(PS9-B35) Impact of Suicide-related Stigma on Crisis Line Uptake

Individuals who perceive mental health issues as stigmatized are less willing to seek help for these issues (see Batterham et al., 2013 for review). An important help-seeking resource for suicidal thoughts and behaviors is suicide crisis phone lines, but perceived stigma may reduce the likelihood of using this resource, with one study finding that youth were likely to worry about what others thought of them if they used a crisis line (Crosby Budinger et al., 2015). The relationship between stigma toward others experiencing a suicide crisis and hotline usage has not been investigated, which is important because this may impact willingness to seek help for others experiencing suicidal thoughts or engaging in suicidal behaviors. Thus, the present study examined how stigma toward dying by suicide affects both reported willingness to save a crisis line number in one’s phone and actually engaging in saving a crisis number. 

Undergraduate students were recruited for a larger study (n = 646) focused on the impact of a brief informational intervention on uptake of a crisis number. As the intervention findings were not significant, participants in both the intervention and control groups were collapsed for the present study. Participants completed the Stigma of Suicide Scale (SOSS-SF) a self-report measure of attitudes toward people who die by suicide with three subscales: stigma (viewing those who die by suicide as weak and immoral), isolation/depression (viewing those who die by suicide as isolated and lonely), and glorification/normalization (viewing those who die by suicide as brave and strong; Batterham et al., 2013). Participants were asked if they were willing to save a crisis line number in their mobile phone with a yes/no binary outcome (“willingness”). Participants answered “yes” were provided with a crisis number to call or text to save in their phone. Later in the study, participants who indicated that they were willing to save a number in their phone were asked to enter the number to determine whether they had actually saved the number in their phone (“behavior”).

Binary logistic regression was used to examine if subscales on the SOSS-SF were associated with willingness and behavior. Higher stigma scores decreased willingness (OR = .940, 95% CI [.913, .967], p < .001) and behavior (OR = .927, 95% CI [.896, .958], p < .001), while higher isolation scores increased willingness (OR = 1.079, 95% CI [1.028, 1.133], p = .002) and behavior (OR = 1.099, 95% CI [1.039, 1.162], p = .001). Glorification scores were not associated with willingness or behavior, p’s > .05.

Results indicate that stigmatizing attitudes toward those who die by suicide may be an important barrier to help-seeking in the context of suicide prevention resources. However, viewing those who die by suicide as isolated or depressed may increase a perceived need for suicidal individuals to seek help. Broadly, findings highlight the importance of understanding attitudes toward suicide in prevention and help-seeking messaging.