An Interpretive Phenomenological Inquiry of Family and Friend Reactions to Suicide Disclosure

Stigma, Support, and Ideation About Suicide in Indonesian Twitter: A Topic Modelling Study

Stigma surrounding suicide is a massive problem in Indonesia. Thus, it is important to study how conversations about suicide take place. We take a machine learning approach and study tweets with suicide keywords to understand how people converse about suicide or express suicide ideation. Tweets with suicide-related keywords were extracted from May to June 2023. 20,057 tweets were subject to topic modelling with an 11-topic solution. While most topics contain negative messages, no purely stigmatizing topics emerge, despite prior research suggesting overwhelming stigma. Various kinds of existential, emotional, and social tweets about suicide take place among Indonesian users, indicating that Indonesian Twitter users utilize the platform to express their thoughts and emotions. Notably, religious-spiritual keywords are highly prevalent, suggesting that in a highly religious society, there is a need for policy makers and awareness campaigns to frame their positive messaging within the society's religious context.

The experiences of living with a suicidal family member, and the impact on daily life: A systematic review and meta-aggregation

INTRODUCTION

Because of the pivotal role that family members play in caring for their suicidal relative, insight into their experiences is necessary to develop good support for them.

AIM

This systematic review aimed to aggregate qualitative research examining the experiences of family members living with their suicidal relative, and their impact on daily life.

METHODS

Systematic searches, covering the period 2000-2022, were conducted in Medline, Embase, PsycINFO, Ovid Nursing database and CINAHL. The JBI-QARI meta-aggregation approach and the PRISMA guidelines were followed.

RESULTS

Eleven studies met the inclusion criteria. Six themes were identified: The hard job of managing the risk of suicide; contributing to the relative's survival; struggling with professional care; being in a lonely position; pressure on relationships; and disruption of well-being.

DISCUSSION

The constant worry of losing their relative and ever-present vigilance dominates their lives in such a way that their well-being may be decreased. Professionals often overlook family members, which leads to feelings of powerlessness and loneliness.

IMPLICATIONS FOR PRACTICE

Collaborating with families in treatment, allowing them to share information and supporting them in the care at home may lead to better outcomes for both the family and their suicidal relative.

Perceptions of Helpful and Unhelpful Responses to Disclosures of Suicidality in a Sample of Mobile App Users

OBJECTIVE

Assessment and management of suicide risk is dependent on the individual at risk disclosing their suicidal thoughts. This study analyzed self-reported data collected via Youper, a mental-health app, to explore user experiences with suicide-related disclosure.

METHOD

2,952 international users who endorsed suicidal ideation reported on experiences with suicide-related disclosure. Differences in experiences were examined according to age, gender, and symptoms of psychopathology.

RESULTS

Just over half of users (56.17%) shared their suicidal thoughts. The primary reason for not sharing was thinking others would not understand. Of those who had disclosed their suicidal thoughts, 56.31% perceived the listener's response to be helpful, with listening and expressing care identified as most helpful. More severe depression and generalized anxiety symptoms were associated with higher disclosure likelihood, whereas higher borderline-personality and social-anxiety symptoms were associated with lower disclosure likelihood. Perceptions of what users found helpful when they disclosed suicidality varied by gender. Lack of understanding was the most frequently reported unhelpful response universally.

CONCLUSION

Findings suggest that listening and expressing care should be prioritized to maximize suicidal individuals' experiences of feeling supported. That said, gender and symptoms impact likelihoods of and experiences with disclosure, which should be considered when receiving suicide-related disclosure.HIGHLIGHTSNearly half of users shared suicidal thoughts and found listener responses helpful.Users most often endorsed listening as helpful and not understanding as unhelpful.Symptom severity and gender informed suicide-related disclosure experiences.

Sexual Orientation and Disclosure of Suicidal Thoughts Before Suicide Mortality

INTRODUCTION

Disclosure of suicidal thoughts and behaviors represents an opportunity to intervene before suicide mortality, representing a cornerstone for suicide prevention. Sexual minority (e.g., lesbian/gay, bisexual) people experience sharply elevated suicide risk, yet there is scant research on patterns of disclosure of suicidal thoughts and behaviors before suicide that might uncover missed opportunities for suicide prevention. Thus, authors leveraged postmortem suicide data to evaluate associations among sexual orientation, sex, and disclosure of suicidal thoughts and behaviors in the month preceding death.

METHODS

Data on suicides from the 2013-2019 National Violent Death Reporting System (N=155,516) were classified for sexual orientation and denoted disclosure of suicidal thoughts and behaviors and to whom suicidal thoughts and behaviors were disclosed in the month preceding death. Logistic regression models stratified by sex and adjusted for sociodemographic covariates assessed the associations between sexual orientation and suicidal thoughts and behaviors disclosure. Analyses were conducted from October 2022 to February 2023.

RESULTS

Among females, sexual minority decedents were 65% more likely to disclose suicidal thoughts and behaviors than heterosexual decedents (95% CI=37%, 99%, p<0.001). No difference in suicidal thoughts and behaviors disclosure was observed between sexual minority and heterosexual men. Of decedents who disclosed suicidal thoughts and behaviors, one in five sexual minority decedents disclosed to a friend/colleague, whereas fewer than 5% disclosed to a healthcare professional. Among sexual minority females, younger age, intimate partner problems, and physical health problems were positively associated with disclosing suicidal thoughts and behaviors.

CONCLUSIONS

These findings suggest that reducing suicide mortality in sexual minority populations will require considering contexts beyond the healthcare system, including engaging peer networks. Gatekeeper training for suicide prevention may be an especially promising approach for reducing suicide among sexual minority women.

Learning of a Classmate's Suicide Ideation Affects Emotions When Advising the Classmate and the Helpfulness of the Advice Provided

OBJECTIVE

Suicide ideation (SI) is prevalent among college students, and suicide disclosure (SD) is critical for crisis intervention. However, students with SI may worry about stigmatizing responses to their disclosure. To better understand the mechanism of stigmatizing responses to SD, we investigated the effects of a hypothetical classmate's SD on college students' emotions and reasoning when providing advice to a distressed classmate.

METHOD

In a randomized controlled experiment, students wrote advice to a hypothetical classmate who recently failed in his pursuit of a romantic relationship with a peer. The experimental/control group also learned he wanted to either commit suicide/quit school. When typing the advice, participants' facial expressions were recorded and analyzed by Facereader7.1. After advising, participants reported their sadness, joy, fear, anger, surprise, and disgust when advising. Finally, trained coders coded the common themes of their advice and rated the wise reasoning involved. Additionally, two experts in suicide prevention rated the helpfulness of their advice for the classmate.

RESULTS

The experimental group showed significantly fewer facial expressions of happiness, reported higher sadness and fear, provided less helpful advice, and mentioned "confronting reality" less during advising. The difference in disgust and wise reasoning was nonsignificant.

CONCLUSION

Learning of a classmate's SI may increase fear and sadness among recipients and reduce the helpfulness of their advice. Increased psychoeducation for students that focuses on improving emotional regulation (especially facial expressions) during SI may reduce the stigma surrounding SI and prevent perceived burdensomeness among individuals with SI after SD.

Social Reactions After Disclosing Suicide Loss Among Women

Background: Suicide loss is often concealed. While initial evidence suggests that disclosure is important for healthy grieving, observed beneficial effects may depend on social reactions. Aim: The current study aimed to identify social reactions and associated consequences experienced by persons who lost a loved one to suicide (i.e., suicide loss survivors). Method: We conducted qualitative interviews with 22 female adult suicide loss survivors focusing on social reactions after suicide loss. Interviews were transcribed and analyzed using qualitative content analysis. Results: When talking about their loss with others, suicide loss survivors experienced a broad range of social reactions including compassionate and supportive responses, speechlessness and insecurity, curiosity and gossip, stigmatization, and grieving expectations. Depending on these social reactions, disclosing suicide loss was associated with both negative and positive long-term effects. Limitations: The findings are limited to the current female sample. Conclusion: Interventions that help suicide loss survivors in finding supportive confidants, combined with public interventions to decrease public suicide stigma and improve the public's readiness to provide helpful support to suicide loss survivors, could improve grieving outcomes among this group.

The Influence of Media on the Stigma of Suicide when a Postsecondary Student Dies by Suicide

This study investigated whether media articles from a postsecondary institution could influence students' stigma toward suicide after a student dies by suicide. Undergraduate participants (N = 425) read a fictitious scenario about a student suicide and were randomly assigned to a control article (no mention of the suicide) or one of three intervention articles that acknowledged the suicide and included a discussion with a psychologist, a friend of the decedent, or a suicide survivor. The stigma toward suicide survivors, particularly stereotypes, was significantly less after the three intervention articles compared to the control. No differences were found between the intervention articles or regarding the stigma toward suicide decedents. Reduced stigma toward survivors indicates that acknowledging a suicide, when possible, should be considered.

A narrative inquiry into caregivers' experiences and management after a relative's suicide attempt in a rural community in Northeast Thailand

Suicide attempts have long-term negative consequences for families. This study reports a narrative inquiry using a social constructionist perspective to investigate how caregivers in rural northeast Thailand describe their experiences and management strategies following a family member's suicide attempt. From thematic analysis, three themes emerged: (1) distress and embarrassment, (2) managing to prevent re-attempts, and (3) letting go and moving on with my life. The implications discussed for mental health professionals include recognizing caregivers' experiences and developing more effective ways to manage the risk of future attempts.

Disclosure of suicidal thoughts and behaviors: The impact of suicide event type

OBJECTIVES

Despite its importance, limited work has investigated the nuances of suicidal thoughts and behavior self-disclosure. The present study aimed to examine potential differences in self-disclosure based on whether an individual has disclosed suicidal thinking versus behavior.

METHODS

Two hundred and four participants having disclosed their suicidal thoughts or behaviors completed a battery of online questionnaires assessing several key aspects of disclosure (i.e., disclosure recipient, perceived helpfulness of disclosure, impact on treatment seeking), as it pertained to both one's first and overall disclosure experiences.

RESULTS

Individuals who disclosed a suicide attempt, versus ideation, were more likely to have disclosed to a formal support (i.e., health professional) and to seek professional help following disclosure. No significant group differences in perceived helpfulness of experiences were found.

CONCLUSION

It may be beneficial to increase opportunities for disclosure of suicidal thinking. Overall, disclosures were perceived as helpful and may not impede future help-seeking behavior.

Under the Surface: The Role of Covert Cues in Peer Suicide Risk Referrals

Suicidal thoughts and behaviors are highly prevalent among adolescents, and peers are often the first, and sometimes only, people to know about youth suicidality. Since many adolescents do not directly disclose suicidal thoughts, school-based suicide prevention programs aim to train youth to recognize warning signs of suicide in their peers that serve as "cues" to refer at-risk peers to an appropriate adult. However, peer-presented cues vary widely in presentation, and adolescents are more likely to recognize overt (i.e., obvious or explicit) as opposed to covert (i.e., hidden or implied) cues. The type of cue exhibited may, in turn, affect whether adolescents make a referral to an adult. The current study examined whether training suicide prevention influences referral intentions for overt and covert suicide cues. Participants included 244 high school students (54% female; M _age = 16.21) in the Southeastern United States who received suicide prevention training (SOS; Signs of Suicide) as part of their health curriculum. Prior to training, students endorsed higher referral intentions for peers exhibiting overt compared to covert cues. Training was associated with increased intentions to refer peers across cue type, but referral intentions for covert cues improved significantly from pre to post-training while those for overt cues remained high and stable. Findings suggest that suicide prevention training might differentially improve students' ability to detect and respond appropriately to less obvious indicators of suicide risk. These findings may inform the adaptation and development of future, more nuanced school-based suicide prevention programming.

Discordance between family report and clinical assessment of suicide attempts: a prospective study from the emergency department

Background

Developing accurate identification methods for individuals with suicide attempts and providing them with follow-up care and supports can be a vital component of all comprehensive suicide prevention strategies. However, because of the difficulties concerning one’s intentions behind injurious behaviour, identifying suicide attempts is a challenge for families and clinicians.

Aims

The aim of this study was to investigate the differences between family report and clinical assessment for suicide attempts in the emergency department (ED).

Methods

A total of 148 patients with suspected suicide attempts (SSAs) and 148 family caregivers in the ED were enrolled. The suicide risk module of the Chinese version of the MINI International Neuropsychiatric Interview and the self-report measure were used to assess those with SSA’s suicidal behaviours. The Family Adaptability and Cohesion Evaluation Scales and semi-structured interviews were used to investigate the characteristics of suicide risk and demographics of patients with SSA, as well as the rate and influencing factors of omitted suicide attempts reported by family caregivers.

Results

The underreporting rate for family reported suicide attempts in the ED was 69.0%. The suicide attempts group indicated lower mean scores on perceptions of family resources, adaptability and cohesion. Patients' suicide risk rating (OR=0.152, 95% CI: 0.037 to 0.620, p=0.009), adult-children relationship (OR=5.037, 95% CI: 1.478 to 17.167, p=0.010) and caregiver’s age (OR=0.279, 95% CI: 0.103 to 0.757, p=0.012) might be associated with underreporting by families. If patients committed suicide attempts through a falling injury or medication overdose, their families may have misreported the suicide attempt.

Conclusions

The discordance of suicide attempt records between family report and clinical assessment reveals the limitations of family self-reports when identifying suicide attempts. Interviews and observations, together with information from certain diagnoses, should be combined to accurately identify suicide attempters in the ED.

Family group conferences for suicidal adolescents: Promising results from naturalistic case study research

Can thwarted belongingness and perceived burdensomeness, risk factors for suicidal adolescents, be turned around by family group conferences? In this case study on Nick, a 17-year-old who undertook six suicide attempts, we (including Nick) share insights and learning opportunities on how family group conferences can be used. The thematic analysis suggests that family group conferences might be a promising intervention for suicidal adolescents. For Nick, the conference was a turning point in his life, correcting perceptions of being a burden, pushing back passiveness, and boosting connection with and support from the broad social network.

"Nobody Hears a Silent Cry for Help": Suicide Attempt Survivors' Experiences of Disclosing During and After a Crisis

Suicide remains an important public health issue across the globe. Until recently the medically dominated field of suicide prevention has neglected first-hand accounts of suicidal thoughts and behaviors from those who have survived prior suicide attempts. This qualitative research provides insight into the experience of suicide attempt, highlighting difficulties with disclosure of suicidal thinking prior to, and after, suicide attempts. Semi-structured interviews were undertaken with 31 adult suicide attempt survivors. The focus of the interviews was to explore their experience of suicide attempt and recovery. This paper reports on the complexity involved in disclosing suicidal thoughts or behavior prior to, at the time, or post attempt; the role that help seeking has when someone is acutely suicidal; and the challenges people have in finding their voice at these critical junctures. These factors are both inter- and intra-personal, and are influenced by stigma and lack of understanding of the suicidal state.

Social Support Mediates the Association between Disclosure of Suicide Attempt and Depression, Perceived Burdensomeness, and Thwarted Belongingness

OBJECTIVE

Prior research has found disclosure of concealable stigmatized statuses, including suicide attempt survivorship, to be associated with positive mental health outcomes. This study sought to test the mediating effect of self-reported social support on the association between disclosure of suicide attempt and suicide risk factors in a sample of undergraduate college students.

METHOD

Data were analyzed from 149 undergraduate college students with a history of one or more suicide attempts. Three parallel mediation analyses tested the simultaneous mediating effect of family social support and peer social support on the association between suicide attempt disclosure and suicide risk factors.

RESULTS

Significant total indirect effects in all models indicated family social support and peer social support simultaneously mediated the association between disclosure of suicide attempt and depression, perceived burdensomeness, and thwarted belongingness. The indirect effect on thwarted belongingness via peer social support was stronger than the indirect effect via family social support.

CONCLUSIONS

Disclosure of suicide attempt was associated with higher social support, which was associated with lower suicide risk factors. In a therapeutic context, it is important to consider social support when discussing disclosure of suicide attempt.

Are the "Right" People Selected for First Disclosures About Suicidal Thoughts? Exploring What We Know About Advance Care Planning in the Context of Safety Planning

Nominating primary confidants (i.e., safety plan nominees) is central to safety planning for suicide but there is a dearth of research about such confidants-a serious oversight given their high-leverage position to affect pathways into clinical care. Informed by advance care planning (ACP) work, this study examined differences between social network members who were and were not identified as primary confidants on attributes that could impact their effectiveness in a helping role. Using social network methodology, information was collected from 41 individuals with affective disorders about the 332 people and relationships in their networks. Logistic regression analysis revealed that being perceived as capable of managing stress and prioritizing the participant's best interests over one's own increased the odds of being a primary confidant. Clinicians working with suicidal individuals may benefit from integrating ACP principles-which recognize the thoughtful selection of nominees based on specific attributes-into their safety planning procedures.

Lived Experiences of Suicide Risk and Resilience among Alaska Native and American Indian People

This study explored the lived experiences of suicidality and help-seeking for suicide prevention among Alaska Native and American Indian (AN/AI) people in a tribal health system. An interpretive phenomenological approach was used to analyze semi-structured, in-depth interviews with 15 individuals (ages 15-56) with self-reported histories of suicide ideation and/or attempt. Several factors were found to be central to acquiring resilience to suicide risk among AN/AI people across a wide age range: meaningful and consistent social connection, awareness about how one's suicide would negatively effect loved ones, and knowledge and utilization of available health services. Findings highlight the mutable nature of suicide risk and resilience, as well as the importance of interpersonal factors in suicidality.

Suicide-related disclosure: implications for inclusion and recovery

Purpose

People who have lived experiences with suicide often struggle with concealable stigmatized identities that threaten their inclusion and recovery. While disclosure of a stigmatized identity can promote support and recovery and therefore prevent suicide, it may also present distinct risks. The purpose of this paper is to summarize key issues in suicide-related disclosure, suggest theoretical models for describing suicide-related disclosure and identify research needs.

Design/methodology/approach

This conceptual paper discusses the existing literature on disclosure of concealable stigmatized identities, then explores research on disclosure of suicidal ideation, suicide attempt and suicide loss. Theoretical models (disclosure processes model and interpersonal theory of suicide) that can be employed in understanding suicide-related disclosure are explored. Finally, the paper suggests areas for future research, including longitudinal research to identify strategic disclosure practices that can lead to greater inclusion and recovery.

Findings

Research on suicide-related disclosure should differentiate between disclosure of past and current suicidality, incorporate theoretical frameworks and examine approaches for preparing potential confidants and disclosers for the disclosure process.

Originality/value

This paper highlights issues unique to the disclosure of suicidal thoughts and behaviors, and to suicide loss.

Factors related to suicide's unpredictability: a qualitative study of adults with lived experience of suicide attempts

Purpose: In recent decades, suicide prevention initiatives have increased substantially, yet the suicide rate has continued to rise, and suicide deaths are still generally perceived as unexpected. This study sought to identify factors that might account for this discrepancy by focusing on the exhibition of suicide warning signs.

Methods: Qualitative interviews were conducted with 15 adults [mean age = 36 (SD = 14), 93% female] who had attempted suicide at least once in their lifetime.

Results: A disconnect between participants and their environment emerged as a central theme. Many expressed ambivalence about whether they wanted others to intervene before their attempts, resulting in either expression or inhibition of warning signs. Regardless of whether they wanted their attempt to be predictable, most participants expressed disappointment if they perceived a lack of intervention before their attempt. In some cases, this disappointment exacerbated distress and may have contributed to the attempt itself. Participants also expressed difficulty disclosing their suicidal ideation to others. Thus, even if they wanted help, participants were unsure how to effectively attain it.

Conclusions: Findings underscore the complexity of predicting and preventing suicide; however, engaging individuals with lived experience in these efforts facilitates greater understanding toward outreach and intervention approaches.

Comparing the reasons for suicide from attempt survivors and their families in Ghana

Background

Family members are key in detecting early suicide warning signs. This study compared the reasons for suicidality as reported by attempt survivors with their family folks in Ghana.

Methods

A qualitative design was used to select a sample size of 20 (10 family members and 10 suicide attempt survivors). Thematic analysis was used to analyse the data.

Results

Analysis of the data showed two major themes: 1) Similar Reasons (where both families and attempt survivors consistently reported similar reasons for suicidality and 2) Different Reasons (where there were sharp divergences).

Conclusions

Findings from this study help to understand the readiness of attempt survivor family members to intervene early during suicidal crisis.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6743-z) contains supplementary material, which is available to authorized users.

Benefits and risks of suicide disclosure

RATIONALE

Individuals who attempt suicide are often subject to stigma and may feel ashamed to talk openly about their experiences with suicide. However, failure to disclose could interfere with care-seeking, increase distress, and limit social support. While research on other concealable stigmatized conditions (e.g. mental illness and HIV) has identified the complexities of disclosure decisions, little is known about disclosure for suicide attempt survivors.

OBJECTIVE

Given the lack of research in this area, this study aimed to explore suicide attempt survivor perspectives on risks and benefits of suicide disclosure.

METHODS

Academic researchers partnered with a community-based participatory research team to develop and conduct the research. The team conducted group and individual interviews with U.S. suicide attempt survivors (n = 40), using thematic analysis to code responses into themes for benefits (n = 12) and risks/barriers (n = 10) of disclosing.

RESULTS

Participants collectively identified how disclosure could benefit them (n = 9) through enhanced social support, strengthening of personal relationships, access to treatment, and opportunities for self-reflection. Participants described how disclosure could benefit others (n = 3) by reducing stigma, allowing attempt survivors to help peers who are currently struggling with suicidal ideation, and by providing psychoeducation on suicidality. Participants also described ways that disclosure could put them at risk (n = 8), in terms of stigma, unsupportive reactions, unwanted treatment, or loss of privacy. Participants were concerned that disclosure could put confidants at risk (n = 2) of being overburdened or triggered.

CONCLUSION

While the study methodology did not allow for an exploration of which benefits or risks may be most salient for suicide attempt survivors, this study lays groundwork for future research on disclosure of suicidal thoughts and behaviors. Furthermore, these results can be used by service providers to support suicide attempt survivors in strategic disclosure decisions that maximize benefits and reduce risks.

The Relationship Between Regulatory Emotional Self-Efficacy and Core Self-Evaluation of College Students: The Mediation Effects of Suicidal Attitude

This study analyzed the mediation effect of a suicidal attitude from regulatory emotional self-efficacy to core self-evaluation. A measurement study was conducted among 438 college students using the Regulatory Emotional Self-Efficacy Scale, the Core Self-Evaluation Scale, and the Suicide Attitude Questionnaire. Results from the plug-in process in SPSS and the bootstrap method showed that the attitude toward suicidal behavior and the attitude toward family members of an individual who has committed suicide played a double-mediation role, from perceived self-efficacy in managing happiness to core self-evaluation. The results also showed that the attitude toward a person who committed suicide or attempted suicide played a mediation effect from perceived self-efficacy in managing curiousness to core self-evaluation. This research has great significance for improving the understanding of college students' sense of happiness and prevention for self-evaluation.

The specificity of public stigma: A comparison of suicide and depression-related stigma

Each year, approximately 1.3 million Americans survive a suicide attempt. While stigma has been reported by suicide attempt survivors, limited research has examined how suicide stigma may differ from the stigma of mental illness. U.S. adults (n = 440) completed an online survey in which they were randomly assigned to one of four vignettes. Vignettes depicted a target individual with either past depression, past suicide attempt, death by suicide, or no information on suicide or mental illness (control). Participants completed a general measure of stigma, a suicide-specific stigma measure, and were surveyed on the recovery potential of individuals with mental illness and suicide attempt. While the general stigma measure failed to distinguish between groups, significant differences on the suicide stigma scale (SSAS-44) emerged between participants assigned in the depression and suicide conditions, especially for stereotype and prejudice subscales. Across conditions, participants believed that recovery was more realistic for someone described as having a mental illness than it was for someone described as having attempted suicide. These findings suggest that individuals who have attempted suicide are subject to differential stigma content from those with depression. Implications are discussed for combating stigma for suicide attempt survivors.

Talking about suicide may not be enough: family reaction as a mediator between disclosure and interpersonal needs

BACKGROUND

Although most people who make an attempt do not die, attempt survivors remain at particularly elevated risk for suicide in the short- and long-term. Moreover, the research on suicide-related disclosure and subsequent family reactions on risk factors for the development of suicidal desire is limited.

AIMS

This study examined the relationships between disclosure, family reaction and two interpersonal needs connected to the development of suicidal desire.

METHODS

Data from 74 attempt survivors who participated in a larger study were analyzed to assess the relationships between degree of suicide-related disclosure, quality of family reaction and thwarted belongingness and perceived burdensomeness.

RESULTS

Results indicated that higher rates of disclosure predicted more positive family reactions, which in turn predicted lower levels of thwarted belongingness and perceived burdensomeness. Although there was no direct relationship between disclosure and the outcome variables, bootstrapping analyses indicated that family reaction mediated the relationship between disclosure and both belongingness and burdensomeness.

CONCLUSIONS

These findings suggest the need for more family interventions that promote healthy reactions following suicide-related disclosure in order to facilitate the recovery and treatment process.

The experiences of attempt survivor families and how they cope after a suicide attempt in Ghana: a qualitative study

BACKGROUND

Ghana's socio-cultural landscape proscribes suicidal behaviour, and this has serious ramifications for attempt survivors and their families. The objective of this qualitative study was to understand the experiences of the families of attempt survivors and how they cope with the aftermath of the attempt.

METHODS

Ten families with attempted suicides agreed to participate in the study, hence they were interviewed. The information gathered was manually analyzed according to Interpretative Phenomenological Analysis (IPA) resulting in three major thematic areas.

RESULTS

Three major themes emerged two of which addressed negative experiences and reactions towards the attempts: Experiencing shame and stigma, and Reactive affect. The third theme addressed the coping resources of these informants under the theme: Surviving the stress of attempt. The specific coping resources included personalized spiritual coping, social support, and avoidance.

CONCLUSIONS

Family systems theory is used to explain some of the findings of this study, and the implication for clinical practice and designing postvention programs for families after a suicide attempt are addressed.