Academic paper Title“Qualitative Approach to Attempted Suicide by Adolescents and Young Adults: The (Neglected) Role of Revenge”Suicide by adolescents and adults is a major public health concern, where repetitive self-harm is the major trigger factor towards attempts of suicide and future suicide attempts. 
Orri, Massimiliano, Matteo Paduanello, Jonathan Lachal, Bruno Falissard, Jordan Sibeoni, and Anne Revah-Levy. 2014. “Qualitative Approach To Attempted Suicide By Adolescents And Young Adults: The (Neglected) Role Of Revenge”. Plos ONE 9 (5): e96716. doi:10.1371/jo
Synopsis of paper  To explore the perspective of adolescents who have directly engaged in suicidal acts. Result section organised as: Negative emotions toward self-collected in interviewNeeding control in their livesPerceived impasse in interpersonal relationshipsCommunication Revenge
Prominent experiences identified Theme 1: Negative emotions toward self. Adolescents had low self-worth and they felt a lack of acceptance and belonging in their lives. Feelings of low self-worth.“I kept repeating that I was disgusting, that no one really cared about me…[I was thinking] that everything about me, was wrong!”Feelings of lack of acceptance and belonging in their lives.“That nothing I did came out right…I don’t know, I continued this thing of not feeling accepted, not feeling that anybody cared about me.”Theme 2: Needing control in their livesThey attempted suicide as they were in a situation which they perceived was out of their control. “I had no control over the others, but I had control over myself…so I could do what I wanted to myself …and the cuts were a way to comfort my pain… I still have the scars – blood everywhere, I was crying, but…but the problem was still there…however, during these moments … it was as if I had control of my life”They attempted suicide as an escape from an overwhelming life situation that they could not manage. Theme 3: Perceived impasse in interpersonal relationshipsSuicidal adolescents reached out to their family members about their suicidal feelings but were written down. Suicidal adolescents had a strained relationship with their family members due to being written down.“Because I was changing and they didn’t realize that, they only realized it when I ran away from home […] at the beginning, I did it because…that is, I didn’t even think about it much, but then, as the hours were going by I kept on thinking about it and…I don’t know, but it was like running away to make myself visible…”Theme 4: Communication Adolescents had a communication breakdown in interpersonal relationships leading to an act of attempting suicide. Their suicidal act concerned the environment of others and not only themselves. However, their efforts to attempt suicide were in vain, as the adolescents’ feelings were not acknowledged. Communication breakdown between mom and suicidal adolescent: “I was sick and tired of my mother’s behavior…and to keep on talking was useless. I went on for several months and kept talking and talking and…that was hurting me…and I was tired. Adolescents’ feelings were not acknowledged.  “And so I finally did something like that [attempted suicide], but it was mainly to make her understand that she was killing me!…either she would kill me, or…or I had to find another way […]. If I tried to do that there, it’s because I had already talked about it in every other way….”Theme 5: RevengeThe strong relational theme was clearly revenge. Adolescents had feelings of aggressiveness involving their act to make other people feel guilty.Intense feelings of revenge:  “I was convinced, utterly convinced…yeah, yeah, I want to do it… revenge! Revenge! this to me all these years…you’ve gotten only my hatred, my contempt…my contempt for life…and…and now you look at me…look at me and suffer.”
What do these prominent experiences mean? Theme 1: Negative emotions toward self.Adolescents had a low self-esteem which created an unhealthy sense of self. Impaired relationships also majorly influenced them to attempt suicide. Theme 2: Needing control in their livesLoss of control in life due to helplessness of situations. Suicidal adolescents perceived suicide as the only form of escape from their own sufferings. Theme 3: Perceived impasse in interpersonal relationshipsLack of acceptance and mistrust in family relationships increased suicidal feelings in adolescents. Lack of proper communication in relationships led to strained family dynamics.Theme 4: Communication Communicative issues led to suicide attempts as a message for others to acknowledge the suicidal adolescents’ feelings.Suicide was the only way out as a result of communication failure. Theme 5: RevengeThe act of suicide was done as revenge out of the suicidal adolescent’s aggressiveness to make others feel guilty about their deaths. Suicidal adolescents saw revenge as a message to others to be aware of their mistakes and carelessness. 
Key messages for HCPHCP to patients/their NOK:
Remember to have regular check-ups with your mental health professional especially if you are on antidepressants. 

HCP to themselves:
Environment should always be safe to not trigger oneself for exacerbating any existing or present symptoms.

Suicide

Henry & Sathwikaw

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