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Reily NM, Tang S, Batterham PJ, Aadam B, Draper B, Shand F, Han J, Nicholas A, Christensen H. Help-Seeking and Barriers to Service Use amongst Men with Past-Year Suicidal Ideation and not in Contact with Mental Health Services. Arch Suicide Res 2024; 28:482-498. [PMID: 36987997 DOI: 10.1080/13811118.2023.2190781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
OBJECTIVE Men are less likely than women to engage with formal mental health services for suicidality. We describe the sources of support, barriers to service use, and coping strategies of men with past-year suicidal ideation who are not receiving formal mental health services. METHOD Australian men experiencing past-year suicidal ideation who also did not receive formal mental health services within the past year (n = 176) completed a survey that assessed help-seeking behaviors, coping strategies and styles, use of general services, barriers to service use, and individual-level characteristics. Analyses included descriptive statistics and bivariate analyses. RESULTS The most common type of support was self-help resources, and self-reliance was the most common barrier to formal mental health service use. Most participants had seen a GP for non-mental-health-related reasons in the past year. Men who did not seek any help for their suicidality experienced lower instrumental barriers and perceived need for support, and lower levels of certain coping styles. Limitations included a cross-sectional design and small sample size. CONCLUSION The current study provides insight into the help-seeking experiences of men with past-year suicidality and not receiving formal mental health services. The findings suggest it may be helpful to improve the linkage between online and informal sources of support and evidence-based interventions.
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Macdonald D, Nicolopoulos A, Habak S, Christensen H, Boydell K. Suicidal Emotions, Motivations and Rationales in Australian Men: A Qualitative Exploration. Glob Qual Nurs Res 2024; 11:23333936241242915. [PMID: 38572389 PMCID: PMC10989048 DOI: 10.1177/23333936241242915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 03/10/2024] [Accepted: 03/13/2024] [Indexed: 04/05/2024] Open
Abstract
Suicide has a devasting and far-reaching effect on our communities. In developed countries, most people who die by suicide are male. Understanding men's mental health and what they experience in a suicidal state is key to preventing future attempts. Our paper explores how a group of 37 men in Australia describe the leadup to their suicidality. Underpinned by interpretive phenomenological analysis, interview transcripts were examined for phrases that the investigative team subjectively identified as profound. Our approach considered language and expression that evoke reactions to the sometimes contradictory nature of suicide. The process enabled our team to identify the emotions, rationales, and motivations for and against suicide that give rise to and arise during suicidal states. One man's source of strength may be another's cause of anguish, so any single, one-size-fits-all pathway to suicide prevention is unlikely to succeed, signaling the need for a tailored approach to suicide prevention.
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Affiliation(s)
- Diane Macdonald
- Black Dog Institute and School of Medicine & Health, UNSW Sydney, Randwick, NSW, Australia
| | | | - Stephanie Habak
- Black Dog Institute and School of Medicine & Health, UNSW Sydney, Randwick, NSW, Australia
| | - Helen Christensen
- Black Dog Institute and School of Medicine & Health, UNSW Sydney, Randwick, NSW, Australia
| | - Katherine Boydell
- Black Dog Institute and School of Medicine & Health, UNSW Sydney, Randwick, NSW, Australia
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Hanlon CA, Chopra J, Boland J, McIlroy D, Poole H, Saini P. A mixed-methods evaluation of the acceptability and fidelity of the James' Place model for men experiencing suicidal crisis. Health Psychol Behav Med 2023; 11:2265142. [PMID: 37842012 PMCID: PMC10572045 DOI: 10.1080/21642850.2023.2265142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/25/2023] [Indexed: 10/17/2023] Open
Abstract
Background Research supports development of informal, community-based suicide prevention interventions that can be tailored to suit men's unmet needs. The James' Place model (JPM) is a community-based, clinical suicide prevention intervention for men experiencing suicidal crisis. Evidence supports the efficacy of the JPM and there are plans to expand to additional sites across the UK. This study evaluates therapists perceived acceptability of the JPM, and if fidelity to the planned delivery of the model is maintained within therapeutic practice. Method A mixed-methods design was used. Descriptive analyses of 30 completed intervention cases were examined to review fidelity of the model against the intervention delivery plan. Eight therapists took part in semi-structured interviews between November 2021 and March 2022 exploring the perceived acceptability, and barriers and facilitators to delivering the JPM. Results Descriptive analyses of James' Place audit notes revealed high levels of adherence to the JPM amongst therapists, but highlighted components of the model needed to be tailored according to individual men's needs. Thematic analysis led to the development of five themes. The first theme, therapeutic environment highlighted importance of the therapy setting. The second theme identified was specialised suicide prevention training in the JPM that facilitated therapists understanding and expertise. The third theme identified was therapy engagement which discusses men's engagement in therapy. The fourth theme, person-centred care related to adaptation of delivery of JPM components. The final theme, adapting the JPM to individual needs describes tailoring of the JPM by therapists to be responsive to individual men's needs. Conclusion The findings evidence therapist's acceptability and their moderate adherence to the JPM. Flexibility in delivery of the JPM enables adaptation of the model and co-production of therapy to meet men's needs. Implications for clinical practice are discussed.
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Affiliation(s)
- Claire Anne Hanlon
- Department of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Jennifer Chopra
- Department of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Jane Boland
- MSc Leadership in Healthcare, James’ Place, Liverpool, UK
| | - David McIlroy
- Department of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Helen Poole
- Department of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Pooja Saini
- Department of Psychology, Liverpool John Moores University, Liverpool, UK
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Violi D, Lewis P, Kwok C, Wilson NJ. Becoming a non-resident father: Marginalised through distress, disadvantage and disempowerment. Health Promot J Austr 2023; 34:714-722. [PMID: 37779196 DOI: 10.1002/hpja.810] [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: 03/20/2023] [Revised: 07/11/2023] [Accepted: 09/13/2023] [Indexed: 10/03/2023] Open
Abstract
ISSUE ADDRESSED Becoming a non-resident father through divorce is stressful and this often results in compromised mental health and well-being. Non-resident fathers' mental well-being has been measured at very low levels which may require clinical treatment, especially when correlated with child access and family court issues. A United Nations report highlighted how non-resident fathers may be marginalised, but to date, limited literature considers the lives of non-resident fathers from their own perspective and reflecting their own voice and it has been claimed that as fathers are often absent from parenting research, this absence, they are not heard. The aim of this paper was to identify how non-resident fathers' interactions with legal and welfare services and ex-partners may result in their marginalisation and affect their mental health. METHODS In-depth interviews with open-ended questions were conducted with 19 non-resident fathers, both long term, newly divorced or in the divorce process, so as to capture a long range view of their experiences. Thematic Analysis was used for data analysis and the generation of the themes. RESULTS Three themes emerged from the data: (1) Becoming a non-resident father with two sub themes; (2) Being in a state of distress, with three sub-themes and (3) Managing distress and seeking help, with two sub-themes. Participants reported a lack of agency, lack of power in decision making and a lack of social and financial resources all contributing to the deterioration in their self-reported experiences of mental health. This impact was highlighted by the number of participants who undertook counselling or psychological assistance to deal with their perceived marginalisation, feeling of invisibility and disempowerment. CONCLUSIONS The implications of marginalisation for non-resident fathers' mental health, as outlined by the participants, are discussed regarding the impact of becoming a non-resident father, legal aspects, welfare service experiences and relationship with ex-partner. The chronic stress experienced by non-resident fathers who often find themselves in a situation which is difficult to resolve without major compromises to their desired outcomes must be recognised. SO WHAT One means of achieving better mental health for non-resident fathers is to address the impact of marginalisation and lack of agency and that court processes are resolved swiftly with a view to increasing non-resident father's agency in post-divorce decision making.
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Affiliation(s)
- Dominic Violi
- School of Nursing and Midwifery, Western Sydney University, Richmond, Australia
| | - Peter Lewis
- School of Nursing and Midwifery, Western Sydney University, Richmond, Australia
| | - Cannas Kwok
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Nathan J Wilson
- School of Nursing and Midwifery, Western Sydney University, Richmond, Australia
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Seidler ZE, Wilson MJ, Oliffe JL, Fisher K, O’Connor R, Pirkis J, Rice SM. Suicidal ideation in men during COVID-19: an examination of protective factors. BMC Psychiatry 2023; 23:46. [PMID: 36650456 PMCID: PMC9845104 DOI: 10.1186/s12888-023-04539-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 01/09/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Men account for three-quarters of all suicide deaths in many Western nations including Australia. Whilst extensive research has examined risk factors for suicidal ideation and behaviour in men, protective factors remain underexplored, particularly social support, resilience and coping behaviours. Such factors are important to examine particularly in the context of COVID-19, where enforced isolation (among other negative lifestyle effects) has created widespread risk for the development of suicidal ideation. This mixed-methods study aimed to examine associations of various protective factors with suicidal ideation in men, using data from an online survey conducted during the COVID-19 pandemic. In addition, we aimed to qualitatively investigate men's self-reported protective strategies when experiencing suicidal thoughts and behaviour. METHODS A convenience sample of 700 men (age M = 50.3 years; SD = 15.2 years) responded to an online survey including quantitative measures of suicidal ideation, planning and attempt, alongside employment and relationship status, coping, social support, resilience, and a qualitative free-text item gauging men's self-reported protective strategies. Multinomial logistic regression was applied to compare odds of sub-categories of suicide risk (ideation; planning) according to protective factors. Qualitative responses were analysed via thematic analysis. RESULTS Men in a relationship, and those lower in emotion-focused and avoidant coping reported lower odds of suicidal ideation. Maintaining employment throughout the pandemic was protective against suicidal ideation and planning; as was greater perceived social support from friends. Greater self-reported resilience was protective against suicidal ideation and planning. Qualitative analyses led to the development of two themes: coping and connecting, reflecting men's intra- and interpersonal management strategies; and sustaining selflessness, where men's imaginings of the collateral damage of their suicidal behaviour was protective against action on suicidal thoughts or plans. CONCLUSIONS Findings of this study speak to the nuanced roles of interpersonal connections, resilience and coping behaviours in protecting against suicidal ideation and planning in men. In addition, qualitative insights further cement men's identification with familial protector and/or provider roles as protective against suicidal action.
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Affiliation(s)
- Zac E. Seidler
- grid.488501.00000 0004 8032 6923Orygen, Melbourne Parkville, Australia ,grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, The University of Melbourne, Parkville, Australia ,Movember, Melbourne, Australia
| | - Michael J. Wilson
- grid.488501.00000 0004 8032 6923Orygen, Melbourne Parkville, Australia ,grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - John L. Oliffe
- grid.17091.3e0000 0001 2288 9830School of Nursing, University of British Columbia, Vancouver, Canada ,grid.1008.90000 0001 2179 088XDepartment of Nursing, The University of Melbourne, Parkville, Australia
| | - Krista Fisher
- grid.488501.00000 0004 8032 6923Orygen, Melbourne Parkville, Australia ,grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Rory O’Connor
- grid.8756.c0000 0001 2193 314XSuicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Jane Pirkis
- grid.1008.90000 0001 2179 088XCentre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Simon M. Rice
- grid.488501.00000 0004 8032 6923Orygen, Melbourne Parkville, Australia ,grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, The University of Melbourne, Parkville, Australia
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Tang S, Reily NM, Batterham PJ, Draper B, Shand F, Han J, Aadam B, Christensen H. Correlates of non-receipt of formal mental health services among Australian men experiencing thoughts of suicide. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Tyler S, Gunn K, Esterman A, Clifford B, Procter N. Suicidal Ideation in the Australian Construction Industry: Prevalence and the Associations of Psychosocial Job Adversity and Adherence to Traditional Masculine Norms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315760. [PMID: 36497834 PMCID: PMC9738943 DOI: 10.3390/ijerph192315760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND Suicide in the Australian Construction Industry (ACI) is a significant issue, however minimal understanding of suicidal ideation prevalence, as well as the potential role psychosocial job adversity and increased adherence to traditional masculine norms may play in its presence, is apparent. METHOD A representative sample of Australian men (n = 11,132) were used to create initial understandings of prevalence of suicidal ideation (past two weeks), psychosocial job adversities and level of adherence to traditional masculine norms for the ACI (n = 1721) in comparison to a general population comprised of the remaining employed males from Other Industries (n = 9411). Additionally, due to their reported increased suicide vulnerability investigation of associations between suicidal ideation, psychosocial job adversities and adherence to traditional masculine norms for the ACI were undertaken. RESULTS No difference in suicidal ideation prevalence was reported between the ACI and those employed in Other Industries (p > 0.05), however, increased prevalence of psychosocial job adversities (p ≤ 0.001) and adherence to traditional masculine norms (p ≤ 0.001) for the ACI was seen. Significant multivariate associations between suicidal ideation, psychosocial job adversities (OR = 1.79, 95%CI [1.12-2.85]) and two domains of traditional masculine norms, self-reliance (OR = 1.29, 95%CI [1.09-1.51]) and risk-taking (OR = 1.20, 95%CI [1.01-1.41]), were reported. CONCLUSION Results suggest need for increased understanding of later stage suicidal trajectory drivers in the ACI. Findings indicate need for prevention group/industry concentration on mitigation of psychosocial job adversities, as well as a more nuanced and increased discussion of the negative role of self-reliance and risk-taking domains of traditional masculine norms may play in ACI suicidal ideation, as opposed to the construct as a whole.
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Affiliation(s)
- Simon Tyler
- Mental Health and Suicide Prevention Research and Education Group, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA 5001, Australia
| | - Kate Gunn
- Department of Rural Health, University of South Australia, Adelaide, SA 5001, Australia
| | - Adrian Esterman
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, SA 5001, Australia
| | - Bob Clifford
- MATES in Construction South Australia, Adelaide, SA 5034, Australia
| | - Nicholas Procter
- Mental Health and Suicide Prevention Research and Education Group, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA 5001, Australia
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Gonçalves de Andrade E, González Ibáñez F, Tremblay MÈ. Microglia as a Hub for Suicide Neuropathology: Future Investigation and Prevention Targets. Front Cell Neurosci 2022; 16:839396. [PMID: 35663424 PMCID: PMC9158339 DOI: 10.3389/fncel.2022.839396] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/22/2022] [Indexed: 12/27/2022] Open
Abstract
Suicide is a complex public health challenge associated worldwide with one death every 40 s. Research advances in the neuropathology of suicidal behaviors (SB) have defined discrete brain changes which may hold the key to suicide prevention. Physiological differences in microglia, the resident immune cells of the brain, are present in post-mortem tissue samples of individuals who died by suicide. Furthermore, microglia are mechanistically implicated in the outcomes of important risk factors for SB, including early-life adversity, stressful life events, and psychiatric disorders. SB risk factors result in inflammatory and oxidative stress activities which could converge to microglial synaptic remodeling affecting susceptibility or resistance to SB. To push further this perspective, in this Review we summarize current areas of opportunity that could untangle the functional participation of microglia in the context of suicide. Our discussion centers around microglial state diversity in respect to morphology, gene and protein expression, as well as function, depending on various factors, namely brain region, age, and sex.
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Affiliation(s)
- Elisa Gonçalves de Andrade
- Neuroscience Graduate Program, Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Fernando González Ibáñez
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Axe Neurosciences, Centre de Recherche du CHU de Québec, Université Laval, Québec City, QC, Canada
| | - Marie-Ève Tremblay
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Axe Neurosciences, Centre de Recherche du CHU de Québec, Université Laval, Québec City, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
- Department of Molecular Medicine, Université Laval, Québec City, QC, Canada
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC, Canada
- Centre for Advanced Materials and Related Technology (CAMTEC), University of Victoria, Victoria, BC, Canada
- *Correspondence: Marie-Ève Tremblay,
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Wilson MJ, Seidler ZE, Oliffe JL, Toogood N, Kealy D, Ogrodniczuk JS, Walther A, Rice SM. "Appreciate the Little Things": A Qualitative Survey of Men's Coping Strategies and Mental Health Impacts During the COVID-19 Pandemic. Am J Mens Health 2022; 16:15579883221099794. [PMID: 35608377 PMCID: PMC9134443 DOI: 10.1177/15579883221099794] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The COVID-19 pandemic has presented a suite of circumstances that will simultaneously affect mental health and mobilize coping strategies in response. Building on a lack of research specifically exploring men's mental health impacts during the COVID-19 pandemic, this study presents the results of a qualitative survey exploring men's self-reported aspects of the pandemic giving rise to mental health challenges, alongside their diverse coping strategies applied during this time. The sample comprised 555 men from North America (age M = 38.8 years; SD = 13.5 years), who participated via an online survey with two open-ended qualitative questions assessing, respectively, the aspects of the pandemic affecting their mental health, and the strategies used to manage these challenges. Free-text responses were coded using inductive content analysis. Results pertaining to the mental health impacts of COVID-19 were categorized into two overarching themes: far-reaching ramifications of COVID-19 encompassing consequences for lifestyle, work, and functioning, alongside novel anxieties related to health risks and daily uncertainty. In addition, coping strategies reported were categorized into two broad themes: efforts to avoid, dull or distract oneself from distress, alongside adapting and doing things differently, which encompassed largely approach-oriented efforts to flexibly ameliorate distress. Results signal the far-reaching impacts of COVID-19, alongside profound flexibility and diverse enactments of resilience among men in adapting to unprecedented challenges. Findings have implications for mental health promotion that should aim to leverage men's adaptive coping to encourage opportunities for social connectedness in response to the mental health impacts of the various psychosocial challenges of the COVID-19 pandemic.
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Affiliation(s)
- Michael J Wilson
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia
| | - Zac E Seidler
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia.,Movember, Richmond, Victoria, Australia
| | - John L Oliffe
- School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada.,Department of Nursing, The University of Melbourne, Victoria, Australia
| | - Nicholas Toogood
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia
| | - David Kealy
- Department of Psychiatry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - John S Ogrodniczuk
- Department of Psychiatry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Andreas Walther
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Simon M Rice
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia
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