{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:24:31Z","timestamp":1777933471364,"version":"3.51.4"},"reference-count":41,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T00:00:00Z","timestamp":1607385600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000925","name":"national health and medical research council","doi-asserted-by":"publisher","award":["APP1158881"],"award-info":[{"award-number":["APP1158881"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000245","name":"Michael Smith Foundation for Health Research","doi-asserted-by":"publisher","award":["18317"],"award-info":[{"award-number":["18317"]}],"id":[{"id":"10.13039\/501100000245","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100021131","name":"Movember Canada","doi-asserted-by":"crossref","award":["11R18455"],"award-info":[{"award-number":["11R18455"]}],"id":[{"id":"10.13039\/501100021131","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Qual Health Res"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>Male suicide rates are high and rising, and important insights can be gleaned from understanding the experiences of men who have attempted suicide. Drawing from a grounded theory photovoice study of diverse Canadian men, three intertwined thematic processes were derived: (a) preceding death struggles, (b) life-ending attempts and saving graces, and (c) managing to stay alive post suicide attempt. Preceding death struggles were characterized by cumulative injuries, intensifying internalized pain, isolation, and participant\u2019s efforts for belongingness in diminishing their distress. Men\u2019s life-ending attempts included overdosing and jumping from bridges; independent of method, men\u2019s saving graces emerged as changing their minds or being saved by others. Managing to stay alive post suicide attempt relied on men\u2019s acceptance that their mental illness was unending but amenable to effective self-management with professional mental health care. The findings offer vital clues about how male suicide might be prevented.<\/jats:p>","DOI":"10.1177\/1049732320975747","type":"journal-article","created":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T13:25:29Z","timestamp":1607606729000},"page":"415-429","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["How to Save a Life: Vital Clues From Men Who Have Attempted Suicide"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9029-4003","authenticated-orcid":false,"given":"John L.","family":"Oliffe","sequence":"first","affiliation":[{"name":"University of British Columbia, Vancouver, British Columbia, Canada"},{"name":"University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2721-4757","authenticated-orcid":false,"given":"Olivier","family":"Ferlatte","sequence":"additional","affiliation":[{"name":"University of Montreal, Montreal, Quebec, Canada"},{"name":"CIUSS du Centre-Sud-de-l\u2019\u00cele-de-Montr\u00e9al, Montr\u00e9al, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John S.","family":"Ogrodniczuk","sequence":"additional","affiliation":[{"name":"University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zac E.","family":"Seidler","sequence":"additional","affiliation":[{"name":"University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Orygen, The National Centre of Excellence in Youth mental Health, Parkville, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Kealy","sequence":"additional","affiliation":[{"name":"University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon M.","family":"Rice","sequence":"additional","affiliation":[{"name":"University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Orygen, The National Centre of Excellence in Youth mental Health, Parkville, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,12,8]]},"reference":[{"key":"bibr1-1049732320975747","doi-asserted-by":"crossref","unstructured":"Armstrong G., Pirkis J., Arabena K., Currier D., Spittal M. J., Jorm A. F. (2017). Suicidal behaviour in Indigenous compared to non-Indigenous males in urban and regional Australia: Prevalence data suggest disparities increase across age groups. Australian & New Zealand Journal of Psychiatry, 51(12), 1240\u20131248. https:\/\/doi.org\/10.1177\/0004867417704059","DOI":"10.1177\/0004867417704059"},{"key":"bibr2-1049732320975747","doi-asserted-by":"crossref","unstructured":"Bilsker D., Fogarty A. S., Wakefield M. A. (2018). Critical issues in men\u2019s mental health. The Canadian Journal of Psychiatry, 63(9), 590\u2013596. https:\/\/doi.org\/10.1177\/0706743718766052","DOI":"10.1177\/0706743718766052"},{"key":"bibr3-1049732320975747","doi-asserted-by":"crossref","unstructured":"Bostwick J. M., Pabbati C., Geske J. R., McKean A. J. (2016). Suicide attempt as a risk factor for completed suicide: Even more lethal than we knew. American Journal of Psychiatry, 173(11), 1094\u20131100. https:\/\/doi.org\/10.1176\/appi.ajp.2016.15070854","DOI":"10.1176\/appi.ajp.2016.15070854"},{"key":"bibr4-1049732320975747","doi-asserted-by":"crossref","unstructured":"Burrows S., Auger N., Gamache P., St-Laurent D., Hamel D. (2011). Influence of social and material individual and area deprivation on suicide mortality among 2.7 million Canadians: A prospective study. BMC Public Health, 11(1), Article 577. https:\/\/doi.org\/10.1186\/1471-2458-11-577","DOI":"10.1186\/1471-2458-11-577"},{"key":"bibr5-1049732320975747","volume-title":"Constructing grounded theory","author":"Charmaz K.","year":"2014"},{"key":"bibr6-1049732320975747","doi-asserted-by":"crossref","unstructured":"Cleary A. (2012). Suicidal action, emotional expression, and the performance of masculinities. Social Science & Medicine, 74(4), 498\u2013505. https:\/\/doi.org\/10.1016\/j.socscimed.2011.08.002","DOI":"10.1016\/j.socscimed.2011.08.002"},{"key":"bibr7-1049732320975747","doi-asserted-by":"crossref","unstructured":"Cleary A. (2017). Help-seeking patterns and attitudes to treatment amongst men who attempted suicide. Journal of Mental Health, 26(3), 220\u2013224. https:\/\/doi.org\/10.3109\/09638237.2016.1149800","DOI":"10.3109\/09638237.2016.1149800"},{"key":"bibr8-1049732320975747","volume-title":"Masculinities","author":"Connell R. W.","year":"2005"},{"key":"bibr9-1049732320975747","doi-asserted-by":"crossref","unstructured":"Ferlatte O., Salway T., Hankivsky O., Trussler T., Oliffe J. L., Marchand R. (2018). Recent suicide attempts across multiple social identities among gay and bisexual men: An intersectionality analysis. Journal of Homosexuality, 65(11), 1507\u20131526. https:\/\/doi.org\/10.1080\/00918369.2017.1377489","DOI":"10.1080\/00918369.2017.1377489"},{"key":"bibr10-1049732320975747","doi-asserted-by":"crossref","unstructured":"Ferlatte O., Salway T., Oliffe J. L., Saewyc E. M., Holmes C., Schick L., Purdie A., Damstrom-Albach D., Mantler E. R., Ho D., Knight R. (2020). It is time to mobilize suicide prevention for sexual and gender minorities in Canada. Canadian Journal of Public Health 111, 737\u2013742. https:\/\/doi.org\/10.17269\/s41997-020-00316-3","DOI":"10.17269\/s41997-020-00316-3"},{"key":"bibr11-1049732320975747","doi-asserted-by":"crossref","unstructured":"Ferlatte O., Salway T., Oliffe J. L., Trussler T. (2017). Stigma and suicide among gay and bisexual men living with HIV. AIDS Care, 29(11), 1346\u20131350. https:\/\/doi.org\/10.1080\/09540121.2017.1290762","DOI":"10.1080\/09540121.2017.1290762"},{"key":"bibr12-1049732320975747","doi-asserted-by":"crossref","unstructured":"Freeman A., Mergl R., Kohls E., Sz\u00e9kely A., Gusmao R., Arensman E., Koburger N., Hegerl U., Rummel-Kluge C. (2017). A cross-national study on gender differences in suicide intent. BMC Psychiatry, 17(1), Article 234. https:\/\/doi.org\/10.1186\/s12888-017-1398-8","DOI":"10.1186\/s12888-017-1398-8"},{"key":"bibr13-1049732320975747","doi-asserted-by":"crossref","unstructured":"Fuller-Thomson E., West K. J., Baiden P. (2019). The tide does turn: Predictors of remission from suicidal ideation and attempt among Canadians who previously attempted suicide. Psychiatry Research, 274, 313\u2013321. https:\/\/doi.org\/10.1016\/j.psychres.2019.02.030","DOI":"10.1016\/j.psychres.2019.02.030"},{"key":"bibr14-1049732320975747","doi-asserted-by":"publisher","DOI":"10.4324\/9780203793206"},{"key":"bibr15-1049732320975747","volume-title":"Making it better: Gender transformative health promotion","author":"Greaves L.","year":"2014"},{"key":"bibr16-1049732320975747","unstructured":"Gross P. A., Efimoff I., Patrick L., Josewski V., Hau K., Lambert S., Smye V. (2016). The DUDES Club: A brotherhood for men\u2019s health. Canadian Family Physician, 62(6), e311\u2013e318. https:\/\/www.cfp.ca\/content\/cfp\/62\/6\/e311.full.pdf"},{"key":"bibr17-1049732320975747","doi-asserted-by":"crossref","unstructured":"Han C. S., Oliffe J. L. (2016). Photovoice in mental illness research: A review and recommendations. Health, 20(2), 110\u2013126. https:\/\/doi.org\/10.1177\/1363459314567790","DOI":"10.1177\/1363459314567790"},{"key":"bibr18-1049732320975747","unstructured":"Hedegaard H., Curtin S. C., Warner M. (2018). Suicide mortality in the United States, 1999\u20132017. Centre for Disease Control and Prevention. https:\/\/stacks.cdc.gov\/view\/cdc\/60894"},{"key":"bibr19-1049732320975747","unstructured":"Heritage Vancouver. (2009). Historic monuments\u2014Angel of Victory in front of Waterfront Station. http:\/\/heritagevancouver.org\/top10-watch-list\/2009\/6-historic-monuments-angel-of-victory\/"},{"key":"bibr20-1049732320975747","doi-asserted-by":"crossref","unstructured":"Hunt T., Wilson C. J., Caputi P., Woodward A., Wilson I. (2017). Signs of current suicidality in men: A systematic review. PLOS ONE, 12(3), Article e0174675. https:\/\/doi.org\/10.1371\/journal.pone.0174675","DOI":"10.1371\/journal.pone.0174675"},{"key":"bibr21-1049732320975747","doi-asserted-by":"crossref","unstructured":"Knizek B. L., Hjelmeland H. (2018). To die or not to die: A qualitative study of men\u2019s suicidality in Norway. BMC Psychiatry, 18(1), Article 263. https:\/\/doi.org\/10.1186\/s12888-018-1843-3","DOI":"10.1186\/s12888-018-1843-3"},{"key":"bibr22-1049732320975747","doi-asserted-by":"publisher","DOI":"10.4324\/9781315430577"},{"key":"bibr23-1049732320975747","unstructured":"Movember. (n.d.). Conversations. https:\/\/conversations.movember.com\/?utm_medium=internal&utm_source=movember&utm_campaign=movember-conversations-link&_ga=2.3737136.1043551117.1589217642-1219668609.1578943237"},{"key":"bibr24-1049732320975747","unstructured":"National Institute of Mental Health (NIMH). (2019, April). Suicide. https:\/\/www.nimh.nih.gov\/health\/statistics\/suicide.shtml#part_154969"},{"key":"bibr25-1049732320975747","unstructured":"North Coast Primary Health Network (NCPHN). (2019, April 18). The way back support service. https:\/\/ncphn.org.au\/archives\/commissioned-services\/the-way-back-support-service"},{"key":"bibr26-1049732320975747","doi-asserted-by":"crossref","unstructured":"Oliffe J. L., Bottorff J. L., Kelly M., Halpin M. (2008). Analyzing participant produced photographs from an ethnographic study of fatherhood and smoking. Research in Nursing & Health, 31(5), 529\u2013539. https:\/\/doi.org\/10.1002\/nur.20269","DOI":"10.1002\/nur.20269"},{"key":"bibr27-1049732320975747","doi-asserted-by":"crossref","unstructured":"Oliffe J. L., Broom A., Rossnagel E., Kelly M. T., Affleck W., Rice S. M. (2020). Help-seeking prior to male suicide: Bereaved men perspectives. Social Science & Medicine, 261, Article 113173. https:\/\/doi.org\/10.1016\/j.socscimed.2020.113173","DOI":"10.1016\/j.socscimed.2020.113173"},{"key":"bibr28-1049732320975747","doi-asserted-by":"crossref","unstructured":"Oliffe J. L., Ogrodniczuk J. S., Bottorff J. L., Johnson J. L., Hoyak K. (2012). \u201cYou feel like you can\u2019t live anymore\u201d: Suicide from the perspectives of Canadian men who experience depression. Social Science & Medicine, 74(4), 506\u2013514. https:\/\/doi.org\/10.1016\/j.socscimed.2010.03.057","DOI":"10.1016\/j.socscimed.2010.03.057"},{"key":"bibr29-1049732320975747","doi-asserted-by":"crossref","unstructured":"Pearson A., Saini P., Da Cruz D., Miles C., While D., Swinson N., Williams A., Shaw J., Appleby L., Kapur N. (2009). Primary care contact prior to suicide in individuals with mental illness. British Journal of General Practice, 59(568), 825\u2013832. https:\/\/doi.org\/10.3399\/bjgp09X472881","DOI":"10.3399\/bjgp09X472881"},{"key":"bibr30-1049732320975747","doi-asserted-by":"crossref","unstructured":"Pirkis J., Schlichthorst M., King K., Lockley A., Keogh L., Reifels L., Spittal M. J., Phelps A. (2019). Looking for the \u201cactive ingredients\u201d in a men\u2019s mental health promotion intervention. Advances in Mental Health, 17(2), 135\u2013145. https:\/\/doi.org\/10.1080\/18387357.2018.1526095","DOI":"10.1080\/18387357.2018.1526095"},{"key":"bibr31-1049732320975747","doi-asserted-by":"crossref","unstructured":"Player M. J., Proudfoot J., Fogarty A., Whittle E., Spurrier M., Shand F., Christensen H., Hadzi-Pavlovic D., Wilhelm K. (2015). What interrupts suicide attempts in men: A qualitative study. PLOS ONE, 10(6), Article e0128180. https:\/\/doi.org\/10.1371\/journal.pone.0128180","DOI":"10.1371\/journal.pone.0128180"},{"key":"bibr32-1049732320975747","doi-asserted-by":"crossref","unstructured":"Randall J. R., Walld R., Finlayson G., Sareen J., Martens P. J., Bolton J. M. (2014). Acute risk of suicide and suicide attempts associated with recent diagnosis of mental disorders: A population-based, propensity score\u2013matched analysis. The Canadian Journal of Psychiatry, 59(10), 531\u2013538. https:\/\/doi.org\/10.1177%2F070674371405901006","DOI":"10.1177\/070674371405901006"},{"key":"bibr33-1049732320975747","doi-asserted-by":"crossref","unstructured":"Rieger K. L. (2019). Discriminating among grounded theory approaches. Nursing Inquiry, 26(1), Article e12261. https:\/\/doi.org\/10.1111\/nin.12261","DOI":"10.1111\/nin.12261"},{"key":"bibr34-1049732320975747","doi-asserted-by":"crossref","unstructured":"Schrijvers D. L., Bollen J., Sabbe B. G. (2012). The gender paradox in suicidal behavior and its impact on the suicidal process. Journal of Affective Disorders, 138(1\u20132), 19\u201326. https:\/\/doi.org\/10.1016\/j.jad.2011.03.050","DOI":"10.1016\/j.jad.2011.03.050"},{"key":"bibr35-1049732320975747","doi-asserted-by":"crossref","unstructured":"Seidler Z. E., Rice S. M., River J., Oliffe J. L., Dhillon H. M. (2018). Men\u2019s mental health services: The case for a masculinities model. The Journal of Men\u2019s Studies, 26(1), 92\u2013104. https:\/\/doi.org\/10.1177\/1060826517729406","DOI":"10.1177\/1060826517729406"},{"key":"bibr36-1049732320975747","doi-asserted-by":"crossref","unstructured":"Shand F. L., Proudfoot J., Player M. J., Fogarty A., Whittle E., Wilhelm K., Hadzi-Pavlovic D., McTigue I., Spurrier M., Christensen H. (2015). What might interrupt men\u2019s suicide? Results from an online survey of men. BMJ Open, 5(10), Article e008172. https:\/\/doi.org\/10.1136\/bmjopen-2015-008172","DOI":"10.1136\/bmjopen-2015-008172"},{"key":"bibr37-1049732320975747","doi-asserted-by":"crossref","unstructured":"Singh S., Estefan A. (2018). Selecting a grounded theory approach for nursing research. Global Qualitative Nursing Research, 5, 1\u20139. https:\/\/doi.org\/10.1177\/2333393618799571.","DOI":"10.1177\/2333393618799571"},{"key":"bibr38-1049732320975747","doi-asserted-by":"crossref","unstructured":"Sloan C., Gough B., Conner M. (2010). Healthy masculinities? How ostensibly healthy men talk about lifestyle, health and gender. Psychology and Health, 25(7), 783\u2013803. https:\/\/doi.org\/10.1080\/08870440902883204","DOI":"10.1080\/08870440902883204"},{"key":"bibr39-1049732320975747","doi-asserted-by":"crossref","unstructured":"Strike C., Rhodes A. E., Bergmans Y., Links P. (2006). Fragmented pathways to care: The experiences of suicidal men. Crisis, 27(1), 31\u201338. https:\/\/doi.org\/10.1027\/0227-5910.27.1.31","DOI":"10.1027\/0227-5910.27.1.31"},{"key":"bibr40-1049732320975747","doi-asserted-by":"crossref","unstructured":"Struszczyk S., Galdas P. M., Tiffin P. A. (2019). Men and suicide prevention: A scoping review. Journal of Mental Health, 28(1), 80\u201388. https:\/\/doi.org\/10.1080\/09638237.2017.1370638","DOI":"10.1080\/09638237.2017.1370638"},{"key":"bibr41-1049732320975747","doi-asserted-by":"crossref","unstructured":"Tavory I., Timmermans S. (2019). Abductive analysis and grounded theory. In Bryant A., Charmaz K. (Eds.), The SAGE handbook of current developments in grounded theory (pp. 532\u2013546). Sage. https:\/\/doi.org\/10.4135\/9781526485656","DOI":"10.4135\/9781526436061.n28"}],"container-title":["Qualitative Health Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1049732320975747","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1049732320975747","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1049732320975747","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:49:40Z","timestamp":1777686580000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1049732320975747"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,8]]},"references-count":41,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1177\/1049732320975747"],"URL":"https:\/\/doi.org\/10.1177\/1049732320975747","relation":{},"ISSN":["1049-7323","1552-7557"],"issn-type":[{"value":"1049-7323","type":"print"},{"value":"1552-7557","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,8]]}}}