Strategies to Stay Alive: Adaptive Toolboxes for Living Well with Suicidal Behavior.

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.

Influence of Spiritual Dimensions on Suicide Risk: The Role of Regional Differences.

The field of suicide prevention has been enriched by research on the association between spirituality and suicide. Many authors have suggested focusing on the various dimensions of religiosity in order to better understand the association between religion and suicidal risk, but it is unclear whether the relationship between spirituality and suicidality differs between countries with different cultures, life values, and sociohistorical experiences. To explore this, the aim of this multicenter study was to investigate the possible relationship between suicide and spirituality in Italy and Austria. In the two countries, two different groups of subjects participated: psychiatric patients and university students. The patients were evaluated with the Mini International Neuropsychiatric Interview. In addition, the following measures were used: a sociodemographic questionnaire, the Columbia-Suicide Severity Rating Scale-B, the Symptom-Checklist-90-Standard, and the Multidimensional Inventory for Religious/Spiritual Well-Being. Our results confirmed the multifactorial nature of the relation between suicide risk and the various religious/spiritual dimensions, including religious/spiritual well-being and hope immanent. However, regional differences moderated this relationship in both the clinical and nonclinical samples.

Religion and spirituality in online suicide bereavement: an analysis of online memorials.

BACKGROUND: Religion and spirituality can be valuable resources in coping with bereavement. There is a paucity of studies focusing specifically on their role in suicide bereavement, although there are indications that religion/spirituality can be helpful for suicide survivors. AIMS: The study explores the role of religion and/or spirituality in suicide bereavement by analyzing this theme in online memorials dedicated to suicide victims. METHOD: We randomly selected 250 memorials in two online cemeteries: Faces of Suicide and Gone too Soon. Interpretative and deductive thematic analysis was used to identify themes in the collected material, including the theme of religion/spirituality. RESULTS: References to religion/spirituality were found in 14% of memorials. These memorials were written by family members, friends, and (ex-)partners of the deceased and were dedicated mostly to young adult males. Religion/spirituality was mentioned in the context of God's will, peace wish, continuation of the spirit, afterlife, reunion, gratitude, description of the deceased, and grief reactions of suicide survivors. CONCLUSION: Some suicide survivors spontaneously mention the role of religious/spiritual beliefs in coping with their loss. Future studies could explore which subgroups of the bereaved are likely to turn to these resources, and whether they can contribute to the well-being of the suicide survivors.