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Roe E, Smith B. Practical strategies for care of individuals impacted by suicide in the emergency department: A narrative review. Int Emerg Nurs 2024; 74:101444. [PMID: 38626555 DOI: 10.1016/j.ienj.2024.101444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 03/09/2024] [Accepted: 03/23/2024] [Indexed: 04/18/2024]
Abstract
Introduction Suicide is among the leading causes of death and nurses care for survivors of suicide at many points in their grief journey. Every individual who dies by suicide leaves behind multiple affected survivors and how they are cared for immediately following the suicide influences how they cope with the death. The purpose of this article is to make recommendations for the care of survivors of suicide loss in the emergency department. METHODS A narrative review of the current literature was conducted using the databases CINAHL and ProQuest. Articles focused on survivors of suicide loss and their care in the immediate period after the death were utilized. RESULTS Four hundred and twenty-nine articles were found. Applying established inclusion and exclusion criteria and quality assessment using the SANSA guideline, 29 were included in the review. DISCUSSION Three themes were identified: 1. Risks for suicide in survivors of suicide loss; 2. Interventions in the immediate period after suicide loss; and 3. Active suicide postvention as suicide prevention. Emergency department nurses need to have the ability to readily assess and recognize the survivors of suicide loss who are at higher risk for complicated grieving, and providing rapid and immediate services and resources will help promote coping and positive mental health outcomes in survivors.
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Affiliation(s)
- Elizabeth Roe
- Saginaw Valley State University, 7400 Bay Road, BA 236, University Center, MI 48710, United states, Saginaw County Sheriff's Department.
| | - Barbara Smith
- Barb Smith Suicide Resource and Response Network, Saginaw County Sheriff's Department, United states.
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2
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Lee H, An S. Stereotype-driven emotional responses and their impact on discriminatory intentions towards suicidal individuals. BMC Psychol 2024; 12:153. [PMID: 38491555 PMCID: PMC10943847 DOI: 10.1186/s40359-024-01633-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 02/29/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND This research delves into the role of stereotypes and emotional prejudice in behavioral intentions, particularly towards individuals with suicidal tendencies. The study extends the cognitive-affective-behavioral process model, identifying pathways that negative stereotypes use to impact emotional responses and behavioral intentions. METHODS A cross-sectional online survey was conducted in South Korea, utilizing the largest Korean online panel (1,623,938 users) to recruit 552 eligible participants (49.1% male, 50.9% female) aged 20 and above with online access and no history of suicide attempts. The survey assessed negative stereotypes, prejudices, and behavioral intentions related to suicidal thoughts, employing specific measurements. RESULTS The findings established the correlation between negative stereotypes and both stigmatized emotional responses and discriminatory intentions. The study uniquely demonstrated that emotional responses act as a bridge between negative stereotypes and behavioral intentions towards suicidal individuals. These findings carry profound implications for health psychology, emphasizing the necessity of modifying attitudes to reduce suicide stigma. It was observed that stereotypical perceptions fuel negative emotions, which in turn provoke various behavioral intentions. CONCLUSIONS The study enhances our understanding of the influential role emotional reactions can have in shaping attitudes. It points towards the potential that addressing emotions holds in the stigma process, enabling people to shift their attitudes about stigmatized individuals, thus establishing intervention opportunities for stigma reduction in health psychology.
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Affiliation(s)
- Hannah Lee
- Ewha Institute for Age Integration Research, Ewha Womans University, #504-1, SK Telecom Building, 52 Ewha Yudae Gil, Seodaemun-Gu, Seoul, 03760, Korea
| | - Soontae An
- Department of Communication and Media, Ewha Womans University, Seoul, South Korea.
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3
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Moseley RL, Gregory NJ, Smith P, Allison C, Cassidy S, Baron-Cohen S. Potential Mechanisms Underlying Suicidality in Autistic People with Attention Deficit/Hyperactivity Disorder: Testing Hypotheses from the Interpersonal Theory of Suicide. AUTISM IN ADULTHOOD 2024; 6:9-24. [PMID: 38435325 PMCID: PMC10902282 DOI: 10.1089/aut.2022.0042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Background Autistic people with co-occurring attention deficit/hyperactivity disorder (ADHD) appear to be at heightened risk of suicide. To understand why, we explored two explanatory mechanisms from the interpersonal theory of suicide: first, that co-occurring ADHD might be associated with greater risk through greater thwarted belongingness and perceived burdensomeness and, secondly, that hyperactive/impulsive features might incur additional risk through their association with painful and provocative events, which are suggested to create "capability" for suicide. Methods Autistic adults (n = 314) completed an online survey including measures of thwarted belongingness, perceived burdensomeness, painful and provocative events, acquired capability for suicide, and ADHD features. Creating an overall index of likely ADHD, we examined associations between likely ADHD, suicide ideation, and lifetime suicide attempts through the parallel mediators of thwarted belongingness, perceived burdensomeness, anxiety, and depression. In several models, we then examined hyperactive, impulsive, and inattentive features as predictors of exposure to painful and provocative events and subsequent capability for suicide, and examined whether these two variables, sequentially or individually, mediated an association with lifetime suicide attempts. Results Likely ADHD was associated with past-year suicide ideation through greater depression and perceived burdensomeness, which also mediated its association with more suicide attempts. Hyperactive and impulsive features were associated with exposure to painful and provocative events and through this acquired suicide capability. Both features were associated with more numerous suicide attempts through these two mediators sequentially, and through exposure to painful and provocative events alone. Conclusions These data suggest that suicidality in autistic people with ADHD may be partially related to perceived burdensomeness and to acquired suicide capability after exposure to painful and provocative events. However, as we observed a pathway to suicidality associated with painful and provocative events alone, it is likely that there are also other explanatory mechanisms for the influence of traumatic events on suicide risk.
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Affiliation(s)
- Rachel L. Moseley
- Department of Psychology, Bournemouth University, Poole, United Kingdom
| | - Nicola J. Gregory
- Department of Psychology, Bournemouth University, Poole, United Kingdom
| | - Paula Smith
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Carrie Allison
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Sarah Cassidy
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
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Jamieson SK, Cerel J, Maple M. Impacts of exposure to suicide of a military colleague from the lived experience of veterans: Informing postvention responses from a military cultural perspective. DEATH STUDIES 2024; 48:688-697. [PMID: 38212987 DOI: 10.1080/07481187.2023.2261408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Although exposure to the suicide death of a military colleague has been shown quantitatively to increase suicide risk factors among veterans, there are very few studies where veterans have been asked about this experience. This article presents a qualitative analysis of 38 interviews with U.S. veterans with exposure to the suicide death of a military colleague in past war operations. Participants described the impact of exposure in relation to the military context and official response to the death, which had long-term ramifications. Our findings suggest suicide prevention and postvention responses for veterans should be informed by the lived experience of veterans, including those for whom this experience occurred significantly in the past, as the impacts of different military policies and practices in response to suicide deaths over time are relevant to the impact of exposure to death of a military colleague in the short and long term.
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Affiliation(s)
- Sacha Kendall Jamieson
- Sydney School of Education and Social Work, The University of Sydney, Sydney, Australia
- School of Health, University of New England, Armidale, Australia
| | - Julie Cerel
- Suicide Prevention & Exposure Lab (SPEL), College of Social Work, University of Kentucky, Lexington, KY, USA
| | - Myfanwy Maple
- School of Health, University of New England, Armidale, Australia
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5
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Black V, Heo S. When a Child Dies by Suicide: An Interpretative Phenomenological Analysis Study. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231194213. [PMID: 37549366 DOI: 10.1177/00302228231194213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Suicide is a global concern for the well-being of families. When parents experience their child's death by suicide, their well-being can be substantially impaired. This study aimed to explore the lived experiences of parents whose children died by suicide. Data were collected from 25 mothers through interviews between 2019 and 2021 and analyzed using interpretive phenomenological analysis. The data revealed five superordinate themes, including (1) who am I; (2) the unrelenting questions; (3) my existence on earth is brutal and cruel; (4) grief; and (5) the meaning. Each superordinate theme includes two to four supporting clusters. Parents' grief associated with a child's suicide is overwhelming and paralyzing but is often a journey to find the meaning or the reason for the death. Parents are traumatized and emotionally vulnerable. Healthcare providers need to support parents who lose their children to death by suicide.
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Affiliation(s)
- Vicki Black
- Georgia Baptist College of Nursing, Mercer University, Atlanta, GA, USA
| | - Seongkum Heo
- Georgia Baptist College of Nursing, Mercer University, Atlanta, GA, USA
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Delgado H, Goergen J, Tyler J, Windham H. A Loss by Suicide: The Relationship Between Meaning-Making, Post-Traumatic Growth, and Complicated Grief. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231193184. [PMID: 37499667 DOI: 10.1177/00302228231193184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Meaning making has been found useful in processing grief, yet individuals who have experienced a loss by suicide may have difficulty with post-loss adjustment due to the traumatic nature of their loss. Through quantitative study, this article acts as an initial exploratory study and examines the relationship between meaning-making, post-traumatic growth, and complicated grief symptoms in 81 college students from a large university in the United States who have experienced the loss of a loved one to suicide. The results of this study indicated that meaning-making serves as a mediator in the relationship with post-traumatic growth and complicated grief. This finding sheds light on the importance of meaning-making as a possible avenue of interventions for clinical use in bereavement from loss by suicide to treat grief symptoms and lead to post-traumatic growth.
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Affiliation(s)
- Heather Delgado
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, AL, USA
| | - Jessica Goergen
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, AL, USA
| | - Jessica Tyler
- Department of Human and Organizational Development, Vanderbilt University, Nashville, TN, USA
| | - Heather Windham
- Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL, USA
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YAZGI ZG, YILMAZ M. Role of the Psychiatric Nurse in Improving the Psychosocial Health of Families After Suicide. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1138902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Suicide is defined as death that occurs as a result of deliberate self-harming behavior with the intention of ending one's life. Each suicide has many physical, economic and psychological short and long-term effects on the individual, family, friends and society. The death of an individual as a result of suicide creates a traumatic effect for family members and causes family members to experience various psychosocial problems. For this reason, it is very important to focus on the consequences of suicide in family members who have lost due to suicide, to evaluate the family's reactions to suicide, and to provide the needed psychosocial support. In this context, in this review, it is aimed to review the literature on the psychosocial problems experienced by families who have lost due to suicide and to present up-to-date information on the role of psychiatric nurse in improving the psychosocial health status of families.
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Nicholas A, Haregu T, Henderson C, Armstrong G. Suicide stigma measures: A scoping review. J Affect Disord 2023; 321:114-125. [PMID: 36283535 DOI: 10.1016/j.jad.2022.10.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/13/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Worldwide, approximately 800,000 people die by suicide every year, and non-fatal suicidal thoughts and behaviours are common. Stigma is likely a major barrier to preventing suicide. The purpose of our review is to scope the development, psychometric properties and use of measures that explicitly seek to measure the construct of suicide stigma. METHODS We conducted a scoping review. We searched PubMed, PsycINFO, Embase and CINAHL using search terms related to suicide, stigma and measures/scales with no date limits. We included any measure the authors defined as measuring suicide-related stigma. Only peer-reviewed articles published in English were included. RESULTS We included 106 papers discussing 23 measures of suicide stigma; 82 provided data on psychometric properties. Measures assessed personal or public stigma; and stigma toward a range of suicidal phenomena (e.g., suicidal thoughts, those bereaved by suicide). 'Stigma' definitions varied and were not always provided. The Grief Experience Questionnaire, Suicide Opinion Questionnaire and Stigma of Suicide Scale were the most commonly cited. Measures varied in the strength of their psychometric properties. LIMITATIONS We only included papers in English. Because we included any measures authors defined as measuring suicide stigma, we may have included measures not commonly considered as measures of suicide stigma, and conversely we might have excluded relevant measures because they did not use the term 'stigma'. DISCUSSION This review aimed to assist in better understanding available suicide stigma measures, their strengths and weaknesses and current uses, and will inform the development of future suicide stigma measures.
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Affiliation(s)
- Angela Nicholas
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Australia
| | - Tilahun Haregu
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Australia
| | - Claire Henderson
- Health Service and Population Research, Kings College London, UK
| | - Gregory Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Australia.
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Levi-Belz Y, Lev-Ari L. Thinking for healing: The role of mentalization deficits as moderator in the link between complicated grief and suicide ideation among suicide-loss survivors. DEATH STUDIES 2022; 47:360-369. [PMID: 35445644 DOI: 10.1080/07481187.2022.2065707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Suicide-loss survivors are an at-risk population for complicated grief and suicide ideation. This study examined mentalization deficits as a possible moderator of the association between complicated grief and suicide ideation. Suicide-loss survivors (N = 152) completed questionnaires on complicated grief, suicide ideation, and mentalization deficits. Mentalization deficits facilitated suicide ideation, beyond the contribution of complicated grief. Complicated grief and suicide ideation were more strongly associated at higher mentalization deficit levels. Limitations include the non-representative cross-sectional nature of the sample and the use of a single item for suicide ideation. The findings highlight the critical link between complicated grief and suicide ideation among suicide-loss survivors and mentalization deficits' role as its possible facilitator.
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Affiliation(s)
- Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
- Behavioral Sciences Department, Ruppin Academic Center, Emek Hefer, Israel
| | - Lilac Lev-Ari
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
- Behavioral Sciences Department, Ruppin Academic Center, Emek Hefer, Israel
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10
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Lee E. Experiences of Bereaved Families by Suicide in South Korea: A Phenomenological Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052969. [PMID: 35270661 PMCID: PMC8910318 DOI: 10.3390/ijerph19052969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022]
Abstract
When an individual commits suicide, family members frequently experience feeling of hurt, denial, shock and anger, resentment, shame, and guilt. These negative emotions experienced by family survivors make their life suffer and impede the grieving process. If left untreated, they become physically and psychologically vulnerable and the risk of suicidal ideation is high, so professional intervention is needed. This study aimed to explore the experiences of suicidally bereaved families in South Korea. This research was designed to a qualitative phenomenological study conducted by using Colaizzi’s methods. Participants were seven individuals who had lost a family member to suicide in Changwon City, South Korea. The Data were collected through in-depth and individual interviews with participants from June to December 2018, and the interviews took place 1 to 15 months after their loss. A total of 25 meaning units, 12 themes, and 5 theme clusters emerged from the analysis. The 5 themes of south Korean bereaved families’ experience were: (1) an absurd breakup that came without notice, (2) a life trapped in pain, (3) family isolation by themselves, (4) uncontrolled mind in daily life, and (5) liberating from the bondage of pain. The findings of this study provide insight regarding how suicide loss affects bereaved families and could inform the development of evidence-based programs to prevention suicide thought experienced by bereaved families.
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Affiliation(s)
- Eunjoo Lee
- Department of Nursing, Kyungnam University, Changwon 51767, Korea
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11
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Weinberg M, Soffer M. The Relationships Between Personality Traits and Public Stigma Attached to Families Bereaved Due To Suicide. OMEGA-JOURNAL OF DEATH AND DYING 2021:302228211029147. [PMID: 34229497 DOI: 10.1177/00302228211029147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Suicide is a serious global public-health issue that is perceived as the most stigmatizing of sudden losses. Most studies on this topic have examined how bereaved families perceive public stigma, paying less attention to the actual stigma experienced by those not directly bereaved. Therefore, this study examined the association between personality traits and the public stigma attached to families that have lost a member to suicide. Three hundred and eighty (N = 380) Israeli participants completed demographic, Big 5, and stigma questionnaires. The study findings demonstrate that neuroticism and openness to experience are associated with higher levels of public stigma, while conscientiousness is associated with lower levels of public stigma. In addition, Arab participants reported higher levels of public stigma than Jewish participants. These findings make an important contribution to our understanding of the relationship between personality traits and the public stigma attached to families that have lost a member to suicide.
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Affiliation(s)
- Michael Weinberg
- School of Social Work, Faculty of Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Michal Soffer
- School of Social Work, Faculty of Welfare and Health Sciences, University of Haifa, Haifa, Israel
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Pinto S, Soares J, Silva A, Curral R, Coelho R. COVID-19 Suicide Survivors-A Hidden Grieving Population. Front Psychiatry 2020; 11:626807. [PMID: 33408658 PMCID: PMC7779552 DOI: 10.3389/fpsyt.2020.626807] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/01/2020] [Indexed: 12/29/2022] Open
Abstract
Present time has been dominated by the COVID-19 pandemic. People are grieving several non-death related situations: the loss of a job, of a status, of a role, of their life. Restrictive measures and uncertainty about the future makes individuals vulnerable to feelings of hopelessness and helplessness. Mental health support has been hindered and teams are reinventing themselves to reach people in need. Nevertheless, decompensation of previous psychiatric disorders, increasing levels of depression and anxiety, economical handicaps and fear of the infection, are prompting several cases of COVID-19 related suicides worldwide. Every suicide affects between 5 and 80 individuals, which are known as suicide survivors. Suicide grief is particularly challenging, with rates of complicated grief as high as 40%. Suicide survivors are at increased risk of developing depression, anxiety disorders and of suicidal behaviors. Moreover, feelings of guilt and shame, as well as social stigma, are major obstacles for them to reach form help. This article aims to review the existing literature on COVID-19 related suicides, complicated grief in suicide survivors and highlight modifiable risk factors for both conditions, as well as propose some public health measures to reduce the impact of the pandemic context on self-inflicted harm and its consequences on families, friends and the community. Obstacles to access to mental health support need to be overcome through the use of technology. Technicians should actively approach populations more vulnerable to develop suicidal ideation. Social media have the obligation to provide accurate an non-sensationalistic information. Families and friends should maintain social proximity, despite the need for physical distancing. When a suicide death occurs, police forces and health staff should be prepared to share the news with the family using an empathic and humane approach and providing psychological support. Funerals, memorials and other services should be held as much as possible. Closer contacts should be signalized and closely followed in order to detect the need for specific interventions. Help seeking behaviors should be promoted. Additionally, people should be educated on suicide and its impacts, in order to reduce stigma.
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Affiliation(s)
- Sara Pinto
- Psychiatry Service, Centro Hospitalar Universitário São João, Oporto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of the University of Oporto, Oporto, Portugal
| | - Joana Soares
- Psychology Service, Centro Hospitalar Universitário São João, Oporto, Portugal
| | - Alzira Silva
- Psychiatry Service, Centro Hospitalar Universitário São João, Oporto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of the University of Oporto, Oporto, Portugal
| | - Rosário Curral
- Psychiatry Service, Centro Hospitalar Universitário São João, Oporto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of the University of Oporto, Oporto, Portugal
| | - Rui Coelho
- Psychiatry Service, Centro Hospitalar Universitário São João, Oporto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of the University of Oporto, Oporto, Portugal
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Hochhauser S, Rao S, England-Kennedy E, Roy S. Why social justice matters: a context for suicide prevention efforts. Int J Equity Health 2020; 19:76. [PMID: 32450868 PMCID: PMC7249373 DOI: 10.1186/s12939-020-01173-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 04/14/2020] [Indexed: 11/16/2022] Open
Abstract
Suicide is among the 10 leading causes of death in the US and has the potential to suddenly change many lives. It often occurs when people are disproportionately affected by societal conditions, including inequities, discrimination, oppression, and historical trauma. We posit that a social justice framework can improve suicide prevention efforts when incorporated into existing strategies because it mandates that inequities be addressed. It does so through education, engagement, advocacy, and action, and can be especially effective in states and nations with high suicide rates and entrenched societal inequities.
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Affiliation(s)
- Shirley Hochhauser
- College of Health and Social Services Building, 1335 International Mall, Suite 326, P.O. Box 30001 MSC 3HLS, Las Cruces, NM, 88003-8001, USA
| | - Satya Rao
- College of Health and Social Services Building, 1335 International Mall, Suite 326, P.O. Box 30001 MSC 3HLS, Las Cruces, NM, 88003-8001, USA
| | - Elizabeth England-Kennedy
- Department of Health & Physical Education, Rhode Island College, 138 Murray Center, 600 Mt. Pleasant Ave, Providence, RI, 02908, USA.
| | - Sharmistha Roy
- College of Health and Social Services Building, 1335 International Mall, Suite 326, P.O. Box 30001 MSC 3HLS, Las Cruces, NM, 88003-8001, USA
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Levi-Belz Y, Lev-Ari L. "Let's Talk About It": The Moderating Role of Self-Disclosure on Complicated Grief over Time among Suicide Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3740. [PMID: 31590225 PMCID: PMC6801618 DOI: 10.3390/ijerph16193740] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/30/2019] [Accepted: 10/01/2019] [Indexed: 12/04/2022]
Abstract
Suicide often imparts highly stressful ramifications to those left behind. Previous research on suicide survivors (SUSs) has demonstrated their being at high risk for developing anxiety and depression, including pathological complicated grief (CG). Self-disclosure (S-D)--the tendency to share one's personal feelings--has been found to be an important component of dealing with grief. In this study, we examined the effect of S-D on CG in an 18-month longitudinal design following one hundred fifty-six SUSs. We found that SUSs suffering from pathological CG at Time 1 (T1) were lower in S-D at T1 and T2 and higher in depression at T2. We also found that SUSs with lower S-D at T1 had higher CG at T2. Using a structural equation model, we found that S-D at T1 contributed significantly (and negatively) to CG at T1, above and beyond the natural fading of CG over time. Our findings emphasize that while CG is highly prevalent among SUSs, S-D has a beneficial effect which can serve as a protective factor against CG for this group. Implications regarding possible interventions with SUSs were discussed.
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Affiliation(s)
- Yossi Levi-Belz
- Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer 40250, Israel.
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer 40250, Israel.
| | - Lilac Lev-Ari
- Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer 40250, Israel.
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer 40250, Israel.
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Stigma, grief and depressive symptoms in help-seeking people bereaved through suicide. J Affect Disord 2019; 244:223-230. [PMID: 30366261 DOI: 10.1016/j.jad.2018.10.098] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 09/08/2018] [Accepted: 10/08/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND The painful experience of mourning after suicide can be further complicated by the stigma surrounding suicide survival. We investigated how grief and depression influence the perception of stigma towards survivors in a sample of help-seeking persons bereaved through suicide. METHODS Cross-sectional design. Information on sociodemographic variables and responses to the Stigma of Suicide Survivor Scale, Beck Depression Inventory (BDI) and Inventory of Complicated Grief (ICG) was collected from 240 people bereaved through suicide who consecutively accessed an online support initiative. RESULTS Despite the strong correlation between ICG and BDI scores, the intensity of depressive but not of grief symptoms was related to perceived stigma towards survivors. Time since loss was also positively related to levels of perceived stigma against survivors. The links between depression and perceived stigma persisted after taking into account relationship with the deceased and other sociodemographic factors. LIMITATIONS The main study limitations are the cross-sectional design, reliance on self-report measures, and the self-selection of the sample of people bereaved through suicide, seeking help through a website. Social support was not measured and the sample included a large proportion of women. CONCLUSIONS Specific interventions designed for persons bereaved by suicide should consider that psychological distress and mourning are qualitatively different reactions to a suicide loss. The relationship among perceived stigma, depressive suffering and time elapsed since the suicide loss suggests the usefulness of closely investigating the experience of stigma in all people bereaved through suicide with depressive symptoms, even long after the event.
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Murphy AL, O'Reilly CL, Ataya R, Doucette SP, Martin-Misener R, Rosen A, Gardner DM. A survey of Canadian and Australian pharmacists' stigma of suicide. SAGE Open Med 2019; 7:2050312118820344. [PMID: 30728964 PMCID: PMC6350138 DOI: 10.1177/2050312118820344] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 11/26/2018] [Indexed: 11/16/2022] Open
Abstract
Background There is limited information available regarding community pharmacists' stigma of suicide. Pharmacists regularly interact with people at risk of suicide and stigmatizing attitudes may impact care. Objective To measure community pharmacists' stigma of suicide. Method Pharmacists in Canada and Australia completed an online survey with the Stigma of Suicide Scale-Short Form. Data were analysed descriptively and with univariate and multivariate analyses. Results Three hundred and ninety-six pharmacists returned completed surveys (Canada n = 235; Australia n = 161; female 70%; mean age = 38.6 ± 12.7 years). The rate of endorsement of stigmatizing terms was low overall. Canadian and Australian pharmacists differed (p < 0.05) for several variables (e.g. age, friend or relative with a mental illness, training in mental health crisis). Pharmacists without someone close to them living with a mental illness were more likely to strongly agree/agree with words describing those who die by suicide as pathetic, stupid, irresponsible, and cowardly. Those without a personal diagnosis of mental illness strongly agreed/agreed with the terms immoral, irresponsible, vengeful, and cowardly. More Australian pharmacists strongly agreed/agreed that people who die by suicide are irresponsible, cowardly, and disconnected. Independent variables associated with a higher stigma were male sex, Australian, and negative perceptions about suicide preventability. Conclusion Community pharmacists frequently interact with people at risk of suicide and generally have low agreement of stigmatizing terms for people who die by suicide. Research should focus on whether approaches such as contact-based education can minimize existing stigma.
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Affiliation(s)
- Andrea L Murphy
- College of Pharmacy, Dalhousie University, Halifax, NS, Canada.,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Claire L O'Reilly
- School of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Randa Ataya
- College of Pharmacy, Dalhousie University, Halifax, NS, Canada
| | - Steve P Doucette
- Research Methods Unit, Nova Scotia Health Authority, Halifax, NS, Canada
| | | | - Alan Rosen
- Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.,Illawarra Institute for Mental Health, University of Wollongong, Wollongong, NSW, Australia
| | - David M Gardner
- College of Pharmacy, Dalhousie University, Halifax, NS, Canada.,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
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Oexle N, Feigelman W, Sheehan L. Perceived suicide stigma, secrecy about suicide loss and mental health outcomes. DEATH STUDIES 2018; 44:248-255. [PMID: 30451645 DOI: 10.1080/07481187.2018.1539052] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 09/12/2018] [Accepted: 09/20/2018] [Indexed: 05/27/2023]
Abstract
Perceived suicide stigma and consequent secrecy about suicide loss could contribute to impaired mental health among suicide loss survivors. Using online survey data from 195 suicide loss survivors, higher perceived suicide stigma was associated with more grief difficulties, higher suicidality, and less personal growth. Secrecy partly mediated the association between perceived suicide stigma and grief difficulties as well as suicidality and completely mediated the association between perceived suicide stigma and personal growth. Our findings suggest that supporting suicide loss survivors in coping with perceived suicide stigma could reduce secrecy about suicide loss and by this improve their mental health outcomes.
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Affiliation(s)
- Nathalie Oexle
- Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
| | | | - Lindsay Sheehan
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
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