Presentation at the National Suicide Prevention Conference, Melbourne Australia, July 2013
Help-negation is defined as the process of help withdrawal or avoidance found among those currently experiencing clinical and subclinical levels of different forms of psychological distress, including low and critical levels of suicidal ideation (Wilson, Bushnell, Caputi, 2011). Understanding the determinants of help-negation in suicidal samples that have not yet come to treatment provides a potent opportunity to target prevention and early intervention strategies to facilitate appropriate and timely help-seeking. Over 20 help-negation studies have ruled out variables that might explain the withdrawal process associated with suicidal thoughts. These results now point to biological and neurological underpinnings working together with social and cognitive variables to influence the help-negation process. This paper presents results of study that examined cognitive, affective, and social processes involved in help-negation after critical suicidal ideation in a sample of 279 non-helpseeking suicidal ideators case-matched by sex, age, and year of data collection (2010-2012) to a sample of 279 non-help-seeking non-suicidal ideators. Results suggest there are at least two types of process underlying help-negation for suicidal ideation: active processes that are specific to suicidal ideation and passive processes that are common to suicidal ideation and depression. The results also implicate affect regulation processes and perceptual processes related to social support in the development of help-negation among suicidal individuals - not cognitive distortion as the primary reason that suicidal individuals don't seek help. The results challenge suicide prevention strategies that primarily target distorted cognitions (e.g., stigma, fears, beliefs, attitudes) to promote help-seeking. The results suggest that prevention strategies must not imply that distorted cognitions are THE primary reason people do not seek help, and raise the possibility of iatrogenic effects, should this focus remain. Additional implications for prevention, early intervention, treatment and directions for future research are presented and discussed.