From Taxi Drivers to Copilots: A Reflexive Thematic Analysis with Relatives Discussing How to Enhance Person-Centeredness in Suicide Preventive Care

Previous studies on suicide prevention in healthcare settings highlight the benefits of including multiple stakeholders in the co-creation of care. However, relatives' perspectives have received little attention in this context. This study aims to elucidate the experiences of relatives of persons with healthcare contacts due to suicidal issues and to gain insights into how to enhance person-centeredness in suicide preventive healthcare. A total of 31 relatives of 27 suicidal individuals, 21 of whom had died by suicide, were included. Focus group methodology was employed; each interview was audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis by Braun and Clarke. Four themes were generated: (1) An underutilized resource, (2) Rigid, fragmented systems, (3) Copilots, not taxi drivers, and (4) Prerequisites for enhancement of person-centeredness. The analysis highlights that active involvement of relatives can provide vital collateral information, enhancing self-care initiatives during stable periods, and facilitating timely treatment during acute exacerbations. A person-centered system was described as fair, with structures that value relatives' expertise and encourage contributions from all stakeholders. Above all, trustworthiness, coherence and transparence were viewed as essential in person-centered suicide prevention.