# A Pilot Qualitative Study to Better Understand the Factors Related to Suicides and Inform Public Health Action Across a Predominantly Coastal and Rural Area: Cornwall, Southwest of England

## TL;DR

This study explores suicide risk factors in a rural and coastal area during the pandemic to guide public health actions.

## Contribution

It introduces using inquest recordings as a novel method to understand suicide factors in rural settings.

## Key findings

- Social isolation and anxiety were key risk factors for suicide during the pandemic.
- Remote working and lockdowns worsened mental health in rural and coastal areas.
- Digital access and continuity of care are critical for suicide prevention.

## Abstract

Background: Better understanding factors leading to suicide and prevention opportunities is a global public health priority. This qualitative pilot study tested whether reviewing inquest recordings could generate insights during COVID-19 and inform public health prevention programmes across a predominantly rural and coastal area where there are significant health inequalities. Methods: Fifty-five inquest recordings reached a suicide conclusion between March 2020 and January 2021. Stratified sampling was used to obtain two samples from each month. Template analysis was employed to thematically analyse data from 30 inquests. Results: Risk factors during this period were social isolation, anxiety, difficulty in routine creation and maintenance, low mood and economic impact. Remote working in a more rural/coastal area impacted both healthcare service users and staff. Lockdown and other multiple risk factors impacted those at increased risk of poor mental health and suicide. Conclusions: There is a need to identify those at risk and with deteriorating mental health. All age trauma-informed approaches are needed to prevent individuals from reaching crisis along with more equitable services and community support due to the complex nature of suicide. This requires consideration of digital access/exclusion, training, continuity of care and enhanced care of those with additional needs and multiple vulnerabilities.