The Reciprocal Relationship between Suicidality and Stigma

Abstract

IntroductionAlthough suicidality is frequently the cause of stigma, it is conversely true that stigma may be the cause of suicidality. The present paper focuses on the complex relationships that exist between suicidal behavior and stigmatizing attitudes.MethodsA narrative review of the topic will be presented on the basis of the relevant literature collected from an electronic search of PubMed, ISI Web of Knowledge, and Scopus databases, using stigma, public stigma, structural stigma, perceived stigma, self-stigma, suicide, attempted suicide, and suicidality as key words.ResultsA negative perception is frequently held of suicidal people, labeling them as weak and unable to cope with their problems, or selfish. Individuals who have attempted suicide are subject to similar processes of stigmatization and “social distancing”; insurance policies include an exclusion clause against death by suicide. Subjects with a direct personal experience of depression or suicide strongly endorse a feeling of self-stigma; those who have attempted suicide are often ashamed and embarrassed by their behavior and tend to hide the occurrence as much as possible. Similar processes are observed among family members of subjects who have committed suicide or made a suicide attempt, with a higher perceived stigma present in those bereaved by suicide. Perceived or internalized stigma produced by mental or physical disorders, or through belonging to a minority group, may represent a significant risk factor for suicide, being severely distressing, reducing self-esteem and acting as a barrier in help-seeking behaviors.ConclusionWith the aim of preventing suicide, greater efforts should be made to combat the persisting stigmatizing attitudes displayed toward mental disorders and suicide itself. Indeed, the role of stigma as a risk factor for suicide should further motivate and spur more concerted efforts to combat public stigma and support those suffering from perceived or internalized stigma. Experts and scientific societies should form an alliance with the media in an effort to promote a marked change in the societal perception of mental health issues and suicide. As stigma may result in severe consequences, specialist care and psychological interventions should be provided to populations submitted to stigma.

Suicide Stigma and Suicide Literacy in a Clinical Sample

“…Suicide stigma, defined as negative attitudes toward suicidal individuals, may similarly lead to a range of negative outcomes, therefore representing an important intervention target for suicide prevention. Stigma has been shown to increase suicide risk (Carpiniello & Pinna, ; Sharaf, Ossman, & Lachine, ), while personal stigma toward suicidal people may reduce engagement with professional services (Han, Batterham, Calear, & Randall, ; Hom, Stanley, & Joiner, ) and lead to more negative attitudes regarding professional service use (Calear, Batterham, & Christensen, ). Other attitudes about suicide, such as glorification of suicide, or attribution of suicide to isolation, may also impact upon outcomes for individuals experiencing suicidal thoughts (Calear et al., ; Chan, Batterham, Christensen, & Galletly, ).…”

Therapeutic optimism and attitudes among medical and surgical nurses towards attempted suicide

“…They are attributed to a number of factors, some of which inform societal impressions of the person who are suicidal. These impressions are that the person is weak, selfish, attention seeking, a failure, or unworthy (Carpiniello & Pinna ; Vatne & Nåden ). The results of our study indicate that nurses’ beliefs in religion and subsequently people's observance of religion or religious beliefs are representative of individual coping strategies.…”

“…The results of our study indicate that nurses’ beliefs in religion and subsequently people's observance of religion or religious beliefs are representative of individual coping strategies. Another study demonstrated that prejudicial attitudes towards people who attempt suicide exist, with participants indicating that these actions are ‘punitive, selfish, offensive, or reckless’ (Carpiniello & Pinna ). Shame and blame lead to stigma, which by its nature is discriminatory.…”

“…To avoid exposure to these experiences, avoidance of help seeking occurs, further exacerbating the underlying issue (Arendt et al . ; Carpiniello & Pinna ; Vatne & Nåden ). The notion of internal stigma builds on the feelings of shame because it enhances what the individual experiences, and also assumes negative perspectives leading to discriminatory behaviour from others (Scocco et al .…”

Análise dos Comportamentos Autolesivos na Unidade de Comportamentos Suicidários do Hospital de Braga

“…nível dos cuidados de saúde primários; melhoria da informação e educação em saúde mental; sensibilização dos meios de comunicação para a necessidade de aplicação dos princípios definidos para a informação/descrição de comportamentos autolesivos e atos suicidas; diminuição do estigma em torno da depressão, ideação suicida, comportamentos autolesivos e atos suicidas. [11][12][13] Com este trabalho pretende-se estudar a realidade da consulta da Unidade de Comportamentos Suicidários (UCS) do Hospital de Braga, através de uma análise estatística de caráter descritivo e analítico.…”