Jo Bell

Why embarrassment inhibits the acquisition and use of condoms: A qualitative approach to understanding risky sexual behaviour

This article is based on research commissioned by the UK Governments Teenage Pregnancy Unit. The Living on the Edge (LOTE) study qualitatively explored factors that shape young peoples experiences and attitudes towards sexual behaviour and young parenthood in three linked seaside and rural areas in England. It identifies embarrassment as a key risk factor in young peoples sexual behaviour and demonstrates why engaging in protective behaviour and seeking information and advice, can be constrained by fear of embarrassment and concerns about how they are regarded by others. This paper also argues that embarrassment around condom use is not necessarily restricted to adolescence. Embarrassment is a deeply unpleasant experience for everyone and people (young and old) are motivated to avoid it. Implications and recommendations for future policy and service provision are highlighted.

Trapped in transition: findings from a UK study of student suicide

ABSTRACT This study of student suicide within UK higher education directs attention to the community context of suicide. A modified psychological autopsy approach was used to explore 20 case studies of student suicide from the period 2000–2005, drawing on the perspectives of family members, friends and university staff. The study identifies features of the higher education community salient for suicide prevention and concludes that the concept of transition is useful in considering the potential interaction across time and place of the risk factors for vulnerable students. These findings can be used to inform suicide prevention strategies in higher education and in other similar settings.

Life Will Never Be the Same Again: Examining Grief in Survivors Bereaved by Young Suicide

This article explores existing assumptions about the nature of bereavement by suicide. Drawing on data from a U.K. study of student suicide, we hope to contribute to a fuller understanding of the uniqueness of bereavement by suicide and new pathways for grief research. In this article we argue that bereavement by suicide has a number of common themes and characteristics. Analyzed in accordance with Jordans (2001) review, our data supports the idea that the thematic content of the grief associated with suicide bereavement is distinctive and guilt is a particularly important feature. We argue that no other type of death is likely to bestow this particular negative emotion on survivors in equivalent measure. Findings on the impact of social processes and family systems were mixed. Explanations to account for these data along with recommendations for intervention and research are discussed.

The role of perfectionism in student suicide: three case studies from the UK

A number of studies have investigated the relationship between suicide and perfectionism but none to our knowledge have been based on studies of completed suicides. This article aims to provide important insight into the potency that certain profiles of perfectionism can claim in the path to suicide by presenting three case studies from a U.K. study of student suicide. Collectively, these case studies provide theoretical support for existing frameworks and are consistent with other literature which emphasizes those forms of perfectionism that engender severe self-criticism and self-doubt and fear of failure as most destructive.

Suicidal students' use of and attitudes to primary care support services.

Aim The aims of this study were to improve responses to students in distress and who are feeling suicidal, to help practitioners to increase their responsiveness to those at high risk of suicide and to develop effective responses to those affected by their deaths. The study sought to build a detailed picture of students’ patterns of service use. Background National suicide prevention strategies emphasise that suicide prevention requires the collaboration of a wide range of organisations. Among these, primary care services play a key role in relation to suicide prevention for young people in crisis. Methods This study, undertaken between 2004 and 2007, focused on 20 case studies of student suicide that took place in the United Kingdom between May 2000 and June 2005. It adopted a psychological autopsy approach to learn from a wide range of informants, including parents, friends, university staff and the records of coroners or procurator fiscals. Twenty families gave permission for their son’s or daughter’s death to be included in the study and agreed to participate in the study. Informants were interviewed in person and the data were analysed thematically. Analysis of the case study data suggested that in a number of cases students had failed to engage with services sufficiently early or in sufficient depth. Primary care practitioners need to be proactive in communicating concerns about vulnerable students to student support services. At local levels, collaboration between student support and National Health Service practitioners varied considerably and channels of communication need to be developed.

Continuing social presence of the dead: exploring suicide bereavement through online memorialisation

The last 10 years have seen a rise in Internet sites commemorating those lost to suicide. These sites describe the life of the deceased and the afterlife of relatives, parents, friends or siblings who have been termed the “forgotten bereaved”. It is clear that such sites have implications for continuing bonds and for what many commentators refer to as the continuing social presence of the dead. This paper presents interim findings from ongoing research which focuses on two aspects of suicide memorial websites. First, we explore the extent to which such sites help us understand how the Internet is enabling new ways of grieving and is, in effect, making new cultural scripts. Second, although there is a large body of writing on the management of trauma there is little evidence-based research. The paper draws on face-to-face interviews with owners of suicide memorial sites (family members and friends) and explores how the establishment and maintenance of such a site is an important part of the therapeutic process and how, for grieving relatives, making or contributing to such sites provides ways of managing trauma in the aftermath of a death by suicide.

‘We do it to keep him alive’: bereaved individuals’ experiences of online suicide memorials and continuing bonds

Abstract This paper presents draws on interviews with individuals who have experience of creating, maintaining and utilising Facebook sites in memory of a loved one who has died by suicide. We argue that Facebook enables the deceased to be an on-going active presence in the lives of the bereaved. We highlight the potential of the Internet (and Facebook in particular) as a new and emerging avenue for the continuation of online identities and continuing bonds. Our study offers unique insight into survivors’ experiences of engaging with the virtual presence of their deceased loved one: how mourners come and go online, how this evolves over time and how the online identity of the deceased evolves even after death. We discuss how Facebook provides new ways for people to experience and negotiate death by suicide and to memorialise the deceased, highlighting the positive impact of this for survivors’ mental health. Finally, we describe the creation of tension amongst those who manage their grief in different ways.

Harmful or helpful? The role of the internet in self-harming and suicidal behaviour in young people

Purpose– The internet plays an important role in the lives of self-harming and suicidal young people yet little is known about how internet use influences this behaviour. The purpose of this paper is to examine the evidence base with a view to determining directions for future research and practice. Design/methodology/approach – Literature relating to self-harming and suicidal behaviour, young people, and the internet is reviewed with a focus on content and methodology. Findings – The internet provides access to: “how-to” descriptions of suicide; unregulated/illegal online pharmacies; forums to spread this information; access to others seeking to end their own lives. Such sites are believed to elevate risk amongst vulnerable individuals. Conversely, the internet provides access to intervention and prevention activity, online support groups, advice, and personal chat. These can be a key resource in helping young people. There is a lack of consensus on what constitutes harmful and helpful online exchange, often evidenced in disparity between the perceptions of professionals and users. Research limitations/implications – Research is needed to map out a more accurate picture of suicide and self-harm resources on the internet and to establish a consensus about what constitutes harmful and helpful exchange. This needs to be based on: a comprehensive and informed range of search terms; a clear distinction between types of resource; a clear and consistent rationale for distinguishing and categorizing sites; a systematic replicable methodology for plotting the scope, content, accessibility, and popularity of web resources at a given point in time; the views of young people who use these sites, as well as practitioners and professionals. Practical implications – Practitioners need to: regularly assess the quantity, quality, and nature of selfharm/suicide focused internet use amongst service users; be aware of which sites are most appropriate for particular individuals; promote sites directed at young people that enhance effective coping. Professional mental health organizations need to find ways of ensuring that: they are consistently well represented amongst search results online; sites are readily accessible; more practitioners are trained in text-based communications. Originality/value – This paper offers a framework and rationale for future research and for those involved in service provision, policy, and practice.