Evaluation of Creative Materials Supporting Healthcare Professionals in Discussing Suicidality in Children and Adolescents

Preliminary research clearly indicates a significant shortage of evidence-based tools and interventions specifically targeting suicidality among children and adolescents. The need for such methodologies is substantial, as suicidal ideation and suicide attempts are relatively common within this age group. According to the 2022 Health Behaviour in School-aged Children (HBSC) study, 16% of boys and 28% of girls aged 13 to 18 reported having had suicidal thoughts on two or more occasions in their lifetime (Schrijvers et al., 2023). Compared to the previous HBSC study conducted in 2018, this represents a negative trend, as 13% of boys and 22% of girls reported suicidal thoughts at that time (Dierckens et al., 2019).

Facilitating open discussions about suicidal thoughts is therefore of critical importance. Research has shown that discussing suicidality does not increase suicidal behavior; rather, it can contribute to a reduction in risk (Blades et al., 2018; Dazzi et al., 2014; DeCou \& Schumann, 2018; Polihronis et al., 2022). Breaking the taboo around suicidality and attuning to the emotional experiences of children and adolescents may serve as an initial step toward providing effective support. Such openness can help reduce feelings of loneliness and isolation by fostering a safe environment in which young people feel heard and understood. Moreover, the act of speaking openly about suicidality is associated with increased social support-an important protective factor (Batty et al., 2018; Calati et al., 2019).

In 2023, a project was launched aimed at developing creative materials to support professionals in initiating conversations about suicidality with children and adolescents. This material is being developed through a co-creative process (EC code: ONZ-2024-0211), in collaboration with youth care professionals, method developers, and young individuals with lived experience of suicidal thoughts. These young people provide essential contributions to ensure that the materials are aligned with their needs and expectations for support. This co-creative approach aims not only to produce a theoretically grounded methodology, but also to yield a practically applicable tool that effectively addresses the real-world challenges faced by both professionals and youth. The creative materials are currently under development and are designed to facilitate exploration and discussion of suicidality, ultimately supporting professionals in formulating a risk assessment and developing a Safety Plan. This approach aligns with the recommendations outlined in the guideline "Detection and Interventions for Suicidal Thoughts and Behaviors in Children and Adolescents" (Dumon et al., 2023).

The next phase of the project focuses on evaluating the creative materials. The evaluation aims to gain insight into their usability and applicability in professional practice. This will be conducted through an evaluation study. Professionals working in Flanders will be recruited via calls on www.zelfmoord1813.be, relevant partner organizations, social media, and newsletters from VLESP and other partners. Additionally, professionals may be invited via email. Those who have used the materials over a three-month period will be asked to retrospectively share their experiences. The study consists of the following steps:

Registration: Eligible professionals complete a short registration form (duration: approximately 5 minutes).

Use of the creative materials: Participants use the materials in their professional context over a period of three months.

Post-assessment: At the end of the three-month period, participants complete a questionnaire regarding their experiences with the materials (duration: approximately 10-15 minutes).

The post-assessment focuses on evaluating user-friendliness, practical applicability, and the potential of the creative materials to facilitate conversations about suicidality. Collected feedback will be used to further refine and optimize the materials. If participants do not complete the post-assessment promptly, they will receive reminder emails after 2 and 4 days. The target sample size for the study is 40 participants.