Table 2 Foundational themes with example statements from each participant group

Person-centred focus

 “I think you kind of gauge that case by case when you go down and you actually talk to parents, like…”

“I think it depends on the circumstances. Going back a few steps, if you've identified with the young person that there's no risky stuff going on that their family is putting them at risk or is damaging their mental health then I think that's a good idea. But I think also realising that's a different kind of clinical discussion you're having than the discussion with the young person themselves”

“Generally, yes, but that should be stated at—while you're in the ED. I've asked my daughters about this and they said that they would like to know in advance to have the right to say yes, they want someone or no, they don't.”

 “It's really hard to kind of provide a generic kind of template around that, because you do it—like you've generally reviewed the notes and you're tailoring the conversation to what the assessment was, so it's hard to say, oh yes, I'd do this and then I'd do that.”

“I would say definitely contacting the young person first is going to be important, because imagine if you're the young person and your family is contacted before you about this, and you're told by your mother or your father, they just called me about this. You weren’t told about this. You weren’t asked any questions directly.”

“It would be helpful also if they could specify some sort of timeframe of when they're going to…”

Phone call dynamics

 “It's a bit kind of like, yeah, just building a banter with them and a therapeutic rapport and then albeit briefly, then being able to dive into those harder questions.”

“Yeah. When they're, like, so when I saw you we talked about this, and I was, like, you remember who I am. That's nice. I'm a human. As opposed to, blah, blah, blah.”

“Often in a crisis, you don't think of everything that needs to be said and that there is follow-up emergency stuff that really unanswered questions that needs to be addressed.”

 “I guess a conversation directly around risk or if they were in hospital previously [around] risk taking their life and how, where are they feeling now … yeah.”

“I feel like it's got to do as well with connection. For me, if don’t have a connection with someone, I'm not going to tell them anything. But if I can at least trust them a little bit and build a little bit of rapport, I'm going to be a lot more open. Maybe just try and build that rapport, talk about something other than the visits. Like, have you seen a movie today? What have you, I don’t know, eaten?

“…should have a checklist that they go through themselves and they can point out on each—the person who rings up can also have that same checklist and they can refer different questions to A, B, whatever and say this is happening. What do you think I should do? Should I go and see someone? Should I just leave it and wait and see?”

Phone call purpose

 “I feel it would be helpful, but there would need to be a purpose of the call, like rather than, oh how are you feeling today, yeah, still suicidal, oh that's shit. Like more of a have you called your GP like you said you would, have you followed like we tell the parents to remove access, have you done this with the parents, like more of a call to follow through and have you put into place what we discussed.”

“I think psychoeducation is a big part of it. I know for my parents they didn’t really understand what I was going through… They might have understood a bit better and been more caring about it.”

“Often in a crisis, you don't think of everything that needs to be said and that there is follow-up emergency stuff that really unanswered questions that needs to be addressed.”

 “We're just trying to make sure that they know how to access support, counselling if they need it, so what our number is, if this happens again how to proactively get help when they need it.”

“How they're going. Check in on them.”