Abstract
BackgroundStudies show that people bereaved by suicide often feel a strong need for professional help. It is hypothesized that aspects related to suicide bereavement, such as stigmatization, shame or guilt, hinder help-seeking process of the bereaved. However, little is known about help-seeking behaviors of people who has lost someone due to suicide.AimsThis study was conducted to attain a better understanding of the contributing factors, including the specific features of grief following suicide, to help-seeking behaviors of the bereaved by suicide.MethodsThe sample consisted of 82 adults bereaved by suicide (64 female; average age 37.79, SD = 14.33). Instruments assessing stigmatization, shame, guilt levels, well-being, tendency to disclose emotional distress and attitudes toward seeking professional psychological help were used. The participants were also asked an open-ended question what professional help-seeking barriers they had encountered. Comparisons between the groups, logistic regression analysis and thematic analysis of the qualitative data were performed.ResultsThe findings revealed that bereaved participants who sought professional psychological help reported experiencing stigmatization and feeling guilty after the loss significantly more often. Also the results showed that attitudes toward mental health specialists had the highest prognostic value in predicting help-seeking behaviors of the bereaved. The participants themselves identified the gaps in the health care system as main barriers to seeking help.ConclusionThe results challenge previously spread notion that stigmatization, guilt and shame after suicide can act only as help-seeking barriers.
Highlights
Studies show that part of grief reactions might be seen as similar among various types of losses, the levels of perceived stigmatization, shame and guilt are usually higher among the bereaved by suicide (Harwood et al, 2002; Pitman et al, 2016)
Professional help can help to reduce tension related to stigma (Miller and Kaiser, 2001). We find it important to investigate the role of the aspects related to suicide bereavement to seeking help from professionals in the context of other potentially relevant factors
There were no statistical differences between the two groups of bereaved people who sought and those who did not seek professional psychological help by participant gender [helpseeking group = 87% female, non-seeking group = 70% female; χ2(1,82) = 2.31, p = 0.128]; age [help-seeking: M = 36.50, SD = 12.99, non-seeking: M = 38.91, SD = 15.46; t(80) = 0.76, p = 0.451]; education [χ2(2,82) = 0.05, p = 0.977]; place of residence [χ2(2,82) = 1.47, p = 0.479]; previous professional psychological help experience [help-seeking group = 41% had previous experience, non-seeking group = 30%, χ2(1,81) = 0.64, p = 0.423]; time since suicide and type of the relationship with the deceased [χ2(1,82) = 1.42, p = 0.491]. Such results indicate that described characteristics were not significantly important in predicting help-seeking behaviors in this sample. Among those participants who sought professional help, 32 (84%) consulted psychologist or psychotherapist, 18 (47%) – a psychiatrist and 13 (34%) participated in a support group lead by a professional. 21 (55%) of the participants used more than one kind of professional help for mental health problems due to suicide
Summary
Studies show that part of grief reactions might be seen as similar among various types of losses, the levels of perceived stigmatization, shame and guilt are usually higher among the bereaved by suicide (Harwood et al, 2002; Pitman et al, 2016). Internalized stigma can be operationalized as feelings of shame (Hanschmidt et al, 2016) that are often related to defensiveness, self-hatred (Fisher and Exline, 2010), experiences of inadequacy or unworthiness (Wiklander et al, 2003) and mental distress (Bos et al, 2013). Such experiences motivate avoidance behaviors such as impulses to hide, flee or conceal oneself (Wiklander et al, 2003). Little is known about help-seeking behaviors of people who has lost someone due to suicide
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