Table 2 The list of included studies

Vatne & Nåden, 2016 [38]. Norway

To develop a deeper understanding of suicidal patients in the aftermath of suicide attempts

Ten patients considered with serious suicidality after a suicide attempt. Non-psychotic. Interviewed after suicide attempt.

Two emergency psychiatric wards and one crisis resolution team.

Semi-structured interviews. Analysed using thematic analysis inspired by Braun and Clarke. Gadamerian hermeneutic approach.

• Connectedness, someone who cares

• Hospital admission important for staying alive

• Support from family and friends

Lees, Procter and Fassett, 2014 [26]. Australia

To explore the experiences and needs of mental health-care consumers who had a suicidal crisis (shortened).

Nine patients recovered from a recent suicidal crisis where they received mental health in-patient care.

Setting not specified. Experiences of psychiatric in-patient care are described.

In-depth, semi-structured interviews collected as part of a larger multi-method study. Analysed with a constant comparative method and classical content analysis.

• Therapeutic engagement central to quality of care

• Isolation, loss of control, objectification

Montross Thomas et al., 2014 [28]. USA

To better understand suicide experiences from the perspective of patients diagnosed with serious mental illness.

23 patients hospitalized after a suicide attempt. Diagnosed with serious mental illness. Interviewed after discharge.

Veterans Affairs Hospital, mental health program.

Qualitative interviews with audio/videotaping. Analysed using van Manen’s phenomenological framework.

• Need for clinicians’ empathy, compassion and listening skills

• Addressing problems underlying suicide attempt

Vatne & Nåden, 2014 [32]. Norway

To explore the experiences of being suicidal and encounters with health care personnel.

Ten patients considered seriously suicidal. Psychosis excluded. Interviewed after suicide attempt.

Psychiatric emergency ward, sub-emergency psychiatric wards and one crisis resolution team.

Semi-structured interviews. Analysed using thematic analysis inspired by Braun and Clarke. Gadamerian hermeneutic approach.

• Openness and trust

• Someone who addresses the matter

• Being met on equal terms, humiliated

Cutcliffe et al., 2012a [41]. Unknown origin.

To better understand the observed increased risk for suicide following discharge from an in-patient psychiatric service. Key theme one.

20 patients admitted to the hospital with suicidal ideation and/or a lifetime history of suicidal behaviour. Interviewed after discharge.

In-patient psychiatric service.

Hermeneutic interviews. Analysed using van Manen’s phenomenology.

• Anxiety to go back to life without having a sense of control

• Need to be involved in discharge planning

Cutcliffe et al., 2012b [42]. Unknown origin.

To better understand the observed increased risk for suicide following discharge from an in-patient psychiatric service. Key theme two.

20 patients admitted to the hospital with suicidal ideation and/or a lifetime history of suicidal behaviour. Interviewed after discharge.

In-patient psychiatric service.

Hermeneutic interviews. Analysed using van Manen’s phenomenology.

• Patients still suicidal at discharge

• Disorientation concerning what to do with their life

• Need for post-discharge support

Pavulans et al. 2012 [27]. Sweden

To explore the experience of being suicidal, including a suicide attempt, and identify possible implications for health care professionals.

Ten patients interviewed after a suicide attempt while hospitalized in a psychiatric ward.

Psychiatric in-patient care at one university hospital.

Semi-structured interviews. Analysed using van Manen’s phenomenology and qualitative content analysis.

• Being in need of control

• Re-establish control before the point of no return

• Control related to problem-solving and insight

Vatne & Nåden, 2012 [29]. Norway

To explore experiences of persons after a suicide crisis or a recent suicide attempt.

Ten patients considered seriously suicidal. Psychosis excluded. Interviewed after suicide attempt.

Psychiatric emergency ward, sub-emergency psychiatric wards and one crisis resolution team.

Qualitative interviews. Analysed using thematic analysis. Gadamerian hermeneutic approach.

• Losing touch with the world

• Someone to see, listen and understand

• Desperation increases with involuntary hospitalization

Holm & Severinsson, 2011 [31]. Norway

To explore how recovery processes facilitate changes in suicidal behaviour in women with borderline personality disorder.

13 patients with suicidal behaviour. Borderline personality disorder.

Recruited from different settings within mental health. Experiences of psychiatric in-patient care were described.

In-depth interviews. Data analysed with thematic analysis.

• Changing suicidal behavior by feeling confirmed, safe, and trusted.

Cutcliffe et al, 2006 [36]. England

To determine if psychiatric/mental health nurses provide meaningful caring responses to suicidal people, and if so, how was it achieved.

20 patients with experiences from a serious suicide attempt.

Crisis care in emergency psychiatric services.

Semi-structured interview. Data analysed with constant comparative method. Glaserian grounded theory approach.

• Reconnecting the person with humanity

• Guiding the individual back to humanity, learning to live

Sun, et al 2006b [25]. Taiwan

Presentation of a nursing care theory developed to guide the care given to people with suicidal ideas and those with a previous suicide attempt.

15 patients with either suicidal ideas or attempted suicide. Interviewed while hospitalized.

Psychiatric hospital ward.

Semi-structured interviews and participant observation. A grounded theory approach.

• Safe and compassionate care giving via the therapeutic relationship

Sun et al, 2006a [24]. Taiwan

To investigate nurses’ and patients’ perceptions of psychiatric wards (the context of care) and the professionals’ response (the intervening conditions) that may impact the delivery of suicidal nursing care.

15 patients with either suicidal ideas or attempted suicide. Interviewed while hospitalized.

Psychiatric hospital ward.

Semi-structured interviews and participant observation. A grounded theory approach.

• Protective environment

• Access to lethal items

• Group support, spiritual support

Talseth, Gilje & Nordberg, 2003 [30]. Norway

To describe a process of consolation revealed by two suicidal patients’ experiences.

Two patients. Interviewed after a suicide attempt (from the Talseth et al., 1999 [34] study).

Psychiatric hospital ward.

Qualitative interviews. Phenomenological hermeneutic study inspired by Ricoeur’s philosophy.

• Vulnerability and deep despair

• Closeness

• Connection

• The dialogue with HCPs

Wiklander, Samuelsson, & Åsberg, 2003 [33]. Sweden

To extract and analyse the interview data concerning experiences of shame.

13 patients with experiences from attempted suicide. Interviewed after discharge.

Specialized psychiatric in-patient care.

Qualitative semi-structured interviews. Transcripts analysed using qualitative methods (not specified).

• Sensitive to attitudes and behaviours of HCPs

• Shame reactions related to aspects of care

Talseth, Jacobsson & Nordberg, 2001 [39]. Norway

To illuminate the experience of being treated by physicians.

21 patients expressing the wish to die or attempted to commit suicide. Interviewed while hospitalized.

Psychiatric emergency wards, psychiatric sub-emergency wards and one psycho-geriatric ward.

Qualitative interviews interpreted using a phenomenological hermeneutic approach inspired by Ricoeur’s philosophy.

• Need for confirmation in interactions with physicians

Samuelsson et al., 2000 [35]. Sweden

To describe the attempted suicide patients’ perceptions of receiving specialized in-patient psychiatric care.

18 patients. Interviewed after a suicide attempt near the time of discharge.

Specialized psychiatric in-patient care.

Qualitative interviews. Analysed for qualitative content using methods inspired by Burnard.

• Perception of care and caregivers, a sense of security

• Confirmation and lack of confirmation

• Commitment and respect

Cardell & Pitula, 1999 [40]. USA

To explore patients’ experience of constant observation to determine whether they derived any therapeutic benefits beyond the intended protective benefit.

20 patients placed under constant observation for suicidality.

Psychiatric hospital ward and a general medical centre with a psychiatric in-patient unit.

Extensive in-depth interviews. Analysis of themes consistent with Hutchinson’s recommended management of grounded theory data.

• Constant observation not merely a protective intervention, but with therapeutic potential.

• Need for engaged and supportive observers

Fletcher, 1999 [43]. UK

To explore the perceptions of staff regarding the constant observation of a suicidal patient in mental health settings.

24 patients at risk for suicide, constantly observed for at least 48 h.

Acute psychiatric hospital.

Ethnographic study with participant observation and semi-structured interviews. Data transcribed onto cards and subjected to content analysis.

• Patients’ negative feelings of being under constant observation related to staff actions

McLaughlin, 1999 [37]. UK

To explore psychiatric nurses’ and patients’ opinions regarding the care offered to suicidal patients and how the care for suicidal patients could be improved.

17 patients admitted for depression, suicidal ideation or overt suicidal behaviour.

Three psychiatric hospital wards.

Observation and semi-structured interview. Data analysed using content analysis by Field and Morse.

• The need to address difficulties

• Help with problem-solving

Talseth et al., 1999 [34]. Norway

To illuminate the meaning of suicidal psychiatric in-patients’ experiences of being cared for by mental health nurses.

21 patients admitted with suicidal ideations or after a suicide attempt.

Psychiatric emergency wards, psychiatric sub-emergency wards and one psycho-geriatric ward.

Qualitative narrative interviews. A phenomenological–hermeneutic method inspired by Ricoeur used in the data analysis.

• Being confirmed

• Lack of confirmation