Exploring suicidality and mental health support pathways following bereavement in rural contexts in the UK

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Doctoral School University of Worcester Henw ick Grove Worcester WR2 6JA Tel: 01905 542182 www.worcester .ac.uk • UNIVERSITYof WORCESTER PhD Studentship Exploring suicidality and mental health support pathways following bereavement in rural contexts in the UK. Supervisory team: Director of Studies: Professor Eleanor Bradley, Deputy Pro Vice Chancellor Research and THRIVE Programme PI, Mental Health Inequities Research Unit, University of Worcester. Supervisors: Dr Molly Miley, Research Fellow, THRIVE Programme, Mental Health Inequities Research Unit, University of Worcester. Dr Maria Michail, Associate Professor in Youth Mental Health and Suicide Prevention, Deputy Director of the Institute for Mental Health, University of Birmingham. Research Unit: The University of Worcester have been awarded a National Institute for Health and Social Care (NIHR) Mental Health Leaders Award to establish a programme of research designed to address mental health inequalities in rural settings. The programme of research will have 3 areas of focus: Earlier intervention and detection of serious mental illness (SMI); Suicide Prevention; and Digital Support. THRIVE sits in a newly established Rural Mental Health Research Unit at the University of Worcester . The THRIVE programme has been developed in partnership with colleagues at the Institute for Mental Health, University of Birmingham and th ere will be opportunities for collaborative working for doctoral candidates across both Worcester and Birmingham. The PhD Studentship: Applications are invited for a full -time PhD studentship for the project : Exploring suicidality and mental health support pathways following bereavement in rural England. Context Bereavement is the experience of losing a loved one and typically refers to the period immediately following death (Matthys et al. 2022). A decline in mental health is commonly reported among people experiencing bereavement, and bereavement is a key risk factor for suicide (Li et al., 2003). Suicidality is likely to be heightened following a bereavement due to associated perceived stigma, resulting in social withdrawal and a concomitant decrease in social interaction (Pitman et al., 2017). Stigma also acts as a barrier to help-seeking behaviours (Carpiniello and Pinna, 2017). People living in rural areas have an elevated risk of suicide (Prazak et al., 2024). Factors such as self-reliance and social isolation intersect with structural inequalities, creating a disadvantage to the access of bereavement and mental health or suicid e prevention support services (Hansford et al., 2023). An urgent need therefore exists to

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Doctoral School University of Worcester Henw ick Grove Worcester WR2 6JA Tel: 01905 542182 www.worcester .ac.uk • UNIVERSITYof WORCESTER explore the lived experience of rural bereavement, with a focus on the barriers and facilitators to suicide prevention and bereavement services. This understanding is necessary for the development of strategies focused upon supporting people experiencing bereavement to access appropriate services and reduce suicide risk.

Aims and Objectives

This PhD research aims to explore suicidality and mental health support for people experiencing bereavement in rural communities. In alignment with the THRIVE People and Community Involvement and Engagement (PCIE) Strategy the successful applicant will work with local stakeholders and people with lived experience to co-produce a programme of research to meet the following objectives: • Conduct a scoping literature review to assess the evidence base on bereavement and suicidality in the UK and understand the barriers to access for people living in rural areas • Use existing data/evidence and undertake stakeholder consultation to ‘map’ the help-seeking journey for people who are bereaved, and the provision of mental health, suicide prevention, and bereavement care and support services in rural Worcestershire and Herefordshire • Undertake qualitative research to explore the lived experience of bereavement and related suicidality in rural Worcestershire and Herefordshire, and the facilitators and barriers to accessing mental health care and support services. • Develop recommendations for policy and practice based on an analysis of their data. Research Questions 1. What does existing evidence reveal about the relationship between bereavement and suicidality, particularly in rural contexts, and what barriers to accessing support are identified? 2. How do people bereaved in rural Worcestershire and Herefordshire navigate their help-seeking journeys, and how is bereavement, mental health, suicide prevention, and support provision configured within these areas? 3. How is bereavement experienced in rural Worcestershire and Herefordshire, and in what ways does it intersect with suicidality and access to care and support services? 4. What implications do these findings have for policy, service development, and practice to better support bereaved individuals and reduce suicide risk in rural communities? Indicative methodology The selected student will be encouraged to bring their own ideas and supported to work with local experts by experience to design the research. A suggested methodology, however, might include:

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Doctoral School University of Worcester Henw ick Grove Worcester WR2 6JA Tel: 01905 542182 www.worcester .ac.uk • UNIVERSITYof WORCESTER Phase 1: A scoping review of the academic, policy and practice literature on bereavement, mental health, and suicide prevention services in the UK, focusing on the provision of support available to, and inequalities of access for, people from rural communities. Phase 2: A mapping exercise to identify the help- seeking journeys of people experiencing bereavement, and the services in rural Herefordshire and Worcestershire, delivering suicide prevention initiatives and mental health care and support to the bereaved (e.g. using online searches and interviews with key stakeholders such as mental health, GPs, social workers, and commissioners). A database of organisations and their key characteristics would be developed. Phase 3: Qualitative primary research exploring the lived experience of bereavement and related suicidality. Data collection may involve a documentation review (e.g. organisational aims/strategy/policies, service user surveys), interviews/focus groups with key stakeholder groups i.e. people who are bereaved, mental health service staff, local commissioners, and relevant health and social care professionals. References: 1. Prazak, M., Bacigalupi, R., & Hamilton, S. C. (2025). Rural Suicide: Demographics, Causes, and Treatment Implications. Community mental health journal, 61(1), 66–75. https://doi.org/10.1007/s10597-024-01327-x 2. Matthys, O., Dierickx, S., Deliens, L., Lapeire, L., Hudson, P., Van Audenhove, C., De Vleminck, A., & Cohen, J. (2022). How are family caregivers of people with a serious illness supported by healthcare professionals in their caregiving tasks? A cross-sectional survey of bereaved family caregivers. Palliative medicine, 36(3), 529–539. https://doi.org/10.1177/02692163211070228 3. Li, J., Precht, D. H., Mortensen, P. B., & Olsen, J. (2003). Mortality in parents after death of a child in Denmark: a nationwide follow-up study. Lancet (London, England), 361(9355), 363–367. https://doi.org/10.1016/S0140- 6736(03)12387-2 4. Carpiniello, B., & Pinna, F. (2017). The Reciprocal Relationship between Suicidality and Stigma. Frontiers in psychiatry, 8, 35. https://doi.org/10.3389/fpsyt.2017.00035 5. Pitman, A., Rantell, K., Marston, L., King, M., & Osborn, D. (2017). Perceived Stigma of Sudden Bereavement as a Risk Factor for Suicidal Thoughts and Suicide Attempt: Analysis of British Cross-Sectional Survey Data on 3387 Young Bereaved Adults. International journal of environmental research and public health, 14(3), 286. https://doi.org/10.3390/ijerph14030286 6. Hansford, L., Wyatt, K., Creanor, S., Davies, J., Horne, G., Lynn, A., McCready, S., Pearce, S., Peeler, A., Rhys, A., Sallnow, L., & Harding, R. (2023). Engaging with communities in rural, coastal and low-income areas to understand barriers to palliative care and bereavement support: reflections on a community engagement programme in South-west England. Palliative care and social practice, 17, 26323524231212514. https://doi.org/10.1177/26323524231212514

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Doctoral School University of Worcester Henw ick Grove Worcester WR2 6JA Tel: 01905 542182 www.worcester .ac.uk • UNIVERSITYof WORCESTER Details of the studentship: The studentship is offered for a 4-year period on a full-time basis. During the period of your studentship you will receive the following: • a tax-free bursary of £20,407 for 3 years • a fee-waiver for 4 years • a budget to support your project costs • a laptop and other IT equipment or software as appropriate to the project • use of the Doctoral School facilities You will be expected to play an active role in the life of both the Doctoral School and of the School. You will be given opportunities to gain experience in learning and teaching within the School under the guidance of your Director of Studies. Application Process: The closing date for this studentship is 18th September. To begin the application process for this studentship please go to our webpage and click ‘apply now’ next to the project you wish to apply for. We request a personal statement, in a specific format, for your application. Please see below for details on the requirements. It is expected that applicants will have the following qualifications: • A Masters in the area of Health Care or equivalent professional experience. • A First or Upper Second Honours Degree It is also expected that applicants will be able to demonstrate the following: • A sound understanding of and interest in both the project and the wider subject area • Experience of relevant research methods and skills • Ability to contribute to the research design of the project • Proficiency in oral and written English • Proficiency in IT relevant to the project • Ability to organise and meet deadlines • Good interpersonal skills • Ability to work independently • Ability to work as part of a team Completing the Personal Statement on the Application Form: To support a fair and consistent shortlisting process, all applicants are required to submit a personal statement of up to 1,000 words, using the structure below.

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Doctoral School University of Worcester Henw ick Grove Worcester WR2 6JA Tel: 01905 542182 www.worcester .ac.uk • UNIVERSITYof WORCESTER Statements that do not follow this structure, or that rely on generic or nonspecific content, may be disadvantaged. Write in your own authentic voice; AI generated content is easy to detect and weakens an application. Provide specific examples throughout to support your personal statement. Finaly, ensure your statement is well structured, clearly written and carefully proofread. Required Personal Statement Structure 1. Motivation for Applying (approx. 150 words) Explain why you are applying for this specific PhD project. Demonstrate your understanding of the topic, why it matters, and what motivates you to pursue doctoral study in this area. Outline your longer-term career aspirations and how this studentship supports them. Avoid general statements that could apply to any project or institution. 2. Relevant Research Experience (approx. 200 words) Provide a focused summary of your research experience, including undergraduate or Masters dissertations, involvement in audits, evaluations or research projects, and any research assistant work. Describe your specific contributions, the methods you used, skills developed and outcomes achieved. Include research related training (e.g., qualitative or quantitative methods, systematic review techniques). Use concrete examples and emphasise what you did. 3. Research Outputs, RKE Activity or Scholarly Achievement (approx. 150 words) Summarise research related achievements such as publications, reports, conference presentations, workshops, knowledge exchange activities, involvement in funding applications, or academic awards. Be clear about your personal contribution to collaborative work and distinguish between published, accepted, in progress, or planned outputs. 4. Professional or Employment Experience (approx. 200 words) Outline employment or voluntary roles relevant to this programme of doctoral study. This may involve work in health, social care, education, community or research settings. Highlight responsibilities such as data collection, participant engagement, safeguarding, communication or project coordination. Provide examples showing independence, reliability, time management and resilience. Explain how these experiences have prepared you for PhD level research and informed your interest in the project area. 5. Skills, Values and Personal Attributes (approx. 200 words) Provide evidence of the qualities expected of a doctoral researcher, including a strong work ethic, conscientiousness, commitment to ethical practice, curiosity, critical thinking, independence and effective communication. Use specific examples that demonstrate these attributes in practice. Avoid generic lists, focus on behaviours and experiences that show your readiness for doctoral study. 6. Fit with the Project and Supervisory Team (approx. 100 words) Explain how your experience, interests and career goals align with the project and supervisory team. Highlight relevant methodological expertise, subject knowledge or

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Doctoral School University of Worcester Henw ick Grove Worcester WR2 6JA Tel: 01905 542182 www.worcester .ac.uk • UNIVERSITYof WORCESTER lived/professional experience. Demonstrate awareness of the broader research area in which the project sits and articulate clearly why you are a strong match. The Interview: Shortlisted candidates will be given at least 7 day’s -notice of interview. In advance of interview, shortlisted candidates will be asked to submit their CV and a sample of their written work (e.g. a publication or a dissertation). Alongside the interview, shortlisted candidates will be asked to deliver a brief presentation (10 minutes) on a topic related to the studentship. This will provide an opportunity to demonstrate understanding of the project context and potential research approaches. Candidates are invited to present on the following suggested topic: ““How would your experience and skills support you to design a PhD Study exploring suicidality and mental health support pathways following bereavement in rural England?” To support their presentation, candidates are encouraged to use a concise slide deck and reflect on how their background or interests align with the aims of the project. Research at the University of Worcester Research is central to the University’s mission to make a difference in everything that we do. We are committed to delivering excellent research which extends the boundaries of human knowledge but which also improves people’s lives by enabling better health outcomes, improving food security, developing environmentally sustainable solutions for crop production and socially sustainable solutions to our ageing population, enhancing public knowledge and understanding of the past and present. The University hence focuses its research around five high-level challenges facing society, locally, nationally and globally: • Human Health and Wellbeing • Sustainable Futures • Digital Innovation • Culture, Identity and Social Exclusion • Professional Education The success of our research is reflected in our continuous improvement in external research assessment processes. In the most recent Research Excellence Framework, REF 2021, the University saw a near 50% increase in the scale of its research and 12% increase in quality, building on its performance in REF 2014 when it was the UK’s most improved university in terms of Research Power, a combination of scale and quality. Research Degrees at Worcester Our research students are central to our overall mission for research. They are working at the cutting edge of their disciplines and driving forward the quality of our

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Doctoral School University of Worcester Henw ick Grove Worcester WR2 6JA Tel: 01905 542182 www.worcester .ac.uk • UNIVERSITYof WORCESTER research whilst enriching our research culture. We are looking to increase our research student numbers as a strategic imperative. Our commitment to our students is reflected in the results of the Postgraduate Research Experience Survey 2023 in which we ranked 3rd for overall research student satisfaction nationally. Key to our success in his area is the Doctoral School, a focal point for all our research students. It provides: • day-to-day support for our students, both administrative and practical, through our dedicated team • a Research Student Study Space with both PCs and laptop docking station • a comprehensive Researcher Development Programme for students and their

supervisors

• a programme of student-led conferences and seminars Widening Participation: As part of its mission statement the University is committed to widening participation for its higher degrees. Although most candidates will have an undergraduate and/or a Masters degree, the University is happy to accept applications from candidates with relevant professional qualifications and work-related experience. Informal enquiries can be made to Professor Liz Hughes - elizabeth.hughes2@worc.ac.uk. Please note that Professor Hughes will not be able to assess individual eligibility or provide feedback on CV’s informally.

Research areas