and extent of the disability/illness, and the nature and extent of care provision, plus measures of suicidality, self-harm, and psychosocial variables. For legal and ethical reasons, questions about homicidal ideation and attempts will be included in Stage Two only.

Descriptive analyses will identify rates of suicidal ideation, suicide attempts, and self-harm.

Independent t-tests and chi-square tests will identify differences between suicidal and non-suicidal carers, and self-harming and non-self-harming carers. Regression analyses will identify risk and protective factors. Stage Two: In-depth interviews with 20 parent carers. The topic guide will be informed by existing research and preliminary analysis of the survey data.

Interviews will be audio recorded and transcribed verbatim.

Transcripts will be analysed using case-centred, narrative thematic analysis to: understand lived experience; identify critical situations and turning points in the caring journey related to suicide, homicide, and self-harm; and, identify carers recommendations for research, practice, and policy.

Safeguarding and risk response protocols will ensure the safety and wellbeing of carers, care recipients, and the research team.

The team has experience conducting research on sensitive topics and with vulnerable populations, and their previous research has informed policy and practice. Timeline & Support The study will take 24 months. A Parents and Partners Network and an Advisory Group will provide strategic guidance and support.

Dissemination & Impact The findings will be published in academic journals and presented at a childhood disability conference.

Lay summaries, policy briefings, short films, mainstream media, and social media will be used to disseminate the findings to government departments, clinicians, social care providers, schools, charities, and carers.

This will: raise awareness; encourage help-seeking; strengthen advocacy; facilitate reviews of existing policy and practice; and provide justification and recommendations for additional support for at-risk parent carers.

A subsequent application for an NIHR Programme Grant will support the development, evaluation, and implementation of sensitive interventions for at-risk carers and training for social care professionals.