Psychosocial Barriers Associated With Suicide Risk Assessment and Intervention Among Counsellors in Institutions of Higher Learning in Kenya

Abstract

Background: Suicide is a national as well a global mental and public health crisis claiming one million lives annually yet preventable evidence-informed strategies exist. Kenya’s suicide rate increased by 58% from 2008 to 2018. In both fatal and non-fatal suicidal cases, counsellors in Institutions of Higher Learning (IHL) are in contact with significant number of students prior to, during and post suicidal behaviour. This contact is a good prospect to assess and manage students’ suicidal behaviour. With learning institutions closed or operating virtually thanks to Covid-19 pandemic, in-person counselling sessions have become untenable and new counselling modes have been adapted. Little is known about counsellors’ practices when in contact with suicidal students and their counselling experiences during Covid-19 pandemic. Objective: The study’s main objective was to establish the psychosocial barriers and key professional experiences that are associated with suicide risk assessment and intervention among counsellors in IHL through a qualitative inquiry. Specific objectives included; to qualitatively explore IHL counsellors’ knowledge, attitudes and practices in risk assessment and intervention and finally to identify key themes based on counselling experiences encountered by counsellors in IHL during Covid-19 pandemic. Study design and methods: The study was a qualitative study. Purposive sampling method was used to select participants. Qualitative data was collected by use of semi structured interview guide. Using NVivo Pro 11 software, themes and sub-themes were derived. Findings were presented in the form of themes as well as by verbatim quotations. Results: Three main themes emerged as challenges in suicide intervention, attitude towards suicide prevention and counsellors’ self-care adaptations. With regards to challenges in suicide intervention, respondents identified conflict with breaking confidentiality, delays in patients seeking help thereby causing crisis, lack of proper protocols and guidelines in handling suicide ix cases, the difficulties of handling suicidal clients and use of cognitive behavioural therapy as intervention of choice.