Help-Negation

Problems with the ‘ask for help’ approach to mental illness and suicide prevention

“…Awareness-raising campaigns for suicide prevention promote the need for help-seeking, preferably early – the implication being that professional support is available if only people ask for it, which is not always the case. Help negation, the refusal or avoidance of available help, is typically considered within the context of suicidal ideation or behaviour 1 but is often a pattern long before someone feels hopeless. Understanding the relationships between developmental experiences, 2 coping behaviours 3 and service provision can help identify earlier pathways and inform policies to better support people and prevent suicide.…”

A caution for suicide prevention focused on help-seeking in young people

“…A number of clinical and cross-sectional community studies, published prior to 2016, have aimed to explain why a large proportion of suicidal young people are also those who are likely to disengage or withdraw from all forms of help and support. Remarkably, none of these studies could adequately explain why suicidal young people negate help (Wilson et al, 2017).…”

“…Advances in neuroscience now point to design and measurement issues for these null results, questioning both the reliability and the validity of the results and conclusions that were reported in these earlier studies. In all cross-sectional help-negation studies that were published prior to 2016, most participants were not, in fact, suicidal – approximately 85% of participants reported no lifetime suicidal ideation or past, but not current, suicidal ideation at the time of data collection (Wilson et al, 2017).…”

“…Yet, neuroscience research confirms that suicidal ideation and behaviour indicates the presence of neurological changes that impair physical capability for cognitive, emotional and behavioural regulation and responding, regardless of co-occurring mental disorders and other social or psychological characteristics. Consequently, advances in neuroscience research now suggest that help-negation is determined more by impaired neurological capability and less, if at all, by demographic and psychological characteristics among suicidal young people (Wilson et al, 2017).…”