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      Stakeholder Perspectives on the Stigma of Suicide Attempt Survivors

      research-article
      1 , , 1 , 1 , the Stigma of Suicide Research Team 1
      Crisis
      Hogrefe Publishing
      stigma, suicide, discrimination, prejudice, stereotypes

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          Abstract

          Abstract. Background: Past scholarly efforts to describe and measure the stigma surrounding suicide have largely viewed suicide stigma from the perspective of the general public. Aims: In the spirit of community-based participatory research (CBPR), the current study brought together a diverse stakeholder team to qualitatively investigate the suicide stigma as experienced by those most intimately affected by suicide. Method: Seven focus groups ( n = 62) were conducted with suicide attempt survivors, family members of those who died by suicide, and suicide loss therapists. Results: Themes were derived for stereotypes ( n = 30), prejudice ( n = 3), and discrimination ( n = 4). People who attempted suicide were seen as attention-seeking, selfish, incompetent, emotionally weak, and immoral. Participants described personal experiences of prejudice and discrimination, including those with health professionals. Conclusion: Participants experienced public stigma, self-stigma, and label avoidance. Analyses reveal that the stigma of suicide shares similarities with stereotypes of mental illness, but also includes some important differences. Attempt survivors may be subject to double stigma, which impedes recovery and access to care.

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          Most cited references29

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          Contact With Mental Health and Primary Care Providers Before Suicide: A Review of the Evidence

          Objective This study examined rates of contact with primary care and mental health care professionals by individuals before they died by suicide. Method The authors reviewed 40 studies for which there was information available on rates of health care contact and examined age and gender differences among the subjects. Results Contact with primary care providers in the time leading up to suicide is common. While three of four suicide victims had contact with primary care providers within the year of suicide, approximately one-third of the suicide victims had contact with mental health services. About one in five suicide victims had contact with mental health services within a month before their suicide. On average, 45% of suicide victims had contact with primary care providers within 1 month of suicide. Older adults had higher rates of contact with primary care providers within 1 month of suicide than younger adults. Conclusions While it is not known to what degree contact with mental health care and primary care providers can prevent suicide, the majority of individuals who die by suicide do make contact with primary care providers, particularly older adults. Given that this pattern is consistent with overall health-service-seeking, alternate approaches to suicide-prevention efforts may be needed for those less likely to be seen in primary care or mental health specialty care, specifically young men.
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            An attribution model of public discrimination towards persons with mental illness.

            In this study, we build on previous work by developing and estimating a model of the relationships between causal attributions (e.g., controllability, responsibility), familiarity with mental illness, dangerousness, emotional responses (e.g., pity, anger, fear), and helping and rejecting responses. Using survey data containing responses to hypothetical vignettes, we examine these relationships in a sample of 518 community college students. Consistent with attribution theory, causal attributions affect beliefs about persons' responsibility for causing their condition, beliefs which in turn lead to affective reactions, resulting in rejecting responses such as avoidance, coercion, segregation, and withholding help. However, consistent with a danger appraisal hypothesis, the effects of perceptions of dangerousness on helping and rejecting responses are unmediated by responsibility beliefs. Much of the dangerousness effects operate by increasing fear, a particularly strong predictor of support for coercive treatment. The results from this study also suggest that familiarity with mental illness reduces discriminatory responses.
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              Self-stigma and the "why try" effect: impact on life goals and evidence-based practices.

              Many individuals with mental illnesses are troubled by self-stigma and the subsequent processes that accompany this stigma: low self-esteem and self-efficacy. "Why try" is the overarching phenomenon of interest here, encompassing self-stigma, mediating processes, and their effect on goal-related behavior. In this paper, the literature that explains "why try" is reviewed, with special focus on social psychological models. Self-stigma comprises three steps: awareness of the stereotype, agreement with it, and applying it to one's self. As a result of these processes, people suffer reduced self-esteem and self-efficacy. People are dissuaded from pursuing the kind of opportunities that are fundamental to achieving life goals because of diminished self-esteem and self-efficacy. People may also avoid accessing and using evidence-based practices that help achieve these goals. The effects of self-stigma and the "why try" effect can be diminished by services that promote consumer empowerment.
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                Author and article information

                Contributors
                Journal
                cri
                Crisis
                The Journal of Crisis Intervention and Suicide Prevention
                Hogrefe Publishing
                0227-5910
                2151-2396
                August 26, 2016
                2017
                : 38
                : 2
                : 73-81
                Affiliations
                [ 1 ]Illinois Institute of Technology, Chicago, IL, USA
                Author notes
                Lindsay Sheehan, 3424 S. State Street, Chicago, IL 60616, USA, E-mail lsheehan@ 123456iit.edu
                Article
                cri_38_2_73
                10.1027/0227-5910/a000413
                27561224
                31c8afb7-29f0-4922-bd0d-ec16d2d9495a
                Copyright @ 2016
                History
                : July 31, 2015
                : March 4, 2016
                : March 16, 2016
                Categories
                Research Trends

                Emergency medicine & Trauma,Psychology,Health & Social care,Clinical Psychology & Psychiatry,Public health
                discrimination,stigma,stereotypes,suicide,prejudice

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