Adult Suicidality and Therapeutic Engagement: A Systematic Review

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Main Authors: Chloé Muscat, Frédéric Verhaegen, Christophe Clesse
Format: Artículo Open Access
Published: Wiley 2025
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author Chloé Muscat
Frédéric Verhaegen
Christophe Clesse
author_facet Chloé Muscat
Frédéric Verhaegen
Christophe Clesse
Chloé Muscat
Frédéric Verhaegen
Christophe Clesse
collection Wiley Open Access
contents Adult Suicidality and Therapeutic Engagement: A Systematic Review Chloé Muscat Frédéric Verhaegen Christophe Clesse Clinical Psychology & Psychotherapy ABSTRACT Background Engagement in mental health care among adults with suicidality remains significantly low, with limited understanding of the factors influencing treatment retention and dropout. Aims Exploring the factors influencing therapeutic engagement, such as attendance, active participation and completion of therapeutic tasks among adults with suicidality, could offer valuable insights for suicide prevention and management. Methods This systematic review explored quantitative and qualitative studies examining barriers and/or facilitators to treatment engagement. Four main databases have been explored (PubMed, Embase, PsycInfo and Web of Science). Data were analysed and thematically organised with the help of a content analysis. Results Eighteen studies focusing on adults experiencing various forms of suicidality, including suicidal ideation, behaviours, plans and attempts, have been included. Engagement is mainly perceived through appointment attendance, active participation or a multidimensional combination of factors. Logistical constraints (service availability, time and money) emerge as the most significant barrier to engagement, followed by stigma, treatment‐related experiences and beliefs and patient perception factors. No consensus between studies can be isolated regarding the impact of social support, severity of suicidal symptoms and psychiatric comorbidities. Trust in mental health professionals and interventions facilitating active patient participation positively influence treatment continuation. Conclusion This review highlights the need to increase mental health funding to enhance service availability and improve the training of mental health professionals in suicide prevention and management. Developing integrative and empowering interventions fosters an essential climate of trust and hope in therapy that enhances engagement. Future research should prioritise study designs that distinguish between perceived and actual barriers to engagement to develop targeted interventions. 10.1002/cpp.70170 http://creativecommons.org/licenses/by/4.0/
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spellingShingle Adult Suicidality and Therapeutic Engagement: A Systematic Review
Chloé Muscat
Frédéric Verhaegen
Christophe Clesse
Clinical Psychology & Psychotherapy
Adult Suicidality and Therapeutic Engagement: A Systematic Review Chloé Muscat Frédéric Verhaegen Christophe Clesse Clinical Psychology & Psychotherapy ABSTRACT Background Engagement in mental health care among adults with suicidality remains significantly low, with limited understanding of the factors influencing treatment retention and dropout. Aims Exploring the factors influencing therapeutic engagement, such as attendance, active participation and completion of therapeutic tasks among adults with suicidality, could offer valuable insights for suicide prevention and management. Methods This systematic review explored quantitative and qualitative studies examining barriers and/or facilitators to treatment engagement. Four main databases have been explored (PubMed, Embase, PsycInfo and Web of Science). Data were analysed and thematically organised with the help of a content analysis. Results Eighteen studies focusing on adults experiencing various forms of suicidality, including suicidal ideation, behaviours, plans and attempts, have been included. Engagement is mainly perceived through appointment attendance, active participation or a multidimensional combination of factors. Logistical constraints (service availability, time and money) emerge as the most significant barrier to engagement, followed by stigma, treatment‐related experiences and beliefs and patient perception factors. No consensus between studies can be isolated regarding the impact of social support, severity of suicidal symptoms and psychiatric comorbidities. Trust in mental health professionals and interventions facilitating active patient participation positively influence treatment continuation. Conclusion This review highlights the need to increase mental health funding to enhance service availability and improve the training of mental health professionals in suicide prevention and management. Developing integrative and empowering interventions fosters an essential climate of trust and hope in therapy that enhances engagement. Future research should prioritise study designs that distinguish between perceived and actual barriers to engagement to develop targeted interventions. 10.1002/cpp.70170 http://creativecommons.org/licenses/by/4.0/
title Adult Suicidality and Therapeutic Engagement: A Systematic Review
topic Clinical Psychology & Psychotherapy
url https://onlinelibrary.wiley.com/doi/10.1002/cpp.70170