Suicide Literacy Research Articles

Suicide literacy mediates the path from religiosity to suicide stigma among Muslim community adults: Cross-sectional data from four Arab countries.

The majority of research attention has been devoted to the link between religiosity and suicide risk, and a considerable amount of studies has been carried out on how stigma impacts individuals with mental health problems of different kinds. However, the interplay between religiosity, suicide literacy and suicide stigma has seldom been empirically researched, especially quantitatively. We sought through this study to redress the imbalance of research attention by examining the relationship between religiosity and suicide stigma; and the indirect and moderating effects of suicide literacy on this relationship. A cross-sectional web-based survey was conducted among Arab-Muslim adults originating from four Arab countries (Egypt: N = 1029, Kuwait: N = 2182, Lebanon N = 781, Tunisia N = 2343; Total sample: N = 6335). The outcome measures included the Arabic Religiosity Scale which taps into variation in the degree of religiosity, the Stigma of Suicide Scale-short form to the solicit degree of stigma related to suicide, and the Literacy of Suicide Scale explores knowledge and understanding of suicide. Our Mediation analyses findings showed that literacy of suicide partially mediated the association between religiosity and stigmatizing attitude toward suicide. Higher religiosity was significantly associated with less literacy of suicide; higher literacy of suicide was significantly associated with less stigma of suicide. Finally, higher religiosity was directly and significantly associated with more stigmatization attitude toward suicide. We contribute the literature by showing, for the first time, that suicide literacy plays a mediating role in the association between religiosity and suicide stigma in a sample of Arab-Muslim community adults. This preliminarily suggests that the effects of religiosity on suicide stigma can be modifiable through improving suicide literacy. This implies that interventions targeting highly religious individuals should pay dual attention to increasing suicide literacy and lowering suicide stigma.

Suicide stigma and suicide literacy among Bangladeshi young adults: a cross-sectional study.

Suicide is one of the leading causes of death worldwide. Owing to poor suicide literacy, people are not aware of the consequences of the suicide stigma, which may affect individuals. This study aimed to examine the status of suicide stigma and literacy among young adults in Bangladesh. This cross-sectional study included 616 male subjects and female subjects residing in Bangladesh aged between 18 and 35 years who were invited to complete an online survey. Suicide literacy and suicide stigma among the respondents were assessed by using the validated Literacy of Suicide Scale and Stigma of Suicide Scale, respectively. Other independent variables that have been found to affect suicide stigma or literacy were included in this study based on prior research. Correlation analysis was used to assess the relationships between the study's main quantitative variables. Multiple linear regression models were used to assess factors affecting suicide stigma and suicide literacy, respectively, after controlling for covariates. The mean literacy score was 3.86. The participants' mean scores in the stigma, isolation, and glorification subscale were 25.15, 14.48, and 9.04, respectively. Suicide literacy was negatively associated with stigmatizing attitudes (p = 0.005). Male subjects, unmarried/divorced/widowed, less educated (below HSC), smokers, less exposure to suicide, and respondents with chronic mental illness had lower suicide literacy and more stigmatizing attitudes. The findings suggest that addressing suicide literacy and stigma by developing and executing awareness programs on suicide and mental health among young adults may increase knowledge, decrease stigma, and hence prevent suicide among this population.

The other side of the hill: counsellor trainees’ suicide literacy and stigmatising attitudes

ABSTRACT Despite the crucial role of mental health professionals in suicide prevention, little is known about mental health professionals’ suicide literacy and attitudes towards suicide in Turkey. Therefore, the aims of this research are twofold: First, we investigated counsellor trainees’ suicide knowledge and stigmatising attitudes. Second, we examined the relationship between suicide literacy and attitudes of counsellor trainees. A total of 344 counsellor trainees were recruited for this study through convenience sampling in Turkey. The descriptive statistics demonstrated that most of the counsellor trainees had a lack of knowledge about causes/nature, risk factors, and signs of suicide. Additionally, the participants had stigmatising attitudes towards individuals who died by suicide. Most importantly, the canonical correlation analysis revealed that the counsellor trainees’ stigmatising attitudes towards individuals who died by suicide were negatively associated with their suicide literacy. The insights gained from this study may be of assistance to design suicide-sensitive counsellor education programs.

Suicide literacy and attitudes toward psychological help-seeking: a cross-sectional study of students.

Higher education students express high levels of suicidal ideation. However, data on students' knowledge of suicide and attitudes toward seeking professional psychological help are lacking. Therefore, a cross-sectional study was conducted to evaluate students' suicidal ideation, suicide literacy and attitudes toward seeking professional psychological help, and to assess whether these variables were interrelated. Higher education students completed an online survey that consisted of 12 questions on suicide literacy (based on the Literacy of Suicide Scale), the Attitudes Toward Seeking Professional Psychological Help Scale and the Suicidal Ideation Attributes Scale. A total of 2004 students completed the survey. Female students and biomedical students showed the highest suicide literacy and most positive help-seeking attitudes. Higher study year was associated with more positive help-seeking attitudes. Art students expressed the highest levels of suicidal ideation. Suicide literacy had a weak positive correlation with help-seeking attitudes (Spearman's rho = 0.186). Suicidal ideation, suicide literacy and help-seeking attitudes may differ according to student's gender, study year and study field. Better suicide literacy may promote psychological help-seeking behavior.

Evaluation of an online suicide prevention program to improve suicide literacy and to reduce suicide stigma: A mixed methods study.

Low-threshold e-health approaches in prevention to reduce suicide stigma are scarce. We developed an online program containing video reports on lived experience of suicide and evidence-based information on suicidality. We evaluated the program by a mixed methods design. We examined pre-post-changes of program completers (n = 268) in suicide literacy, suicide stigma (self and perceived), and self-efficacy expectation of being able to seek support in psychologically difficult situations using linear mixed models. To examine reported changes and helpful program elements 12-26 weeks after program completion, we content analyzed transcripts of telephone interviews (n = 16). Program completers showed more suicide literacy (Cohen's d = .74; p < .001), higher self-efficacy expectations to seek support (d = .09; p < .01), lower self-stigma (subscales glorification/normalization: d = -.13, p = .04; isolation/depression: d = -.14; p = .04; stigma: d = -.10; p = .07; n = 168) compared to baseline. We found no significant differences in perceived suicide stigma. We identified lived experience reports, the possibility of sharing own narrative on stigma and suicidality, and information on support as helpful elements. The current online program can increase suicide literacy and self-efficacy expectations to seek support and reduce self-stigma. We recommend a larger randomized controlled trial with longer follow-up to confirm these findings.

Knowledge, attitudes and practices towards suicide among immigrants from the horn of Africa in Victoria, Australia.

This study explored suicide risks and protective factors in the first generation-immigrants to Victoria, Australia, from five countries of the Horn of Africa. The aim was to contribute towards an effective and culturally sensitive interventions to prevent suicide. The research used a survey study of knowledge, attitudes and practices towards suicide, in representative samples recruited from each community using snowball sampling. The results identified three major risk factors including, (1) lack of interface between community resources and support services, (2) prevalent negative attitudes towards suicide, and (3) gaps in suicide awareness. The roles of religious and community leaders and spiritual healers were identified as protective factors providing the communities with support to deal with suicide and other mental health issues. In conclusion, the overall impact of these risk factors was that they lead to delayed lifesaving interventions, thus contributing to an increased likelihood of suicide incidents or other adverse outcomes. These protective factors have a key role to serve as a link between the communities and health services, to address issues of delay in accessing services as well as to address negative attitudes towards suicide and the gaps in suicide literacy.

The Associated Factors of Self-Harm and Suicide Ideation Among Chinese Indonesians During the COVID-19 Pandemic

Abstract: Background: This study aimed to identify the associated factors of self-harm and suicide ideation among Chinese Indonesians during the COVID-19 pandemic. Methods: A nonrandom sampling was performed through a nationwide online survey in Indonesia (May–June 2021). The online survey covered participants’ demographic information, suicide literacy, suicide stigma, loneliness, and self-harm and suicide ideation. A series of t-tests, χ2 tests, and hierarchical logistic regressions with the backward stepwise method were used to identify the factors associated with self-harm and suicide ideation. Responses from a total of 484 Chinese Indonesians were analyzed in this study. Results: The predictive model showed a significant goodness of fit to the observed data [χ2(17) = 174.1, p &lt; .001; R N2 = .41]. Chinese Indonesians with an average monthly income of ≥USD 843 were found to be 0.23 times (95% CI = 0.07–0.99) less likely to experience self-harm and suicide ideation than those who did not have an income. A one-point increase in the intensity of suicide glorification and loneliness were associated with 3.06 and 3.67 increase in the chance of experiencing self-harm and suicide ideation, respectively. Conclusion: One third of Chinese Indonesians self-reported self-harm and suicide ideation during the COVID-19 pandemic. Mental health and suicide prevention intervention programs are recommended to target those with low socioeconomic status, high glorification toward suicide, and high perceived loneliness.

Title page: psychometric properties of literacy of suicide scale (LOSS) in iranian population: long form

IntroductionSuicide and suicide attempts are among the most important indicators of mental health in the world. In this research, the validity and reliability of Literacy of Suicide Scale (LOSS) was examined in general people over the age of 18.MethodsThis cross-sectional psychometric study was conducted in 2022 among 952 general population in Iran. Participants were selected by two methods of proportional stratified sampling and simple random sampling. The internal consistency of the tools was assessed using Cronbach’s alpha coefficient, and McDonald omega coefficient. Also, test-retest reliability was checked by Intraclass Correlation Coefficient (ICC).ResultsIn the confirmatory factor analysis section, the factor loading of all questions were above 0.4 and one questions were deleted and final model with four factors and 25 questions was confirmed (Some of goodness-of-fit indexes: AGFI = 0.910, RMSEA = 0.050, IFI = 0.901, and χ2/df = 3.333). For all questions, the Cronbach’s alpha coefficient was 0.859, McDonald omega coefficient was 0.866, and ICC was 0.895. Finally, the Persian long version of LOSS was approved with 25 items and four subscales: causes/triggers (9 items), risk factors (7 items), signs and symptoms (5 items) and treatment/prevention (4 items).ConclusionThe Persian long version of LOSS with four subscales and 25 items is an appropriate tool to investigate the state of suicide literacy in the public population.

Mind the gap: Exploring differences in suicide literacy between cybersuicide and offline suicide.

The highly public nature of cybersuicide contradicts long-held beliefs of offline suicide, which may cause differences in the way people perceive and respond to both of them. However, knowledge of whether and how suicide literacy differs between cybersuicide and offline suicide is limited. By analyzing social media data, this paper focused on livestreamed suicide and aimed to compare suicide literacy between cybersuicide and offline suicide on three aspects, including false knowledge structure, extent of association with stigma, and linguistic expression pattern. 7,236 Sina Weibo posts with relevant keywords were downloaded and analyzed. First, a content analysis was performed by human coders to determine whether each post reflected suicide-related false knowledge and stigma. Second, a text analysis was conducted using the Simplified Chinese version of LIWC software to automatically extract psycholinguistic features from each post. Third, based on selected features, classification models were developed using machine learning techniques to differentiate false knowledge of cybersuicide from that of offline suicide. Results showed that, first, cybersuicide-related posts generally reflected more false knowledge than offline suicide-related posts ( 255.13, p < 0.001). Significant differences were also observed in seven false knowledge types. Second, among posts reflecting false knowledge, cybersuicide-related posts generally carried more stigma than offline suicide-related posts ( = 116.77, p < 0.001). Significant differences were also observed in three false knowledge types. Third, among established classification models, the highest F1 value reached 0.70. The findings provide evidence of differences in suicide literacy between cybersuicide and offline suicide, and indicate the need for public awareness campaigns that specifically target cybersuicide.

HELP-SEEKING FOR SUICIDE RISK AMONG MIDDLE- TO OLD-AGE ADULTS

Abstract Suicide is a major public health concern. Suicide rates have increased steadily in the U.S. and are highest among middle-aged (ages 45-64) and older (age 75+) adults. Help-seeking represents an important coping behavior that can mitigate suicide risk. However, research on this topic is sparse, especially among older adults. To address this gap, a systematic review of the existing literature describing help-seeking for suicide risk among middle- to old-age adults was conducted. Using PRISMA guidelines, we searched electronic databases (e.g., ProQuest, EBSCOhost, PsycINFO, PubMed, Medline) and key journals with suicide and/or gerontology focuses for peer-reviewed publications in English between 2010-2020. The search yielded 4,732 unduplicated publications. After screening articles for relevance based on titles and abstracts, 52 articles were reviewed in full text. A total of 24 articles met inclusion criteria and were included in this review. The articles reviewed included a range of topics, including prevalence of service utilization, service use prior to suicide-related behaviors, and correlates of help-seeking. Overall, prevalence of service utilization was generally low and varied by suicidal history (e.g., greater prevalence among those with a history of suicide attempt, as compared to those with suicide ideation but no attempts). The systematic review also identified key service use facilitators (e.g., higher suicide literacy, previous or current suicidality) and barriers (e.g., stigma). Results of this systematic review highlight the need for future research and tailored services to improve suicide prevention and intervention strategies for middle-aged and older adults.

Level and Associated Factors of Literacy and Stigma of Suicide among Bangladeshi Physicians: A Cross-Sectional Assessment

Objectives. Literacy and stigma of suicide among doctors affect health-service delivery for persons with suicidal behavior. However, no attempt has been identified to assess those among physicians in Bangladesh. We aimed to determine the level and associated factors of suicide literacy and stigma toward suicide among physicians in Bangladesh. Methods. We collected data from 203 physicians in February 2022 by Google Forms. We used the Bangla literacy of suicide scale (LOSS-B) and the Bangla stigma of suicide scale (SOSS-B) to assess the literacy and stigma of suicide. The instrument also included questions for collecting sociodemographic variables and assessing suicidal behavior. Results. The mean age of the physicians was34.17±7.86(range 23–66) years, 109 (53.7%) were females, 150 (73.9%) were married, and 181 (89.2%) were Muslim. The mean LOSS-B score was5.9±1.96(range 1-10). Suicide literacy was higher in singles (p=0.013), doctors with a family history of suicide (p=0.018), a history of suicidal thought in lifetime (p≤0.001), and in the last year (p=0.03). Muslims (p=0.017) and city dwellers (p=0.021) had higher scores in the stigma subscale of SOSS-B whilst respondents with history of mental illness had a significantly lower level of stigma (p≤0.006). The stigma and isolation subscales were positively correlated indicating a higher value stigma creates higher isolation (p≤0.001). No relationship between suicide literacy and suicide stigma was identified among the physicians. Conclusions. Suicide literacy among the physicians of Bangladesh is low albeit higher than the level among the students. Appropriate programs should be designed to improve the status quo because physicians play fundamental roles as health-service providers as well as gatekeepers in suicide prevention.

Professional help-seeking for suicide in Japan: Modifiable factors influencing help-seeking beliefs, attitudes, and intentions

• Japan has a high suicide rate but concerningly low use of professional services • Beliefs, attitudes and intentions for help seeking for suicidal ideation were examined • High suicide literacy, low stigma, and low self-reliance associated with more positive attitudes • Specific subgroups of the Japanese population with increased risk were identified • There is a need to develop public health messaging to increase professional service use Despite high suicide rates in Japan, many people do not seek professional help for suicidal thoughts. We identified modifiable factors associated with help-seeking beliefs, attitudes, and intentions for suicidal ideation, and examined characteristics associated with suicidal ideation. Participants were 217 Japanese adults recruited online. We assessed beliefs, attitudes and intentions regarding professional help seeking, and recent suicidal ideation. Greater suicide exposure and less social support were associated with more negative help-seeking beliefs. More positive help-seeking attitudes were associated with less education, no religious affiliation, greater suicide literacy, lower suicide stigma, and lower self-reliance. No significant correlates of help-seeking intentions were identified. Recent suicidal ideation was associated with non-binary gender, less education, negative beliefs/attitudes towards help-seeking, poorer mental health, lower mastery, less social support, greater self-reliance, and greater suicide normalisation. Interventions to improve help-seeking in Japan emphasise the limits of self-reliance, and increase knowledge around suicide prevention and professional psychological services.

Factors Affecting Nursing Performance for Patients after Attempted Suicide among Clinical Nurses

Purpose: This study aimed to identify the factors that influence nursing performance for patients after attempted suicide among clinical nurses.Methods: The participants in this study were 200 clinical nurses working at hospitals in Korea. Data was collected from February 22, 2022 to March 18, 2022 through a structured online survey that included general characteristics, suicide literacy, attitudes towards suicide, social stigma toward suicidal people, and nursing performance for patients after attempted suicide. SPSS/WIN 25.0 program was used for data analysis, including a descriptive analysis, t-test, one way analysis of variance, the Scheffé test, Pearson correlation coefficients, and multiple linear regression.Results: A higher level of suicide literacy (r=.36, p&lt;.001) and attitudes towards suicide (r=.23, p&lt;.001) were associated with higher nursing performance for patients after attempted suicide. The factors affecting nursing performance for patients after attempted suicide were suicide literacy (β=.38, p&lt;.001) and attitudes towards suicide (β=.26, p&lt;.001). This model showed a 18.0% explanation of nursing performance for patients after attempted suicide.Conclusion: It is necessary to develop an effective educational program and to establish an organizational system to improve the quality of nursing performance for patients after attempted suicide.

Level and predictors of mental health literacy of depression and suicide among undergraduate medical students

BackgroundPoor mental health literacy (MHL) is considered a significant barrier to medical students seeking treatment for depression and suicide. This study aimed to assess the level of mental health literacy of depression and suicide among undergraduate medical students as well as to determine its predictors. An online survey was conducted on 361 undergraduate medical students through the Microsoft Team platform using a Google form application-structured questionnaire that included a sociodemographic section, the depression literacy scale (D-Lit), and the modified suicide literacy scale (LOSS).ResultsThe mean D-Lit score was 7.9 ± 1.8 (total score ranged from 0 to 22), while the mean LOSS score was 4.5 ± 1.7 (total score ranged from 0 to 12). Only 36.8% of students had depression literacy levels higher than the mean depression score, whereas 28.8% had a suicide literacy level exceeding the mean suicide score. A statistically significant positive correlation was revealed between the mean score of depression literacy and that of suicide literacy (r = 0.16, p-value = 0.002). Male gender (p < 0.05), family history of depression (p < 0.05), and history of suicidal ideations (p < 0.01) are all predictors of higher depression literacy scores.ConclusionsAccording to the results, there is compelling evidence that depression and suicide literacy among medical students was low. Therefore, rather than waiting until a medical student reaches the clinical years, mental health education should be introduced early in medical school curricula or even in high school.

The Malay Literacy of Suicide Scale: A Rasch Model Validation and Its Correlation with Mental Health Literacy among Malaysian Parents, Caregivers and Teachers.

The 27-item Literacy of Suicide Scale (LOSS) is a test designed to measure the respondent’s suicide knowledge. The purpose of this study is to examine the psychometric properties of the Malay-translated version of the LOSS (M-LOSS) and its association to sociodemographic factors and mental health literacy. The 27-item LOSS was forward–backward translated into Malay, and the content and face validities were assessed. The version was distributed to 750 respondents across West Malaysia. Rasch model analysis was then conducted to assess the scale’s psychometric properties. The validated M-LOSS and the Malay version of the Mental Health Knowledge Schedule (MAKS-M) were then distributed to 867 respondents to evaluate their level of suicide literacy, mental health literacy, and their correlation. Upon Rasch analysis, 26 items were retained. The scale was found to be unidimensional, with generally satisfying separation and reliability indexes. Sex, socio-economic status, and experience in mental health were found to significantly impact the mean score for mental health literacy. This study also found a significant mean difference for suicide literacy across school types. Furthermore, while this study observed a weak but significant negative correlation between age and suicide literacy, no correlation was found between mental health and suicide literacy.

Impact of Education on Suicides in India

Aim. The aim of this paper is to examine the impact of education on the rate of suicides in India. The paper further attempts to take a global outlook on how prevalent is suicide among countries with high education indicators.&#x0D; Methodology. The paper is based on secondary research with data collected from National Databases like National Crime Records Bureau and International databases of World Health Organization and Organisation for Economic Co-operation and Development (OECD). Data analysis is done using statistical technique like Correlation and using Microsoft Excel.&#x0D; Results. The study reveals that in India, the increase education levels of people have had negligible impact on the number of suicides in the country. Across states, the suicide rate and literacy rate have a positive correlation of 0.35; while correlation doesn’t mean causation and the two are mildly correlated, it does establish the fact that education doesn’t have a direct impact on the suicide rate. Also, the analysis indicates that even though the education levels in the country have risen, subsequently, the educational level among people who committed suicides also increased. Further, it is found that the countries that are ranked higher on PISA ranking and tertiary education attainment have mostly higher rates of suicide.&#x0D; Conclusions. As shown throughout the study, education hasn’t been an effective instrument in equipping people with life skills: with the increase in education levels across the country, there has been an increase in the education level of people who commit suicides concomitantly, as if the education is happening in vacuum with no effect on the persona of people committing suicides. Thus, it’s significant we question our educational practices; and re-align our goals of education such that it leads to overall development of an individual.

Parent Education for Responding to and Supporting Youth with Suicidal Thoughts (PERSYST): An Evaluation of an Online Gatekeeper Training Program with Australian Parents.

The gatekeeper training of parents is a promising approach for suicide prevention in young people, but little research has addressed the effectiveness of such training, especially using online delivery. This study aimed to evaluate the efficacy and acceptability of the delivery of an online suicide prevention training program, LivingWorks Start, to improve the capacity of parents to support young people at risk of suicide. The participants were 127 parents of young people aged 12–25 who completed the LivingWorks Start training and consented to participate in the evaluation. The participants completed online surveys before, after, and 3 months after training. The participants showed increases in perceived self-efficacy and formal help-seeking intentions, and reductions in suicide stigma, although stigma returned to the baseline three months post-training. Suicide literacy also increased, but only at the three-month follow-up. Most parents found the training acceptable, and did not find it upsetting. Prior mental health, suicide-related experiences, and pre-participation vulnerability were not predictive of finding the training distressing. Overall, the findings show that online gatekeeper training for parents can be beneficial, and is rarely associated with distress.

Suicide literacy in nurses: A cross-sectional study.

This study is a cross-sectional study aiming to determine the suicide literacy level of nurses and to examine the relationship between nurses' suicide literacy and certain variables. Suicide literacy in nurses is a factor which affects knowledge levels. The level of suicide literacy in nurses may affect the care given to patients and the behaviour of obtaining help in relation to themselves. The study was conducted with 348 nurses between January and March 2020 at a hospital in the city of Antalya in Turkey. A personal information form and the Literacy of Suicide Scale (LOSS) were used to collect data. Descriptive statistical methods were used in data analysis. Stepwise multiple linear regression analysis was performed to determine the predictors of suicide literacy. The STROBE checklist was followed for this cross-sectional study. The nurses' mean score on LOSS was 11.08 ± 3.92. Significant predictors of suicide literacy in nurses were being single, working in the emergency department, having previous experience in the psychiatry clinic, not having a mental illness, having suicide attempts in the family, having previously obtained information on intervention on individuals at risk of suicide and stating that their sources of information on this topic were nursing education and the Internet. These variables explained 19.8% of the variance in suicide literacy. The nurses' suicide literacy was at a low level. It is recommended that education programs on the care of patients at risk of suicide be set up for all nurses working in general clinics. It is important to raise the levels of suicide literacy in nurses in order to provide better quality care to patients who are at risk of suicide. Also, raising levels of suicide literacy may strengthen nurses' behaviours in seeking help for themselves.

Two sides of the same coin? The association between suicide stigma and suicide normalisation.

Evidence suggests that suicide stigma (i.e. negative attitudes towards persons affected by suicide/suicidality) and suicide normalisation (i.e. liberal attitudes towards suicide) are both associated with increased suicide risk. Despite conceptual similarities and potential interaction, suicide stigma and suicide normalisation have usually been investigated separately. We used cross-sectional data from a community sample to test the association between suicide stigma and suicide normalisation as well as to identify their respective determinants and consequences. Participants were N = 3.269 adults recruited from an established online-panel using quotas to reflect the composition of the German general population with regard to age, gender, education and region. We collected information about suicide stigma, suicide normalisation, intentions to seek help for suicidality, current suicidality, suicide literacy, negative mood and socio-demographic variables. We used regression modelling to determine the association between suicide stigma and suicide normalisation as well as to identify their determinants and consequences. Suicide stigma and suicide normalisation were inversely associated so that higher suicide stigma scores were linked to lower suicide normalisation. More suicide stigma was associated with reduced intentions to seeking professional help, increased willingness to seek help from family and friends and lower odds to experience current suicidality, however the association between suicide stigma and intentions to seek professional help diminished after controlling for confounding variables. Increased suicide normalisation was linked to reduced intentions to seek help from professionals or family and friends, as well as higher odds to experience current suicidality, even after controlling for confounding variables. Our findings suggest that interventions to reduce public suicide stigma are at risk to unintentionally increase suicide normalisation, which appears to be a key barrier to seeking help for suicidality. Future research should therefore identify strategies to improve attitudes towards persons affected by suicidality that avoid normalisation, i.e. do not convey the message of suicide as an acceptable solution for difficult life situations. One strategy with great potential to safely reduce public suicide sigma could be interventions that stimulate interpersonal contact with affected persons sharing their recovery story.

The Relationships between Rural Elderly’s Suicide Literacy, Suicide Stigma and Coping Advice for Suicide Prevention: The Moderated Mediation Effect of Social Expectations for Experiencing Negative Emotions

The Relationships between Rural Elderly’s Suicide Literacy, Suicide Stigma and Coping Advice for Suicide Prevention: The Moderated Mediation Effect of Social Expectations for Experiencing Negative Emotions