Experiences and Beliefs about Supports and Interventions for Suicidal Thoughts and Behaviors: A Lived Experience Perspective

Body of Abstract: Experiences and Beliefs about Supports and Interventions for Suicidal Thoughts and Behaviors: A Lived Experience Perspective

Clinical and Lived Experience Tracks

This project was approved by the IRB at Salem State University

Research Aims

Although much has been written about help-seeking and interventions for suicidal thoughts and behaviors, most of the research does not include the perspectives of those with lived experience. Instead, it focuses on effective interventions, disclosure behaviors, and strategies to increase help-seeking. However, we know that many people do not seek treatment services for suicidality or disclose suicidal thoughts and behaviors to mental health professionals (Holt et al., 2024; McGillivray et al., 2022; Shin et al., 2024), and this is more likely for those who had previously been hospitalized (Podlogar et al., 2022). It is essential to develop a better understanding of people’s experiences with help-seeking, barriers to accessing services, and ways to make services more accessible and helpful for individuals experiencing suicidal thoughts and behaviors. This project explored the experiences of individuals with lived experiences with suicidal thoughts and behaviors with informal and formal support services, how helpful these supports were, and plans to use supports in the future.

Methods

A cross-sectional survey design explored individuals’ experiences with help-seeking and planned future help-seeking for suicidal thoughts and behaviors. Using an online survey [via Survey Monkey] created by the researchers, participants responded to questions about past experiences seeking informal and formal support, the helpfulness of those supports, and plans to use support or treatment in the future. Chi Square analyses explored associations between marginalized identities and these experiences. Thematic analysis was used to code open-ended responses.

Results

Participants (N=303) were individuals with a history of suicidal thoughts and/or behaviors, with 48.8% female, 30.7% male, and 5.6% genderqueer. One-quarter (26.4%) identified as LGBTQ+ and 24.1% were neurodiverse. The sample was majority White (62.4%), with 13.5% Black, 5.0% Asian, 3.3% multiracial, and 2.6% indigenous. Only 4.8% were Hispanic. Most (75.6%) ranged from 18 to 44 years old.
Most participants (81.8%) had sought either formal or informal support for suicidal thoughts and behaviors with the most common being telling a trusted person (friend or family member) (60.1%), disclosing to a mental health professional (49.8%), and going to an ER (29.7%). Online support was commonly utilized, with 61.7% reporting they use websites to find support.

More than half (65.4%) reported at least one treatment service was harmful or traumatic. The most frequently named harmful intervention was ER visits, which were reported to be harmful by 15.6% of those who used that intervention. Experiencing a harmful or traumatic intervention was more common for genderqueer people (91.7%) than men (70.0%) or women (59.5%) (χ2(2)=6.200, p=0.045), for trauma survivors vs. those who had not experienced trauma (72.9% vs 58.7%) (χ2 (1)=5.073, p=0.024), and for suicide attempt survivors vs. those who had not made an attempt (77.1% vs. 58.1%) (χ2 (1)=8.882, p=0.003). There was no significant association between race, ethnicity, neurodiversity, or sexual identity and harmful/traumatic treatment experiences.

Many participants were reluctant to engage in additional formal help-seeking, with only 36.0% reporting they would definitely use individual therapy to address suicidality in the future. Intensive treatment services and inpatient hospitalization received even less endorsement (16.2% and 11.6%, respectively). In fact, 36.3% said they would definitely or probably not use inpatient hospitalization in the future. Suicide attempt survivors were even less likely to include hospitalization as an aspect of their future treatment, with 26.2% of suicide attempt survivors reported they would definitely not use inpatient hospitalization services in the future, twice as many as the 11.1% who were not suicide attempt survivors (χ2 (1)=5.073, p=0.024). Nonbinary/genderqueer participants were much more likely to report they would definitely not use inpatient hospitalization in the future (41.2%) compared to 20.4% of women and 6.6% of men. There were no significant differences by race or ethnicity.

Conclusion

In conclusion, many people with a history of suicidal thoughts and/or behaviors have had negative experiences with treatment services and do not plan to use them in the future, especially those from specific high-risk groups (e.g. genderqueer, suicide attempt survivors). Better understanding this reluctance and improving treatment services, especially for traditionally marginalized populations, is essential future work (Holt et al., 2024; Shin et al., 2024).