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男性自杀前寻求帮助:遗属的观点。

Help-seeking prior to male suicide: Bereaved men perspectives.

机构信息

School of Nursing, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada; Department of Nursing, University of Melbourne, Victoria, 3010, Australia.

Faculty of Arts and Social Sciences, The University of Sydney, Sydney, NSW, 2006, Australia.

出版信息

Soc Sci Med. 2020 Sep;261:113173. doi: 10.1016/j.socscimed.2020.113173. Epub 2020 Jul 22.

Abstract

Male suicide is a significant issue globally, and implicated are men's challenges around help-seeking and engagement with peer or professional mental health care. While men's reticence for help-seeking predominates as an explanatory gendered dimension for male suicide, there are significant caveats and complexities to fully understanding those practices in the context of men's mental illness and suicidality. The current photo-voice study offers considerable insight into such issues - through the eyes of the bereaved - retrospectively exploring accounts of the deceased's mental health help-seeking prior to the death. Using an interpretive design, and based on semi-structured individual photo-elicitation interviews with 20 men who had lost a male friend, family member or partner to suicide, three key dimensions were identified: 1) Entrapped by secrecy and concealing the need for help, in which the deceased hid their suicide risk and need for peer or professional mental health care; 2) Overwhelming illness that couldn't be helped, wherein the deceased had previously connected with an array of social supports and medical services but was estranged from peer and professional help ahead of the suicide, and 3) Services and systems providing ineffectual help, whereby the deceased was connected with mental health care shortly before the suicide. These themes reveal complex relations to help, and help-seeking in men lost to suicide, as well as bereaved men's reliance on normative masculinities as an explanatory framing of these practices. Discussed within a critical masculinities framework, the current study highlights the need to destigmatize men's mental illness and help-seeking as well as address significant health inequities to aid the efficiencies of men's suicide prevention programs.

摘要

男性自杀是一个全球性的重大问题,涉及到男性在寻求帮助和接受同伴或专业心理健康护理方面的挑战。尽管男性在寻求帮助方面的沉默寡言是解释男性自杀的一个重要性别维度,但在理解男性精神疾病和自杀倾向背景下的这些行为时,存在着重大的限制和复杂性。目前的照片声音研究通过死者亲友的视角,回溯性地探讨了死者在自杀前寻求心理健康帮助的情况,为这些问题提供了重要的见解——通过死者亲友的视角。本研究采用解释性设计,基于对 20 名男性(他们失去了男性朋友、家人或伴侣)的半结构化个人照片访谈,这些男性都经历过自杀,确定了三个关键维度:1)陷入秘密和隐瞒寻求帮助的需要,死者隐瞒了自己的自杀风险和寻求同伴或专业心理健康护理的需要;2)压倒性的疾病无法治愈,死者之前曾与一系列社会支持和医疗服务联系在一起,但在自杀前与同伴和专业帮助疏远;3)服务和系统提供无效的帮助,死者在自杀前不久与心理健康护理机构联系。这些主题揭示了与帮助以及自杀身亡的男性的寻求帮助有关的复杂关系,以及死者亲友依赖于规范性的男子气概来解释这些行为。在批判的男子气概框架内讨论,本研究强调需要消除男性精神疾病和寻求帮助的污名化,并解决重大的健康不平等问题,以提高男性自杀预防计划的效率。

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