The impact of community-based mental health service provision on stigma and attitudes towards professional help-seeking.

BACKGROUND: Stigma of mental ill-health and attitudes towards help-seeking are recognized barriers to seeking professional help, and have previously been linked to the type of support services available. AIMS: This study examined if the introduction of community-based mental health services to an area impacts mental health stigma and attitudes towards professional help-seeking amongst local residents. METHOD: A repeated cross-sectional study comprising of community surveys in two localities was carried out before and after community-based mental health services were introduced (N = 1074). Measures including perceived public and self-stigma of mental ill-health, and attitudes towards seeking professional help were compared across the two time points. RESULTS: Both public and self-stigma were significantly lower, and attitudes towards seeking professional help significantly more positive, after community-based mental health services had been introduced in each locality. CONCLUSIONS: The presence of local, accessible mental health services can positively impact help-seeking behaviour by reducing stigma and changing norms and attitudes around professional help-seeking.

Identification Reduces Stigma of Mental Ill-Health: A Community-Based Study.

The stigma surrounding mental ill-health is an important issue that affects likelihood of diagnosis and uptake of services, as those affected may work to avoid exposure, judgment, or any perceived loss in status associated with their mental ill-health. In this study, we drew upon social identity theory to examine how social group membership might influence the stigma surrounding mental ill-health. Participants from two urban centers in Ireland (N = 626) completed a survey measuring stigma of mental health, perceived social support as well as identification with two different social groups (community and religion). Mediation analysis showed that subjective identification with religious and community groups led to greater perceived social support and consequently lower perceived stigma of mental ill-health. Furthermore, findings indicated that high identification with more than one social group can lead to enhanced social resources, and that identification with a religious group was associated with greater community identification. This study thus extends the evidence base of group identification by demonstrating its relationship with stigma of mental ill-health, while also reinforcing how multiple identities can interact to enhance social resources crucial for well-being.

Therapists' Perspectives on Suicide: A Conceptual Model of Connectedness.

BACKGROUND: A sense of disconnection for people who are suicidal seems to be a key construct of previous literature. Therapists' ways of encountering and understanding people who are suicidal have not been previously researched in depth using qualitative methodologies. AIMS: The current study aims to develop a theoretical framework for the role played by connectedness in relation to suicide based on the perspectives of psychotherapists working in the field of suicide intervention. METHOD: Psychotherapists (N = 12) from a suicide intervention service in Ireland were interviewed in relation to connectedness and suicide. The interviews were analysed using Constructivist Grounded Theory. A tentative theoretical model for connectedness in relation to suicide was developed. RESULTS: Therapists view self-disconnect as at the core of suicidality and note that toxic relationships also play a critical role. Therapeutic connection can present as a life-saving paradox for people who are suicidal. Risk of death and therapeutic endeavour may present as challenging dynamics for working with people who are suicidal. Some discussion points include the worth of self-compassion development for people who are suicidal, the rephrasing of "psychotherapy" when trying to save someone's life and the emphasis on relationship skills for all healthcare professionals who encounter people who are suicidal. Clinical or methodological significance of this article: This article is one of the first in which therapists are interviewed about their understandings of suicide and the processes of suicide in the therapeutic space. It offers novel insights about how people who are suicidal present in therapy and what may be contributing to this presentation. The research also gives insights on the struggles for therapists working with people who are suicidal and who may be ambiguous about the prospect of therapy and connecting. The study also offers important direction for future studies in relation to what requires further discussion and exploration regarding engaging in therapy with people who are suicidal. In addition, the current study can offer previously unexplored insights regarding suicide and therapy that may have the potential to assist in future intervention for people who are risk of killing themselves.

Understanding help-seeking amongst university students: the role of group identity, stigma, and exposure to suicide and help-seeking.

BACKGROUND: Despite a high prevalence of suicide ideation and mental health issues amongst university students, the stigma of help-seeking remains a barrier to those who are in real need of professional support. Social identity theory states that help received from an ingroup source is more welcome and less threatening to one's identity than that from a source perceived as outgroup. Therefore, we hypothesized that students' stigma toward seeking help from their university mental health service would differ based on the strength of their identification with the university. METHOD: An online survey including measures of stigma of suicide, group identification, experience with help-seeking and exposure to suicide was administered to Irish university students (N = 493). RESULTS: Group identification was a significant predictor of help-seeking attitudes after controlling for already known predictors. Contrary to our expectations, those who identified more strongly with their university demonstrated a higher stigma of seeking help from their university mental health service. CONCLUSIONS: RESULTS are discussed in relation to self-categorization theory and the concept of normative fit. Practical implications for mental health service provision in universities are also addressed, specifically the need for a range of different mental health services both on and off-campus.

Developing the Pieta House Suicide Intervention Model: a quasi-experimental, repeated measures design.

BACKGROUND: While most crisis intervention models adhere to a generalised theoretical framework, the lack of clarity around how these should be enacted has resulted in a proliferation of models, most of which have little to no empirical support. The primary aim of this research was to propose a suicide intervention model that would resolve the client's suicidal crisis by decreasing their suicidal ideation and improve their outlook through enhancing a range of protective factors. The secondary aim was to assess the impact of this model on negative and positive outlook. METHODS: A quasi-experimental, pre-test post-test repeated measures design was employed. A questionnaire assessing self-esteem, depression, and positive and negative suicidal ideation was administered to the same participants pre- and post- therapy facilitating paired responses. RESULTS: Multiple analysis of variance and paired-samples t-tests were conducted to establish whether therapy using the PH-SIM had a significant effect on the clients' negative and positive outlook. Analyses revealed a statistically significant effect of therapy for depression, negative suicidal ideation, self-esteem, and positive suicidal ideation. Negative outlook was significantly lower after therapy and positive outlook significantly higher. CONCLUSIONS: The decreased negative outlook and increased positive outlook following therapy provide some support for the proposed model in fulfilling its role, though additional research is required to establish the precise role of the intervention model in achieving this.