Primary Mental Health, Suicide Prevention and Postvention, WellSouth Primary Health Network, Dunedin 9016, New Zealand.
Centre for Science Communication, University of Otago, Dunedin 9054, New Zealand.
Int J Environ Res Public Health. 2021 Jul 29;18(15):8013. doi: 10.3390/ijerph18158013.
Suicidal behavior constitutes a major global problem. Qualitative research utilizing the first-hand experiences of those who have survived attempts to take their own lives can offer much in the way of understanding how to live well despite ongoing suicidal behavior. Given that suicidal intentions and behaviors occur within the person's subjective construal, the solutions to living-and preferably living well-despite such inclinations must also be subjective and adaptive. The aim of this study was therefore to understand how individuals live with different aspects of their suicidal behavior and their use of effective strategies to protect themselves from future attempts. Thematic analysis of semi-structured, qualitative interviews with 17 participants with lived experience of suicidal behavior from the USA yielded two main themes: (i) the 'dynamic relationship with suicidal behavior: living with, and through', and (ii) 'the toolbox'. Each of these themes had four subthemes. Participants in this study offered important insights into what helped them not just survive ongoing suicidal behavior, but how they created unique toolboxes to continue living, and to live well. These toolboxes contained personalized solutions to dealing with recurring threats to their subjective wellbeing and included diverse solutions from spirituality, pets, peer-support, participating in the arts, through to traditional therapeutic supports. Some participants also discussed the importance of broader social policy and societal changes that help them live. The findings highlight crucial implications for suicide prevention efforts, especially in terms of encouraging collaborations with the lived experience community and furthering a strengths-based approach to mitigating suicidal behaviors. We encourage the clinical community to work in partnership with service-users to enable them to generate effective solutions to living-and living well-through suicidal behavior.
自杀行为是一个全球性的重大问题。利用那些曾试图自杀但幸存下来的人的第一手经验进行定性研究，可以深入了解如何在持续存在自杀行为的情况下过上健康的生活。鉴于自杀意图和行为发生在人的主观建构中，因此，尽管存在这种倾向，过上健康的生活——最好是过上健康的生活——的解决方案也必须是主观的和适应性的。因此，本研究的目的是了解个体如何应对自杀行为的不同方面，以及他们如何使用有效的策略来保护自己免受未来的自杀企图。对来自美国的 17 名有自杀行为经历的参与者进行半结构化定性访谈的主题分析产生了两个主要主题：（i）“与自杀行为的动态关系：生活在其中并通过它”，和（ii）“工具包”。这两个主题都有四个子主题。本研究的参与者提供了重要的见解，了解到是什么帮助他们不仅在持续的自杀行为中幸存下来，而且他们如何创建独特的工具包来继续生活，以及如何过上健康的生活。这些工具包包含了个性化的解决方案，以应对对他们主观幸福感的反复威胁，包括从精神信仰、宠物、同伴支持、参与艺术到传统治疗支持的各种解决方案。一些参与者还讨论了广泛的社会政策和社会变革的重要性，这些政策和变革有助于他们生活。研究结果突出了自杀预防工作的重要影响，特别是在鼓励与生活经验社区合作以及进一步采用以优势为基础的方法来减轻自杀行为方面。我们鼓励临床界与服务使用者合作，使他们能够制定有效的解决方案，通过自杀行为过上健康的生活。
