Key points

• • This chapter disrupts the academy by explaining how the experiences of people with lived experience of suicidal ideation should be considered and addressed in collaborative research on this topic.

• • People with lived experience must have agency and equality with project team members throughout the research and co-design processes, with the same people with lived experience involved throughout.

• • We should be encouraged to share our experiences to challenge traditional research-based and practice paradigms that often fail to legitimise subjective experience and experiential insight.

• • Suicide should not be viewed as a disease in search of a cure. Given the life experiences and circumstances of individuals with suicidal ideation, it can seem to be a perfectly rational choice, and their reality must be validated and respected as ‘normal’ before help is offered.

Introduction

Suicide is the leading cause of death for Australians aged 15 to 44 years (Australian Bureau of Statistics, 2020). Between 50 and 60 per cent of individuals who die by suicide ‘fly under the radar’, that is, without receiving formal mental health care (Johnston et al, 2009). Most have been in contact with services for physical health issues in the days or months preceding an attempt but did not receive help for their suicidal thoughts or mental health problems (Stene-Larsen and Reneflot, 2019). Little is known about individuals at risk of suicide who are not receiving mental health care.

In 2021, the Black Dog Institute, a mental health research organisation in Sydney, Australia, undertook a four-year research project to develop a person-centred service for individuals at risk of suicide but not in care. The project consisted of multiple phases and several stakeholders including a project manager, institute research teams, a design team, a lived experience team and representatives from external organisations. The project aimed to adhere to a co-design methodology and a governance structure was created with a Core Co-Design team established at the outset. At the time of writing this chapter (August 2022), the first three phases had been completed.