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Coping With Thoughts of Suicide: Techniques Used by Consumers of Mental Health Services

Dr. Alexander is affiliated with the Department of Epidemiology and Health and Mr. Haugland is with the Department of Statistics and Services Research, both at the Nathan S. Kline Institute, 140 Old Orangeburg Rd., Building 37, Orangeburg, NY 10962 (e-mail: mja{at}nki.rfmh.org). Mr. Ashenden is with the Depression Bipolar Support Alliance, Chicago. Dr. Knight is with the Department of Recovery, Rehabilitation, and Mutual Support, ValueOptions, Colorado Springs. Mr. Brown is with the Mental Health Empowerment Project, Albany, New York. A draft of this article was presented at the American Public Health Association annual meeting, Washington, D.C., November 3–7, 2007.

OBJECTIVE: Suicide is a devastating public health problem, and research indicates that people with prior attempts are at the greatest risk of completing suicide, followed by persons with depression and other major mental and substance use conditions. Because there has been little direct input from individuals with serious mental illness and a history of suicidal behavior concerning suicide prevention efforts, this study examined how this population copes with suicidal thoughts. METHODS: Participants in 14 regional consumer-run Hope Dialogues in New York State (N=198) wrote up to five strategies they use to deal with suicidal thoughts. Strategies were classified according to grounded theory. RESULTS: First responses included spirituality, talking to someone, positive thinking, using the mental health system, considering consequences of suicide to family and friends, using peer supports, and doing something pleasurable. Although a majority reported that more formal therapeutic supports were available, only 12% indicated that they considered the mental health system a frontline strategy. Instead, respondents more frequently relied on family, friends, peers, and faith as sources of hope and support. CONCLUSIONS: Consumers' reliance on formal therapeutic supports and support from peers and family suggests that education and support for dealing with individuals in despair and crisis should be targeted to the social networks of this high-risk population. The disparity between availability of formal mental health services and reliance on them when consumers are suicidal suggests that suicide prevention efforts should evaluate whether they are effectively engaging high-risk populations as they struggle to cope with despair.

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