Table 4.
STARS-p PART A – summary of suggestions for improvement of item wording, language, and ordering.
| Domain of Enquiry | Type of change | Summary of suggestions | Example suggestion (quote) | ||
|---|---|---|---|---|---|
| Death ideation | Addition | Reorder | Reword | Alternative wording suggestions focused on more clearly delineating thoughts of death from thoughts of suicide. | “Have you thought about your death or dying in general, such as by natural causes, but not suicide specifically?” Reword for: Have you wished to be dead (i.e., by natural causes?)] |
| 0 | 0 | 11 | |||
| Suicidal thoughts | Addition | Reorder | Reword | Question on ‘intensity’ and temporal nature of ideation. Reduce jargon and ask less directly about suicide. | “have the thoughts been increasing recently?” (Addition) |
| 1 | 0 | 1 | “Might read better the other way around (to reduce jargon, but still then mention “suicide” at the end of Q) [ask about ending your life first]” [Reword for: Have you thought about suicide/ending your life (recent, past, current)?] | ||
| Plans/intent | Addition | Reorder | Reword | Alternative wording suggestions for ‘planning’, focused on need for clarity, and lay person language, while ‘communication to others’ focused on relational context of plan (e.g., alone or around others). | “2 questions sound much the same – a bit confusing how things are ordered.” (Reorder) |
| 0 | 1 | 5 | “‘Have you ever made a plan to end your life? Not just ‘have you ever made a plan?” (Reword from: Have you ever made a plan in the past?) | ||
| Access to method | Addition | Reorder | Reword | Alternative wording focused on more specific questions around method use. | “How did you come to this method? To find out if they have actually researched the lethality” (Addition) |
| 2 | 0 | 2 | “Which methods do you have access to? (not just one specific method).” (Reword from: Do you have access to any specific method?) | ||
| Previous attempt | Addition | Reorder | Reword | Alternative wording suggestions for prior method-use, type of help sought, and acting impulsively focused on need for sensitivity around client perceived judgments. | “When you last felt like this how did you get access to help/support?” (Addition) |
| 1 | 0 | 4 | “Could be I wonder if you think that you acted suddenly/without thought?” (Reword from: Do you think you acted impulsively?) | ||
| Previous non suicidal self injury (NSSI) | Addition | Reorder | Reword | Alternative wording suggestions for acts of NSSI, concerned seeking more information or more sensitive questioning around self-harm. | “Add why? – to, have you engaged in any acts of non-suicidal self-injury before?” (Addition) |
| 1 | 0 | 5 | “Have you hurt or harmed yourself before?” (Reword from: Have you engaged in any acts of non-suicidal self-injury before?) | ||
| Psychiatric care/help | Addition | Reorder | Reword | Alternative wording suggestions focused on eliciting experience of care from services. | “Ask if there has been trauma related to the medical system that may prevent/discourage access of care as a barrier” (Addition) |
| 1 | 0 | 3 | “Do you have / Have you had / Are you satisfied with your psychiatric care?” [Reword from: Have you received mental health treatment in the past? (Specify experience –negative/positive/perceived stigma, etc.)] | ||
| Current mental state | 0 | 0 | 0 | ||
| All/admin | Addition | Reorder | Reword | Suggestion to move sensitive items related to death later in Part A. | “Also feel like the first part of line of question might be better in the middle. Not at the start.” (Reorder) |
| 0 | 1 | 0 | |||