The study aimed to understand the tendencies of help seeking before a suicide attempt in Lithuania. An analysis of interviews with 21 Lithuanian adults demonstrated strong avoidance of seeking help. The main reasons for avoidance included a lack of trust in other people, thinking that one must solve problems independently without sharing them, avoiding troubling others, and a belief that showing genuine emotions is a sign of weakness. These findings may contribute to suicide prevention by more deeply understanding the barriers to help seeking among high suicide risk groups, particularly in countries with a traumatic historical experience.

Background: Studies 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. Aims: This 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. Methods: The 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. Results: The 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. Conclusion: The results challenge previously spread notion that stigmatization, guilt and shame after suicide can act only as help-seeking barriers.

BackgroundAlong with other suicide risk factors, masculinity has been analyzed as an important subject for suicidal behavior in men. This study examines masculinity as a gender self-confidence which is the intensity of an individual's belief that he meets his standards for masculinity. We use Hoffman and her colleague's concept, which provides two theoretical constructs as elements of gender self-confidence: gender self-definition and gender self-acceptance. Gender self-definition relates to how salient masculinity is in one's identity; gender self-acceptance relates to how positively one views his masculinity.MethodsThe quantitative research approach was applied in the study. The survey with a nonprobability quota sampling design was implemented to collect the data. The sample consisted of 562 Lithuanian men from various age groups and regions. The age of participants varied from 18 to 92 years (M = 42.99, SD = 17.18); 40.9% of men were from cities, 28.1% from towns, and 30.8% from rural locations. We used the Hoffman Gender Scale to measure gender self-definition and gender self-acceptance. Suicide risk was estimated with the Suicide Behavior Questionnaire—Revised. Patient Health Questionnaire-2 was used to measure depression symptoms as a controlled variable. Statistical analysis of regression and moderation was used to test the hypothesis.ResultsHigher gender self-definition and higher gender self-acceptance were associated with lower suicide risk. The moderation analysis showed that in men with relatively low gender self-definition, the effect of gender self-acceptance on suicidality was larger than in men with high or moderate gender self-definition.DiscussionWe conclude that a stronger gender self-confidence is an important protective factor in male suicide risk. Both, a smaller part of masculinity in one's identity and a negative view of one's masculinity have a cumulative effect on increased suicide risk. The findings have been discussed in accordance with the theories that explain suicidal behavior through the lenses of self-concept.

Male suicides are often associated with masculinity norms that encourage certain behaviours that increase the risk of suicide. For example, research shows that restricted emotionality, avoidance of seeking help and self-reliance are associated with higher suicide risk. However, these pre-formulated aspects of masculinity do not necessarily reflect men’s subjective opinions of what masculinity is to them. Researchers argue that it is important to consider personal views about what masculinity is, not only stereotypes about masculinity. The aim of this study is to reveal and compare the subjective opinions about the masculinity of men with and without suicidal ideation. 281 men answered the open-ended question during the survey: “What does masculinity mean to you?”. The answers were analyzed using a content analysis method. We transformed qualitative data into quantitative and compared them statistically between two groups: men with and without suicidal ideation. It turned out that men with suicidal thoughts were more likely to mention that masculinity is the control of emotions, intelligence, and decision-making. Men without suicidal thoughts were more likely to mention family and caring for it as essential aspects of masculinity. The results showed that certain aspects of masculinity might be related to higher risk for suicide, but the study also revealed the masculinity that might be a source of coping.

Different elements of suicidal communication have been explored; however, the understanding of suicide attempters' perception of surrounding people's reactions is scarce. This study aims to unravel perceived reactions of surrounding people to suicidal communication and their effect on suicidal intent. Twenty-one person (7 men and 14 women, 18-62 years, M ¼ 31.5) admitted to a general (N ¼ 6) or psychiatric (N ¼ 15) hospital after a suicide attempt participated. Hybrid thematic analysis was used for semistructured interview data analysis. Indifference and disengaging in helping are the most common perceived reactions to reports before the attempt. Reactions during the attempt are noticeably more active. Unresponsiveness and provocation to suicide are considered as impelling factors to commit suicide. Active reactions, for example, prohibitions are not viewed as such. Mostly suicide intent is communicated prior to attempt or after harming oneself, but it is taken into account by surrounding people more seriously during the attempt.