Planning on Dying to Live: A Qualitative Exploration of the Alleviation of Suicidal Distress by Having a Suicide Plan

Abstract

Suicide prevention is for the most part seen in terms of reducing risk factors and increasing protective factors for suicide, and having a suicide plan is considered to fall on the side of risk. Although it seems likely that the role of a suicide plan in a person’s life is more complex than this, there is to date little research exploring first-hand descriptions of suicidality in order to understand this role. The purpose of this study was to explore the therapeutic effects of having a suicide plan. Secondary, thematic analysis of data from a qualitative study aiming to understand first-hand experiences of the feeling of being suicidal was carried out. Having a suicide plan can function to reduce the immediate experience of suicidal distress through 1) providing a sense of control, and 2) relieving mental effort. Having a suicide plan provides a sense of control by: being ‘able to act’; ‘having an option’; and, ‘having an obstacle’. Having a suicide plan relieves mental effort by: providing resolution; reducing the need to control mental urges; fixing the future, where uncertainty about the future is relieved; and, things not mattering as much. Having a suicide plan can be a protective factor against suicide as well as an indicator of risk. Our analysis suggests that an exploration of both the costs and benefits to someone of having a suicide plan would inform appropriate intervention design for people in suicidal distress.