OBJECTIVES: Suicide research and prevention are complex. Many practical, methodological and ethical challenges must be overcome to implement effective suicide prevention interventions. Implementation science can offer insights into what works, why and in what context. Yet, there are limited real-world examples of the application of implementation science in suicide prevention. This study aimed to identify approaches to employ principles of implementation science to tackle important challenges in suicide prevention. METHODS: A questionnaire about promoting implementation science for suicide prevention was developed through thematic analysis of stakeholder narratives. Statements were categorised into six domains: research priorities, practical considerations, approach to intervention design and delivery, lived experience engagement, dissemination and the way forward. The questionnaire (n=52 statements-round 1; n=44 statements-round 2; n=9 statements-round 3) was administered electronically to a panel (n=62-round 1, n=48-round 2; n=45-round 3) of international experts (suicide researchers, leaders, project team members, lived experience advocates). Statements were rated on a Likert scale based on an understanding of importance and priority of each item. Statements endorsed by at least 85% of the panel would be included in the final guidelines. RESULTS: Eighty-two of the 90 statements were endorsed. Recommendations included broadening research inquiries to understand overall programme impact; accounting for resources in the translation of evidence into practice; embedding implementation science in intervention delivery and design; meaningfully engaging lived experience; considering channels for dissemination of implementation-related findings and focusing on next steps needed to routinely harness the strengths of implementation science in suicide prevention research, practice and training. CONCLUSION: An interdisciplinary panel of suicide prevention experts reached a consensus on optimal strategies for using implementation science to enhance the effectiveness of policies and programmes aimed at reducing suicide.

8 8 Suicide Crisis Helpline Centre for Addiction and Mental Health Toronto Ontario Canada

Australian Institute for Suicide Research and Prevention World Health Organization Collaborating Centre for Research and Training in Suicide Prevention School of Applied Psychology Griffith University Brisbane Queensland Australia

Black Dog Institute University of New South Wales Sydney New South Wales Australia

Centre for Mental Health and Community Wellbeing Melbourne School of Population and Global Health The University of Melbourne Melbourne Victoria Australia

Centre for Mental Health Law and Policy Indian Law Society Pune Maharashtra India

Centre for Mental Health Research National Centre for Epidemiology and Population Health Australian National University Canberra Australian Capital Territory Australia

Centre for Youth Mental Health The University of Melbourne Melbourne Victoria Australia

Clinical Epidemiology Program Ottawa Hospital Research Institute Ottawa Ontario Canada

Danish Research Institute for Suicide Prevention Mental Health Centre Copenhagen Copenhagen Denmark

Department of Epidemiology and Biostatistics School of Health Occupational Environment Research Center Rafsanjan University of Medical Sciences Rafsanjan The Islamic Republic of Iran

Department of Health Services Research Peter MacCallum Cancer Centre Melbourne Victoria Australia

Department of Medicine University of Minnesota Minneapolis Minnesota USA

Department of Mental Health Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA

Department of Psychiatry Psychosomatics and Psychotherapy Goethe Universität Frankfurt am Main Frankfurt am Main Germany

Department of Psychiatry Sunnybrook Health Sciences Centre Toronto Ontario Canada

Department of Psychiatry University of Toronto Toronto Ontario Canada

Department of Psychiatry Voluntary Health Services SNEHA Suicide Prevention Centre Chennai India

Department of Psychology University of Ghana Accra Ghana

Faculty of Psychology in Sopot SWPS University of Social Sciences and Humanities Warsaw Poland

Health Services Authority Grand Cayman Cayman Islands

Hong Kong Jockey Club Centre for Suicide Research and Prevention The University of Hong Kong Hong Kong Hong Kong

Hunter New England Local Health District New Lambton New South Wales Australia

Independent Mental Health and Psychosocial Support Expert Bergen Norway

Institute for Health Metrics and Evaluation University of Washington Seattle Washington USA

Institute of Psychiatry and Neurology Warsaw Poland

Kopp Mária Intézet a Népesedésért és a Családokért Budapest Hungary

Korea Foundation for Suicide Prevention Ministry of Health and Welfare Seoul The Republic of Korea

Linnaeus University Kalmar Växjö Sweden

Maria Grzegorzewska University Warsaw Poland

Memorial University St John's Newfoundland and Labrador Canada

Mental Health and Alcohol and Other Drugs Country South Australia Nuriootpa South Australia Australia

Mental Health Literacy Wellbeing Depression and Suicide Prevention Lab EPIUnit Institute of Public Health University of Porto Porto Portugal

Mental Health Unit Ministry of Health Gaza city State of Palestine

National Center for Suicide Research and Prevention Institute of Clinical Medicine University of Oslo Oslo Norway

National Centre for Mental Health Department of Health Manilla Philippines

National Centre for Neurology and Psychiatry Tokyo Japan

National Council for Suicide Prevention Minneapolis Minnesota USA

National Institute of Mental Health Klecany Czech Republic

Orygen Melbourne Victoria Australia

Public Health Foundation of India New Delhi India

Public Mental Health Research Unit Department of Social and Preventive Medicine Center for Public Health Medical University of Vienna Wien Austria

San Francisco Veterans Health Administration San Francisco California USA

School of Governance Law and Society Tallinn University Tallinn Estonia

School of Health and Medicine University of New England Armidale New South Wales Australia

School of Health Sciences The University of Melbourne Melbourne Victoria Australia

School of Medicine and Public Health The University of Newcastle Australia Callaghan New South Wales Australia

School of Medicine University of Toyama Toyama City Japan

School of Psychological Sciences Monash University Clayton Victoria Australia

School of Public Health College of Medicine and Health National Suicide Research Foundation University College Cork Cork Ireland

School of Public Health Deakin University Geelong Victoria Australia

School of Social Work University of Washington Seattle Washington USA

Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine Shanghai China

Slovene Centre for Suicide Research Andrej Marusic Institute University of Primorska Koper Slovenia

Suicide Prevention Lab College of Education University of Oregon Eugene Oregon USA

Végeken Egészséglélektani Alapítvány Budapest Hungary

Veterans Affairs Health Services Research and Development Center for Care Delivery and Outcomes Research Minneapolis Veterans Affairs Health Care System Minneapolis Minnesota USA

Veterans Affairs Rehabilitation Research and Development Rehabilitation and Engineering Center for Optimizing Veteran Engagement and Reintegration Minneapolis Veterans Affairs Health Care System Minneapolis Minnesota USA

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