'It wasn't just me'. Community voices of hope in suicide prevention: mixed-methods study of a community-based crisis...

National policy frameworks, including the UK Government's Suicide Prevention Strategy (2023-2028), emphasise person-centred, relational approaches that prioritise therapeutic engagement, collaborative safety planning and a flexible understanding of psychosocial risk. Peer support and lived experience initiatives are increasingly recognised as vital components of suicide prevention and recovery support. Community-based suicide crisis (CBSC) support, which emphasises rapid access, person-centred care and lived experience integration, was established to provide immediate support without clinical criteria, barriers to access or waiting lists.

To examine outcomes of a CBSC intervention supporting individuals in suicidal crisis, with particular attention to differences in outcomes across National Health Service (NHS) and non-NHS/self-referral pathways.

A mixed-methods explanatory sequential design was adopted to provide a comprehensive assessment of service impact and client outcomes among individuals (n = 9801) referred through the NHS (n = 2929, 30%) or non-NHS/self-referrals (n = 6872, 70%) between 2019 and 2025.

A subanalysis of 1387 (14%) client interventions showed significant improvements across all mental health recovery domains (p < 0.05), particularly among older clients (aged ≥65 years). Fifty interviews with clients, carers, staff and referrers generated three themes around accessibility, rapid response, continuity of care and the value of lived experience in building trust, reducing stigma and helping with long-term recovery.

CBSC services would benefit from the expansion of NHS partnerships to extend regional reach, standardised monitoring and follow-up, and the strategic use of outcome data to strengthen advocacy and secure sustainable funding. Embedding this community-based model firmly within wider health systems has the potential to enhance its impact, ensure equitable access and inform broader systemic developments in suicide prevention.