Suicide and Depression Support Group

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This support group offers a safe, nonjudgmental place for people to talk about the feelings that led them to attempt suicide and the impact that their attempt had on their lives. The group provides an opportunity for its participants to connect with peers who share similar experiences

Inspire hope and help people find meaning and purpose in life

• Build community connectedness
• Engage and support family and friends
• Respect and support cultural, ethnic, and spiritual beliefs and traditions
• Provide timely access to care and support
• Preserve dignity and counter stigma, shame, and discrimination
• Promote choice and collaboration in care
• Connect persons to peer support

People who have survived a suicide attempt are often embarrassed or ashamed about their attempt. Frequently, as a result of the crisis or mental health issues that led to their suicide attempt, they have withdrawn from their support systems. It is common for people who have survived an attempt to continue to face thoughts of suicide. Individuals trying to share a wish to die with family, friends, significant others, and even helping professionals are rarely met with empathy due to the fear and alarm these thoughts may engender in others.

The rationale for this support group is that freely talking about suicidal thoughts may reduce their urgency and potency, leaving space for new alternatives to be considered. Talking about a suicide attempt within a group of peers can reduce shame and stigma. If unaddressed, the taboo and secrecy around suicidal ideation and the legacy of having made an attempt could contribute to future suicidal behaviors.

When met with empathy and mutual respect, there is important healing potential in being able to talk about what led them to their suicide attempt, to find acceptance, and to feel more empowered to ask for help should suicidal thoughts return. Members can learn how to identify when they may be at risk of suicide again and put supports in place to help them cope with their suicidal feelings while staying safe. Having an established space of safety for members to openly disclose suicidal impulses without fear of judgment or overreaction can be very empowering.

After an attempt, people often report feeling vulnerable and raw. It may be that some members don’t have the energy or will to complete tasks that could be related to their healing, such as traditional individual therapy. A support group is a non-demanding atmosphere where members can be among others who understand their experience and take small steps toward healing as they choose.

In previous support groups, when asked what they hoped to get out of the group, some participants have stressed the need for emotional support and relief such as the following:

• Connecting with peers who have had similar lived experience (having survived a suicide attempt) in order to find a safe, nonjudgmental environment where they can talk about their experiences
• Letting go of a sense of failure
• Lessening the isolation that preceded their suicide attempt and that often continues after their attempt because those closest to them are uncertain how to respond
• Being able to trust
• Having a place of “no shame”
• Letting go of the “big red label” of having made a suicide attempt
• Finding self-acceptance
• Developing a sense of hope

Other participants have expressed fear of being in a suicidal state again or of acting impulsively when feeling depressed or overwhelmed. These participants have expressed the desire to receive tools and learn skills to equip them to feel that they have more control over their behavior and ultimately their lives.

The support group serves the unique needs of survivors of suicide attempts. In offering a time-limited support group, there is a focus on short-term goals, one of the most important being reducing internalized stigma. An individual who feels fragile and vulnerable after an attempt may be more willing to make the first tentative steps of “opening the door” to their internal world with others who have been there too. In contrast to a time when participants may have felt most isolated leading up to their attempt, the group offers a timely experience of belonging, relating, and being understood.

The group environment, focused on the common experience of having survived a suicide attempt, helps survivors feel more connected, a key component in reducing suicide risk. Because the suicidal state can lead a person to withdraw from others, the group offers a corrective experience of reaching out, opening up, and encouraging connectedness.

In brief, short-term goals of the group include:

• Maintain participants’ safety and manage risk
• Reduce internalized/ perceived stigma
• Increase comfort with and ability to speak about the thoughts and feelings that led to their suicide attempt and learn how to recognize and cope with these feelings if they return in order to decrease the likelihood of reattempts
• Increase coping skills as they relate to suicidal thoughts
• Increase knowledge about, and the likelihood of using, safety planning tools
• Increase connectedness, including access to peers who can support each other in times of crisis
• Creating a “built-in” safety net where members are comfortable sharing thoughts/risk for suicide without fear of how others will react
• Manage and reduce lethal means
• Increase hopefulness

Longer-term goals can be met as participants return for future cycles or as the group process starts to move in a forward direction with greater gains made over time. The seeds may be planted for growth and progress on a slower timeline than the initial eight weeks.

Long-term goals include:

• Reduce suicidal desire
• Reduce suicidal intent
• Increase protective factors
• Prevent future attempts
• Create a peer support network
• Increase in individual’s ability to plan for the future

Some individuals may also choose to increase involvement in advocacy and community service, particularly in the area of suicide prevention. Many participants have reported that using their experiences related to their attempt to help others provides a sense of meaning and connectedness.

While most people who attempt suicide do not attempt again, data from one study show that 37 percent of survivors repeat attempts within five years. The risk that a person may reattempt suicide is highest immediately after discharge from an emergency department or inpatient psychiatric unit and remains high over the next one to five years. For some attempt survivors, this suicide risk remains high for a longer time. Data show a higher rate of suicide deaths decades after the attempt.

The evidence clearly identifies this risk group, yet services often fail to move attempt survivors towards better outcomes. As Continuity of Care for Suicide Prevention and Research points out, emergency room staff s often harbor negative attitudes toward suicidal patients:

“One common attitudinal theme mentioned is: ‘Suicide is a choice.’ Another frequent mention is: ‘Suicide attempts are willful, deliberate, selfish and attention seeking.’ It is no surprise, then, that following a suicide attempt, patients very often feel invalidated, isolated and ignored by health professionals without special training in counseling for suicide”

Studies show that as many as 50 to 70 percent of people discharged from a psychiatric hospital or emergency department following a suicide attempt do not keep their first scheduled outpatient session for ongoing care. This may stem from a sense of shame or dissatisfaction following their initial treatment in the hospital. The people who do attend therapy often drop out after a few sessions and do not complete therapy. Many people who go to the emergency department for suicidal crises are discharged without mental health assessments. Aside from attempt survivors who are seen in emergency departments, hospitals, or doctors’ offices, a number of individuals who attempt suicide do not seek treatment and remain unknown to any health or mental health provider.

There exists a gap of services for people recovering from a suicide attempt.

While it is commonly agreed that therapy and support services are vital after a suicide attempt, there are very few effective programs devoted specifically to this population. Many attempt survivors don’t seek any mental health treatment after their attempt, often discouraged by previous experiences in therapy where they may not have benefited. Some look for services specifically for suicide attempt survivors and are disappointed to find few exist. Other attempt survivors may feel embarrassed that they let their therapist down by making a suicide attempt.

Still other attempt survivors might be angry with the mental health system because when trying to talk about their suicidal thoughts and feelings, they were prematurely involuntarily hospitalized by the outpatient mental health provider, thereby precluding their ability to explore this issue in therapy on an outpatient, and ongoing, basis.

For attempt survivors facing significant barriers to mental health services, support groups may provide an alternative option or a first step that leads to treatment and recovery.