"What helps?": qualitative analysis of self-management strategies among adults with suicidal distress.

PURPOSE: Self-management is an important skill for people experiencing suicidal ideation, especially when they are not engaged with mental health services. The present study qualitatively examined what helps people when experiencing suicial thoughts in a large sample of Australian adults with current suicidal ideation.

METHODS

A large online population-based longitudinal cohort study of Australian adults with suicidal ideation was initiated in 2023. In the baseline survey (July-November 2023), participants were asked, "When you have suicidal thoughts, what helps?" Reflexive thematic analysis was undertaken.

RESULTS

Participants (n = 658) reported a wide variety of self-management strategies. Five themes were developed: (1) Reframing or redirecting thoughts as a reminder to live and have hope, (2) Balancing between staying connected and the urge to disconnect, (3) using formal or learnt preventative strategies, (4) finding an alternative strategy to manage thoughts, and (5) engaging with suicidal distress.

CONCLUSION

There is no one-size-fits-all self-management approach. The significance of social connection was complex, indicating a need for flexible, supportive and non-judgemental social responses. Both clinical and lifestyle strategies should be considered for supporting people at risk of suicide. Moreover, knowledge of the diverse motivations for and responses to suicidal ideation may enable family, friends, clinicians and crisis workers to better connect with people experiencing suicidal ideation.