Suicide-ality poses social, political and health concerns worldwide due to the significant psychological and social burden incurred (Maltsberger & Goldblatt, 1996; Hawton, 2005). In Ireland, rates for completed suicide are notably high among young men aged 15-34 years, who accounted for almost 40% of deaths by suicide in 2003 (NOSP, 2005). While a range of response initiatives have been developed, aimed at addressing suicide-ality at preventive, interventive and post-ventive levels, there has not been a corresponding decrease in prevalence rates of youth suicide in many countries, including Ireland (NOSP, 2009).
The field of suicidology has expanded in recent years, giving rise to substantial theoretical, practice and policy literature. Research in the field has been helpful in: identifying rates and trends in suicide-ality in general and among specific groups, identifying risk and protective factors, and designing and evaluating response strategies. It has been argued that research has been dominated by quantitative methodology and has primarily concentrated on prediction and control rather than understanding (Maris et al., 2000; Leenaars, 2004). Consequently understanding of the suicidal process (Aldridge, 1998) and suicidal person (Webb, 2002) is limited and there is inadequate guidance for professionals working in the area (Maltsberger & Goldblatt, 1996; Ting et al., 2006; Cutcliffe & Stevenson, 2007).
This Grounded Theory study aimed to address these gaps by developing a substantive theory pertaining to the phenomena of suicide-ality among young Irish men that could be utilized to inform mental health theory and practice (Glaser & Strauss, 1967). This involved interviewing seventeen formerly suicidal young men who had contact with mental health services and eliciting their views about their suicidality and what they considered constituted meaningful responses to them in their particular situation.
The study lead to the development of a substantive theory that explains how these young men transcended suicidality when facilitated to re-vitalize their worthiness as persons of value and deserving of life. The theory incorporated a two-stage psychosocial process wherein the young men moved from a death orientation to a life orientation. This was a complex and unpredictable process that entailed identity re-configuration and was punctuated by turning points (Strauss, 1969). Turning points involved profound moments of inner and outer dialogue (Seikkula et al., 1995) that significantly influenced the young men’s lives and their journies on their suicide trajectories and life pathways. It is proposed that the mental health practitioner can play a key role in enhancing worthiness by providing and promoting validating interpersonal dialogic encounters, thereby facilitating young men to transcend suicidality.