The link between mental health-related discrimination and suicidality: service user perspectives
Abstract
Background: Suicide is a major global public health issue. Mental illness is a risk factor for suicide, but as many individuals with a diagnosed mental health problem do not experience suicidal ideation or attempt suicide, other individual and societal factors must be considered. Mental illness-related discrimination is one potential risk factor. Method: Using mixed methods, the influence of discrimination on suicidality amongst 194 individuals diagnosed with depression, bipolar or schizophrenia spectrum disorders was investigated. Qualitative interviews with a sub-sample of 58 individuals who reported a link between experience of discrimination and suicidality were analysed using framework analysis. Quantitative methods were used to examine the model derived from qualitative analyses. Results: Results indicate that the experience of discrimination led 38% of the overall sample of 194 participants, to suicidal feelings and 20% reported that it contributed to making a suicide attempt. The qualitative model derived from interviews with a sub-sample of 58 participants suggested that the experience of discrimination is experienced as a stressor that exceeds coping resources, leading to a negative self-image and a perception of decreased supportive networks/social structure. The anticipation of further negative events and treatment, and the perception of a lack of supportive networks led individuals in this study to feelings of hopelessness and suicidality. Quantitative analyses provided support for the model. Conclusions: These data suggest that both psychological therapies aimed at improving coping skills and population-level anti-stigma interventions that reduce the occurrence of discrimination may provide some protection against suicide amongst individuals with mental health problems.
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- Authors
- Farrelly, S., Jeffery, D., Rüsch, N., Williams, P., Thornicroft, G., & Clement, S.
- Affiliations
- King's College London (GB)
- Universität Ulm (DE)
- Corresponding author
- Farrelly, S.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2015-02-13
- Volume
- 45
- Issue
- 10
- Pages
- 2013-2022
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2151033809
- Cited by
- 90
- References
- 35
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 5 · 2023: 6 · 2022: 9 · 2021: 8 · 2020: 9 · 2019: 14 · 2018: 8 · 2017: 6 · 2016: 9 · 2015: 7
- FWCI
- 12.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- South London and Maudsley NHS Foundation Trust
- National Institute for Health and Care Research (RP-PG-0606-1053)
- Inyuvesi Yakwazulu-Natali
- National Institutes of Health
- Programme Grants for Applied Research
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Keywords
- suicidality, suicide risk factors, depression, bipolar disorder, schizophrenia spectrum disorders, stigma, hopelessness, coping resources, social support networks, negative self-concept, service user perspectives, stigma reduction interventions, coping strategies
- MeSH terms
- Adult, Aged, Mental Disorders, Cross-Sectional Studies, Female, Humans, Interpersonal Relations, Interviews as Topic, Male, Mental Health, Middle Aged, Risk Factors, Self Concept, Suicide, Attempted, Young Adult, Suicidal Ideation, Social Discrimination
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