title: Coping with thoughts of suicide: techniques used by consumers of mental health services.
abstract: OBJECTIVE
  Suicide is a devastating public health problem, and research indicates that people with prior attempts are at the greatest risk of completing suicide, followed by persons with depression and other major mental and substance use conditions. Because there has been little direct input from individuals with serious mental illness and a history of suicidal behavior concerning suicide prevention efforts, this study examined how this population copes with suicidal thoughts.
  
  
  METHODS
  Participants in 14 regional consumer-run Hope Dialogues in New York State (N=198) wrote up to five strategies they use to deal with suicidal thoughts. Strategies were classified according to grounded theory.
  
  
  RESULTS
  First responses included spirituality, talking to someone, positive thinking, using the mental health system, considering consequences of suicide to family and friends, using peer supports, and doing something pleasurable. Although a majority reported that more formal therapeutic supports were available, only 12% indicated that they considered the mental health system a frontline strategy. Instead, respondents more frequently relied on family, friends, peers, and faith as sources of hope and support.
  
  
  CONCLUSIONS
  Consumers' reliance on formal therapeutic supports and support from peers and family suggests that education and support for dealing with individuals in despair and crisis should be targeted to the social networks of this high-risk population. The disparity between availability of formal mental health services and reliance on them when consumers are suicidal suggests that suicide prevention efforts should evaluate whether they are effectively engaging high-risk populations as they struggle to cope with despair.
authors.affiliation: Department of Epidemiology and Health, Nathan S. Kline Institute, 140 Old Orangeburg Rd., Building 37, Orangeburg, NY 10962, USA. mja@nki.rfmh.org
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Alexander
authors.forename: Gary
authors.initials: G
authors.lastname: Haugland
authors.forename: Peter
authors.initials: P
authors.lastname: Ashenden
authors.forename: Ed
authors.initials: E
authors.lastname: Knight
authors.forename: Isaac
authors.initials: I
authors.lastname: Brown
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D004493:Education; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D009518:New York; D010361:Patients / Q000523:psychology*; D014342:Truth Disclosure; D055815:Young Adult; D000092864:Suicide Prevention