Twenty-seven people aged from their early twenties to their mid-seventies were interviewed for the study. All had experienced mental illness for three years or more and had reported feeling suicidal, and most had previously attempted suicide. All had received treatment from either primary or secondary mental health services.
Self-management was grouped into five categories: activities they undertook to reduce, distract or protect themselves from their suicidality; practical ways of looking after themselves; reframing their thoughts and attitudes; getting to know themselves better; and peer support.
Some of those interviewed said abstaining from alcohol, exercising, surrounding themselves with friends, joining a community group and writing poetry were active things they did to help stop themselves from acting on suicidal thoughts.
Dr Peterson says while traditional clinician-orientated interventions have a place in helping people who are experiencing suicidality there has been an under estimation of the role that people who are experiencing suicidality can play in their own treatment.
“Giving people the skills to cope and recover over the long term, where they are then not solely reliant on a mental health system that they may or may not choose to access when needed, makes sense,” she says.
Dr Peterson says that people are self-managing their mental illness is positive. Study participants reported that self-management brought with it an increased confidence, made them more aware of themselves, and gave them a purpose and meaning in their life.
Most of the participants had drifted into self-management of their suicidality over time, as they learned more about themselves, their mental illness and their suicidal thoughts and feelings. The majority of people interviewed for the study used more than one self-management technique to help themselves when they were feeling suicidal and viewed it as something that required commitment.
Professor Sunny Collings says the benefits of self-management techniques need to be more widely acknowledged by mental health professionals as an option for helping people who felt suicidal along with better support provided to help them develop their own self-management strategies.
Further research is needed to look at not only the practicalities of self-management and its acceptability to mental health clinicians and organisations but also the nature of self-management strategies, she says.
Professor Collings says this included how self-management techniques can be taught and which are the most successful and acceptable to people with experience of mental illness.
The study is part of a broader research project that looks at the experiences of suicidal thoughts, feelings and behaviour of people with experience of mental illness.