Maintaining safety while discussing suicide: Trauma informed research in an online focus groups

Although trauma informed (TI) care has been well researched and is used in many disciplines, TI practices for research are less developed. In this article, we explore the use of TI practices when discussing the sensitive topic  of suicide within an online focus group. Qualitative studies on rural suicide are sparse, even though the incidence of suicide is higher rurally than in urban areas.  Rural communities are often close knit and stigma can be  greater toward non-normative experiences such as mental illness and suicide. Due to the nature of rural communities, the trauma of suicide can affect many people. We conducted focus groups with rural community  participants who had an interest in suicide prevention to explore the gaps in rural suicide research and the best methods for knowledge dissemination of existing research. Steps were taken to mitigate re-traumatization  and/or severe distress in the participants through a TI research approach. An online video conferencing platform became necessary due to the COVID-19 pandemic. The online features promoted safety and transparency by:  enabling participants to turn off camera and microphone if they became distressed, allowing them time to self-regulate until feeling sufficiently safe to return to the focus group discussion; leaving the discussion at any time  with little disruption; and being able to choose a comfortable place to join the discussion. Other TI activities included ensuring ongoing consent throughout the process, recruiting through a third party to enhance safety,  having support resource lists tailored to the region, and encouraging participants to share and debrief final thoughts. A number of participants commented on feeling safe within the environment of the focus group.  imitations included challenges identifying distress online and technological difficulties associated with rural internet services. To our knowledge, this is the first article using a TI approach for discussing suicide through an  online method.