Elza Berk12, Benny Prawira13, Latifah N. Wangui14, Arnold Agaba15, Julieann Cullen16, Rory R. O’Connor17, Ian Marsh18, Farshid Shamsaei19,
Ilaria Bonoldi3, Alberto Stefana20, Stefano Damiani1, Ilaria Basadonne1, Angad Singh21, Silvia Fontana1, Irene Curti1, Laura Massari1,
Aurora Legittimo1, Samuele Cortese22-24, Dong Keon Yon25, Jae Il Shin26, Luis Madeira27, Giovanni Stanghellini28,29, Mario Rossi Monti30,
Matthew Ratcliffe31, Maurizio Pompili32, Mario Maj33
1 Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy;
2 Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK;
3 OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK;
4 National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley, London, UK;
5 Department of Neurosciences and Mental Health, IRCCS Fondazione Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy;
6 S. Kierkegaard Research Centre, University of Copenhagen, Copenhagen, Denmark; 7 Department of Psychology, School of Medicine and Health Sciences, G. D’Annunzio University of Chieti and Pescara, Chieti, Italy;
8 Australian Centre for Lived Experience, Melbourne, Australia;
9 Global Mental Health Peer Network, Jakarta, Indonesia;
10 Indonesian Community Care for Schizophrenia, Jakarta, Indonesia;
11 University of Manchester, Manchester, UK;
12 Global Mental Health Peer Network, Cape Town, South Africa;
13 Into The Light Indonesia, Jakarta, Indonesia;
14Global Mental Health Peer Network, Nairobi, Kenya;
15 Global Mental Health Peer Network, Kigali, Rwanda;
16 Global Mental Health Peer Network, Dublin, Ireland;
17 Centre for Applied Behavioural Sciences, Heriot-Watt University, Edinburgh, UK;
18 Canterbury Christ Church University, Canterbury, UK;
19 School of Nursing & Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran;
20 Center for Behavioural Sciences and Mental Health, National Institute of Health, Rome, Italy; 21 Department of Psychiatry, University of Toronto, Toronto, ON, Canada;
22 Developmental EPI (Evidence synthesis, Prediction, Implementation) lab, Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK;
23 Solent NHS Trust, Southampton, UK;
24 Hassenfeld Children’s Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA;
25 Department of Pediatrics, Kyung Hee University College of Medicine, Yonsei University College of Medicine, Seoul, South Korea;
26 Severance Underwood Meta-Research Center, Institute of Convergence Science, Yonsei University, Seoul, South Korea;
27 Faculty of Medicine, University of Lisbon, Lisbon, Portugal;
28 Department of Health Sciences, University of Florence, Florence, Italy;
29 D. Portales University, Santiago, Chile;
30 Department of Humanistic Studies, University of Urbino, Urbino, Italy;
31 Department of Philoso-phy, University of York, York, UK; 32Suicide Prevention Center, Department of Neurosciences, Mental Health and Sensory Organs, St. Andrea Hospital, Sapienza University of
Rome, Rome, Italy; 33Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
PDFAbstract
This is the first bottom-up review of the lived experience of persons who attempt suicide. The study has been co-designed, co-conducted and co-written by experts by experience and academics, focusing on first-person narratives within and outside the medical field. The lived world of individuals who attempt suicide is characterized by experiences related to the attempt itself (“contemplating suicide as a deliberate death”, “contemplating suicide as an escape route”, “looking for online answers about suicide”, “planning suicide”, “finding rest between the suicidal decision and the final act”, “changing one’s mind during the suicide attempt”, “acting on suicidal impulses”); experiences related to the self and time (“feeling unworthy”, “feeling detached from oneself or the world and lacking a sense of agency”, “splitting the self between the decision to live or die”, “perceiving an abortive and doomed future”); and experience of emotions and the body (“feeling overwhelmed by hopelessness and despair”, “feeling empty and drained of energy”, “feeling alone”). The lived experience of individuals who attempt suicide is also described in terms of the social and cultural context, including the experience of others (“feeling that no one cares”, “feeling like a burden to others”, “facing others’ difficulty in understanding”); cultural, gender and age differences (“experiencing geographical, cultural and religious taboos about suicide”, “feeling inadequate in relation to gender stereotypes”, “feeling abandoned in old age”); and the perception of stigma (“facing social stigma”, “experiencing a stigmatized self”, “silencing suicidal behaviors”). The lived experience of persons after an attempted suicide is characterized as a complex process of self-acceptance and rediscovery (“living with suicidal thoughts”, “navigating the challenges of recovery”, “gaining new perspectives during recovery”, “restoring interpersonal relationships to recover”). Finally, the lived experience of individuals who attempt suicide is described with respect to their access to general health care (“seeking help before the suicide attempt”, “feeling abandoned after a suicide attempt”) and mental health care (“experiencing shame as a barrier to care”, “fearing mental disorder label”, “feeling accepted and listened to”, “facing economic difficulties in accessing support”, “coping with distress during hospitalization”). The experiences described in this paper hold educational and social value, informing medical and psychological practices and research, public health approaches, and promotion of social change. This research overcomes embarrassment, fear and stigma, and helps us to understand the fragile nature of our emotions and feelings, our immersion in the social world, and our sense of meaning in life.
https://onlinelibrary.wiley.com/doi/10.1002/wps.70003
