Paolo Fusar-Poli,Cecilia Maria Esposito,Andres Estradé,Renè Rosfort,Milena Mancini,Matthew Jackman,Anto Sugianto,Elza Berk,Benny Prawira,Latifah N Wangui,Arnold Agaba,Julieann Cullen,Rory R O'Connor,Ian Marsh,Farshid Shamsaei,Ilaria Bonoldi,Alberto Stefana,Stefano Damiani,Ilaria Basadonne,Angad Singh,Silvia Fontana,Irene Curti,Laura Massari,Aurora Legittimo,Samuele Cortese,Dong Keon Yon,Jae Il Shin,Luis Madeira,Giovanni Stanghellini,Mario Rossi Monti,Matthew Ratcliffe,Maurizio Pompili,Mario Maj
This is the first bottom-up review of the lived experience of persons who attempt suicide. The study has been co-designed, co-conducted and co-written by experts by experience and academics, focusing on first-person narratives within and outside the medical field. The lived world of individuals who attempt suicide is characterized by experiences related to the attempt itself ("contemplating suicide as a deliberate death", "contemplating suicide as an escape route", "looking for online answers about suicide", "planning suicide", "finding rest between the suicidal decision and the final act", "changing one's mind during the suicide attempt", "acting on suicidal impulses"); experiences related to the self and time ("feeling unworthy", "feeling detached from oneself or the world and lacking a sense of agency", "splitting the self between the decision to live or die", "perceiving an abortive and doomed future"); and experience of emotions and the body ("feeling overwhelmed by hopelessness and despair", "feeling empty and drained of energy", "feeling alone"). The lived experience of individuals who attempt suicide is also described in terms of the social and cultural context, including the experience of others ("feeling that no one cares", "feeling like a burden to others", "facing others' difficulty in understanding"); cultural, gender and age differences ("experiencing geographical, cultural and religious taboos about suicide", "feeling inadequate in relation to gender stereotypes", "feeling abandoned in old age"); and the perception of stigma ("facing social stigma", "experiencing a stigmatized self", "silencing suicidal behaviors"). The lived experience of persons after an attempted suicide is characterized as a complex process of self-acceptance and rediscovery ("living with suicidal thoughts", "navigating the challenges of recovery", "gaining new perspectives during recovery", "restoring interpersonal relationships to recover"). Finally, the lived experience of individuals who attempt suicide is described with respect to their access to general health care ("seeking help before the suicide attempt", "feeling abandoned after a suicide attempt") and mental health care ("experiencing shame as a barrier to care", "fearing mental disorder label", "feeling accepted and listened to", "facing economic difficulties in accessing support", "coping with distress during hospitalization"). The experiences described in this paper hold educational and social value, informing medical and psychological practices and research, public health approaches, and promotion of social change. This research overcomes embarrassment, fear and stigma, and helps us to understand the fragile nature of our emotions and feelings, our immersion in the social world, and our sense of meaning in life.
{"title":"The lived experience of persons who attempt suicide: a bottom-up review co-designed, co-produced and co-written by experts by experience and academics.","authors":"Paolo Fusar-Poli,Cecilia Maria Esposito,Andres Estradé,Renè Rosfort,Milena Mancini,Matthew Jackman,Anto Sugianto,Elza Berk,Benny Prawira,Latifah N Wangui,Arnold Agaba,Julieann Cullen,Rory R O'Connor,Ian Marsh,Farshid Shamsaei,Ilaria Bonoldi,Alberto Stefana,Stefano Damiani,Ilaria Basadonne,Angad Singh,Silvia Fontana,Irene Curti,Laura Massari,Aurora Legittimo,Samuele Cortese,Dong Keon Yon,Jae Il Shin,Luis Madeira,Giovanni Stanghellini,Mario Rossi Monti,Matthew Ratcliffe,Maurizio Pompili,Mario Maj","doi":"10.1002/wps.70003","DOIUrl":"https://doi.org/10.1002/wps.70003","url":null,"abstract":"This is the first bottom-up review of the lived experience of persons who attempt suicide. The study has been co-designed, co-conducted and co-written by experts by experience and academics, focusing on first-person narratives within and outside the medical field. The lived world of individuals who attempt suicide is characterized by experiences related to the attempt itself (\"contemplating suicide as a deliberate death\", \"contemplating suicide as an escape route\", \"looking for online answers about suicide\", \"planning suicide\", \"finding rest between the suicidal decision and the final act\", \"changing one's mind during the suicide attempt\", \"acting on suicidal impulses\"); experiences related to the self and time (\"feeling unworthy\", \"feeling detached from oneself or the world and lacking a sense of agency\", \"splitting the self between the decision to live or die\", \"perceiving an abortive and doomed future\"); and experience of emotions and the body (\"feeling overwhelmed by hopelessness and despair\", \"feeling empty and drained of energy\", \"feeling alone\"). The lived experience of individuals who attempt suicide is also described in terms of the social and cultural context, including the experience of others (\"feeling that no one cares\", \"feeling like a burden to others\", \"facing others' difficulty in understanding\"); cultural, gender and age differences (\"experiencing geographical, cultural and religious taboos about suicide\", \"feeling inadequate in relation to gender stereotypes\", \"feeling abandoned in old age\"); and the perception of stigma (\"facing social stigma\", \"experiencing a stigmatized self\", \"silencing suicidal behaviors\"). The lived experience of persons after an attempted suicide is characterized as a complex process of self-acceptance and rediscovery (\"living with suicidal thoughts\", \"navigating the challenges of recovery\", \"gaining new perspectives during recovery\", \"restoring interpersonal relationships to recover\"). Finally, the lived experience of individuals who attempt suicide is described with respect to their access to general health care (\"seeking help before the suicide attempt\", \"feeling abandoned after a suicide attempt\") and mental health care (\"experiencing shame as a barrier to care\", \"fearing mental disorder label\", \"feeling accepted and listened to\", \"facing economic difficulties in accessing support\", \"coping with distress during hospitalization\"). The experiences described in this paper hold educational and social value, informing medical and psychological practices and research, public health approaches, and promotion of social change. This research overcomes embarrassment, fear and stigma, and helps us to understand the fragile nature of our emotions and feelings, our immersion in the social world, and our sense of meaning in life.","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"57 1","pages":"34-49"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rethinking stigma reduction programs for people with severe mental illness.","authors":"Nicola Reavley","doi":"10.1002/wps.70007","DOIUrl":"https://doi.org/10.1002/wps.70007","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"281 1","pages":"86-87"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lea Schumacher,Levente Kriston,Omid V Ebrahimi,Adam Finnemann,Jan Philipp Klein,Jonas M B Haslbeck
{"title":"A data re-analysis confirms the value of symptom networks in predicting psychotherapy outcome.","authors":"Lea Schumacher,Levente Kriston,Omid V Ebrahimi,Adam Finnemann,Jan Philipp Klein,Jonas M B Haslbeck","doi":"10.1002/wps.70021","DOIUrl":"https://doi.org/10.1002/wps.70021","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"39 1","pages":"152-154"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Harnessing civil society to promote social inclusion of people with severe mental illness.","authors":"Rob Whitley","doi":"10.1002/wps.70004","DOIUrl":"https://doi.org/10.1002/wps.70004","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"266 1","pages":"83-84"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Social inclusion in global mental health contexts: how can we do more for what matters most?","authors":"Charlotte Hanlon","doi":"10.1002/wps.70006","DOIUrl":"https://doi.org/10.1002/wps.70006","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"8 1","pages":"87-89"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Advancing social inclusion for people with co-occurring mental health and substance use disorders.","authors":"David Smelson","doi":"10.1002/wps.70010","DOIUrl":"https://doi.org/10.1002/wps.70010","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"51 1","pages":"90-91"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The causal structure of psychopathology and why it matters.","authors":"Eric Turkheimer","doi":"10.1002/wps.70000","DOIUrl":"https://doi.org/10.1002/wps.70000","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"48 1","pages":"1-2"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hussien Elkholy,Mariana Pinto da Costa,Felipe Picon,Florian Riese,Mariana Paim Santos,Alex Vicente Spadini,Fairouz Tawfik,Rick Peter Fritz Wolthusen,Lamia Jouini
{"title":"Ten years of growth, collaboration and innovation: celebrating the WPA Early Career Psychiatrists Section.","authors":"Hussien Elkholy,Mariana Pinto da Costa,Felipe Picon,Florian Riese,Mariana Paim Santos,Alex Vicente Spadini,Fairouz Tawfik,Rick Peter Fritz Wolthusen,Lamia Jouini","doi":"10.1002/wps.70028","DOIUrl":"https://doi.org/10.1002/wps.70028","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"32 1","pages":"162-164"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Why climate action is an opportunity multiplier for mental health.","authors":"Emma L Lawrance","doi":"10.1002/wps.70029","DOIUrl":"https://doi.org/10.1002/wps.70029","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"51 1","pages":"54-55"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Social inclusion means being able to participate in activities valued within one's community or wider society as one would wish. People with severe mental illness (i.e., psychoses, bipolar disorder, and severe depression) experience some of the highest rates of social exclusion compared to people with other disabilities. This is the case regardless of the availability of specialist mental health services. Therefore, questions arise about the extent to which mental health services can and do prioritize social inclusion as a goal of service provision, and what strategies are needed outside of mental health services, at the levels of legislation and policy, statutory services, and civil society. In this paper we consider what social inclusion means in different cultures and contexts, since the value attached to different activities varies by culture and by life stage and gender. We discuss the subjective impact of low levels of social inclusion in terms of loneliness, and the evidence base for interventions to address it. We then turn to strategies to increase observable forms of social inclusion, considering them at the levels of legislation, services and other community assets. While evidence for some interventions is largely based on the Global North, we use evidence and examples from the Global South to the extent that we have found them. We also consider the predominant frameworks for social inclusion used in health services, followed by alternatives that may offer a more empowering approach to social inclusion for some people. We then describe strategies to reduce social exclusion through interventions to address stigma and discrimination, directed at key target groups or at population level. We make recommendations for policy makers, researchers, health professionals, and advocates based on the evidence and examples we have found, covering various forms of legislation, services and mental health research. Our conclusions identify the next steps for interventions, including development, evaluation, implementation or modification for better contextual adaptation.
{"title":"Social inclusion of people with severe mental illness: a review of current practices, evidence and unmet needs, and future directions.","authors":"Claire Henderson,Yasuhiro Kotera,Brynmor Lloyd-Evans,Gerald Jordan,Matthew Gorner,Anthony Salla,Jasmine Kalha,Peter A Coventry,Laura Bojke,Sebastian Hinde,Mike Slade","doi":"10.1002/wps.70031","DOIUrl":"https://doi.org/10.1002/wps.70031","url":null,"abstract":"Social inclusion means being able to participate in activities valued within one's community or wider society as one would wish. People with severe mental illness (i.e., psychoses, bipolar disorder, and severe depression) experience some of the highest rates of social exclusion compared to people with other disabilities. This is the case regardless of the availability of specialist mental health services. Therefore, questions arise about the extent to which mental health services can and do prioritize social inclusion as a goal of service provision, and what strategies are needed outside of mental health services, at the levels of legislation and policy, statutory services, and civil society. In this paper we consider what social inclusion means in different cultures and contexts, since the value attached to different activities varies by culture and by life stage and gender. We discuss the subjective impact of low levels of social inclusion in terms of loneliness, and the evidence base for interventions to address it. We then turn to strategies to increase observable forms of social inclusion, considering them at the levels of legislation, services and other community assets. While evidence for some interventions is largely based on the Global North, we use evidence and examples from the Global South to the extent that we have found them. We also consider the predominant frameworks for social inclusion used in health services, followed by alternatives that may offer a more empowering approach to social inclusion for some people. We then describe strategies to reduce social exclusion through interventions to address stigma and discrimination, directed at key target groups or at population level. We make recommendations for policy makers, researchers, health professionals, and advocates based on the evidence and examples we have found, covering various forms of legislation, services and mental health research. Our conclusions identify the next steps for interventions, including development, evaluation, implementation or modification for better contextual adaptation.","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"39 1","pages":"56-82"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：