A protocol for a rapid realist policy review (RRPR) of the impact of social determinants on self-harm and suicidal thoughts and behaviours in England.

Abstract

Self-harm and suicidal thoughts and behaviours are a significant public health concern. While individual risk factors have been widely studied, the role of social determinants in shaping these outcomes remains underexplored within policy contexts. This Rapid Realist Policy Review aims to investigate how macro level (national) policies in England address the impact of social determinants of self-harm and suicidal thoughts and behaviours. This Rapid Realist Policy Review adapts the rapid realist review method to place policy documents at the centre of analysis. It will identify and extract relevant English policy documents (2002-2023) related to suicide, self-harm and mental health, using government and archival databases.Policy documents will be mapped and categorised based on their pertinence to proximal and distal outcomes and social determinants. A predefined template will be used to extract and appraise data based on relevance, richness and rigour. Context-mechanism-outcome configurations will be developed, validated by content experts and synthesised into an initial programme theory. The review will follow Realist And Meta-narrative Evidence Syntheses: Evolving Standards for realist syntheses. This review does not require ethical approval due to the use of secondary sources. Findings will be disseminated via an open-access, peer-reviewed journal article. A summary of key recommendations will be produced with the expert stakeholder group to inform policy and practice. CRD420251057759.