Exploring community nurses' perspectives on adolescent suicide prevention in Indonesia: A descriptive qualitative study

BACKGROUND: Adolescent suicide prevention is not only a clinical or service-delivery problem; it is also socially organized through stigma, family and community norms, trust, help-seeking expectations, and the relationships that connect adolescents with potential helpers. In Indonesia, community nurses work at the interface of adolescents, families, schools, primary health care, and community institutions, yet little is known about how they interpret and negotiate this role.

PURPOSE: To explore community nurses' perspectives on adolescent suicide prevention in Indonesia, focusing on how suicide risk becomes visible or remains hidden, how nurses understand their preventive roles, the barriers that constrain action, and the support and system conditions needed to strengthen practice.

METHOD: A descriptive qualitative study was conducted in Bandung, West Java, Indonesia with 14 purposively selected community nurses. Individual semi-structured interviews were analyzed using a codebook-oriented thematic analysis. Reporting was guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ).

RESULTS: Four interpretative themes were developed: suicide risk is socially hidden before it becomes clinically visible; community nurses function as relational gatekeepers whose effectiveness depends on trust; normative stigma and professional uncertainty constrain preventive action; and nurses are expected to coordinate across sectors without sufficient structural enablement. Participants described shame, fear of judgment, family responses, and religious or moral sensitivities as shaping disclosure and help-seeking. They also described roles in mental health education, early recognition, supportive communication, family engagement, and referral, while emphasizing limited suicide-specific training, unclear pathways, and fragmented school-family-health service coordination.

CONCLUSIONS: Community nurses occupy a potentially important social-psychological and service-system position in adolescent suicide prevention in Indonesia. Their effectiveness depends not only on individual knowledge but also on the social conditions that make disclosure safe and help-seeking legitimate, together with clear protocols, referral pathways, cross-sector collaboration, and institutional support within existing Indonesian adolescent and primary-care platforms.