Abstract
BACKGROUND: Promoting bystander interventions is a core strategy to prevent suicides in public places, but little is known about how people with lived experience perceive this intervention. AIMS: To explore people's experiences of receiving an intervention during a suicide attempt on the railways. METHOD: Interviews were conducted with 28 people with experience of receiving a bystander intervention during a suicide attempt on the railways. Interview data were triangulated with an online ethnography exploring posts made on forums and similar platforms openly discussing suicide. RESULTS: Using reflexive thematic analysis, five themes were generated: (a) 'I'm a good actor… we all carry a mask': concealing feelings and intentions; (b) 'It kind of draws your attention away but it doesn't almost shine a spotlight': interventions should be gentle and not draw more attention; (c) 'People that were getting in my way were just making me want to try harder': interventions can trigger difficult feelings in the moment; (d) 'I did feel different, I felt better': the power of small talk; and (e) 'You feel like a human being and you feel like they actually care': wanting to feel cared for. CONCLUSIONS: Findings suggested that some people actively avoid receiving an intervention by concealing how they are feeling in that moment. Interventions that are gentle and do not draw attention may be preferable, such as making small talk and simple gestures such as smiling or being near the individual. Conversely, more intrusive or aggressive interventions may be triggering and exacerbate suicidality.