Living with suicidality following traumatic brain injury: a qualitative study

Abstract

Numbers of traumatic brain injury (TBI) are increasing, and with suicidality post-injury presenting at 3-4 times higher than in the general population, understanding this is crucial in reducing a devastating outcome. Given the lack of literature, this study investigated the experiences of living with suicidality after TBI.Methods: Interview data from nineteen TBI participants with TBI from a Brain Injury Rehabilitation Unit (BIRU) in New South Wales (NSW), Australia wereas collected and thematically analysed. Findings: The participants (predominantly male) had sustained extremely severe injuries (median PTA 60 [IQR 81.0] days) and were in the chronic phase post-injury (median 8.0 [IQR 9.0] years). Six main themes were identified; Loss of sense of self, TBI as a hidden disability, Chronic but transient suicidality, Reliance, Protective factors, and Hope. Tentative relationships between themes and subthemes were identified. Conclusion:Chronic suicidality after TBI was demonstrated consistently regardless of receiving long-term support. However, their engagement with protective factors such as social support, spirituality and positive personal qualities was also identified.Implementing these as coping strategies during long-term rehabilitation may reduce the levels of suicidal distress. Implications, methodological considerations and future research were discussed, with the aim of improving experiences of individuals with TBI to reduce suicidality.

Identifying group‐based patterns of suicidal ideation over the first 10 years after moderate‐to‐severe TBI

“…Little research has examined protective factors among individuals with moderate‐to‐severe TBI, but qualitative findings suggest that social support, a sense of meaning in life, religion and spirituality, connection to mental health services (Brenner et al, 2009), and identification of positive personal qualities (Knight et al, 2020) may buffer against suicidal behavior. Although no interventions have been tested to directly target suicidal behavior in individuals with TBI, a manualized cognitive‐behavioral group intervention has been effective in reducing hopelessness, a significant risk factor for suicidal behavior, among civilians (Simpson et al, 2011) and veterans with TBI (Brenner et al, 2018).…”

Just a little bit of history repeating: the recurring and fatal consequences of lacking professional knowledge of acquired brain injury

“…The cognitive impairments following ABI make long-term reintegration problematic for individuals wishing to return to education or employment or wanting to re-engage with social networks (De Netto and McKinlay, 2019; McKinlay and Buck, 2019; Odumuyiwa et al , 2019; Abrahamson et al , 2017; Hicks et al , 2017; Piccenna et al , 2016; Mealings et al , 2012; Van Velzen et al , 2009). An inability to return to work has a devastating impact on people’s quality of life, with increased social isolation and high levels of social deprivation (Knight et al , 2020; Williams et al , 2020; Odumuyiwa et al , 2019; Oddy et al , 2018; Sariaslan et al , 2016; Whiteneck et al , 2016a, 2016b).…”

Living with suicidal thoughts: A scoping review

“…The second theme related to how living with suicidal thoughts was experienced as a loss of personal self, which required attention to facilitate and support recovery. Suicidal thoughts were interpreted as a loss of a sense of self [34,35,41,42], and a life with suicidal thoughts was described as a life with a lack of self-esteem and significant loss of selfworth [25,[43][44][45]. The consequences of a lack of self-esteem and significant loss of self-worth were expressed as a loss of meaning in life, leading to self-hatred, comparing oneself with others, and a feeling of worthlessness [30,34,39,46].…”