“People experiencing suicidal thoughts feel they are at the “mercy of life,” “but there remains one aspect of life over which they can maintain total control…They can decide whether they live or die. The choice for suicide thus provides a chance for dignity via the conduit of self-determination.”
I had the pleasure of speaking with Luke Bayliss, a researcher from Australia who is doing fascinating work around the concept of agency in suicide prevention. Our conversation challenged the traditional approach of restricting choices and instead explored how expanding options and empowering individuals might be more effective. Luke's research, which started as an open-ended exploration of suicide attempt survivors' stories, revealed something profound about personal agency and decision-making in the pathway to suicide attempts.
What particularly struck me was how this lens of agency could transform our approach to suicide prevention. Instead of focusing solely on restriction and control, which often compounds feelings of powerlessness, we might consider how to help people reclaim their sense of agency in healthier ways. As I often reference David Jobes' work, we need to remember that we're not driving the bus - the person experiencing suicidal thoughts is. At best, we're invited passengers who can offer support and perhaps point out alternative routes, but ultimately, they're at the wheel.
This shift in thinking has important implications for mental health providers, who are often trained in fear-based, restrictive approaches. Rather than focusing solely on risk assessment and mandatory holds, we might consider how to partner with individuals to co-create safety plans and treatment priorities. As Luke thoughtfully pointed out, we need to move away from putting all the onus on individuals in crisis to seek help, and instead focus on making help more accessible and offering a "buffet" of options that people can choose from. This approach honors both personal dignity and the complexity of each individual's journey toward healing.
About Dr. Luke Bayliss:
Dr Luke T. Bayliss works at the Australian Institute for Suicide Research and Prevention, School of Applied Psychology at Griffith University; he is also a research assistant for the International Association for Suicide Prevention. Luke believes that the most promising avenue for reducing suicide deaths is by preventing the development of or reducing an individual’s capability for suicide. He aims to continue working towards this goal by learning from those with lived experience and using innovative methodologies to further understanding of suicide capability.
Takeways:
For Individuals Experiencing Suicidal Intensity
Importance of hope and recognizing choices
Encouragement to find supportive peers or professionals
For Mental Health Providers
Expanding assessments beyond ideation to include agency and capability
Collaborative approaches and crisis response plans
SHOW NOTES:
LinkedIn: https://www.linkedin.com/in/luketbayliss/
Twitter: @LukeTBayliss1
Google Scholar: https://scholar.google.com/citations?user=timKGkcAAAAJ&hl=en&oi=ao
Luke’s Publications [He has one more]
Bayliss LT, Lamont-Mills A, du Plessis C. “I Will Die by My Own Hand”: Understanding the Development of Suicide Capability in the Narratives of Individuals Who Have Attempted Suicide. Qualitative Health Research. 2024;0(0). doi:10.1177/10497323241235861
Resources
Roses in the Ocean https://rosesintheocean.com.au/
Additional Citations
Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68-78. https://doi.org/10.1037/0003-066X.55.1.68
Explains how autonomy and the feeling of competence are critical for well-being and can be protective against mental health crises.
This theory is often used to guide programs aiming to enhance personal empowerment and intrinsic motivation.
Deci, E. L., & Ryan, R. M. (2000). The "what" and "why" of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11(4), 227-268. https://doi.org/10.1207/S15327965PLI1104_01
This foundational paper on Self-Determination Theory explores how autonomy, competence, and relatedness contribute to psychological well-being, which can be crucial for resilience in mental health challenges.
3. White, V. M., & Berry, H. L. (2016). Reducing suicide in rural Australia: Applying an action framework for community-based prevention. Australian Journal of Rural Health, 24(2), 78-84. https://doi.org/10.1111/ajr.12222
This article discusses community-based prevention approaches in rural areas, emphasizing the role of empowerment and fostering autonomy in local support structures to reduce suicide risk.
4. Leamy, M., Bird, V., Le Boutillier, C., Williams, J., & Slade, M. (2011). Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis. The British Journal of Psychiatry, 199(6), 445-452. https://doi.org/10.1192/bjp.bp.110.083733
This review provides insights into the concept of personal recovery, highlighting autonomy and empowerment as key factors that contribute to recovery processes, including reducing vulnerability to suicidal thoughts.
5. Zortea, T. C., Gray, C. M., & O’Connor, R. C. (2019). Perceptions of past parenting and adult attachment as vulnerability factors for suicidal ideation in the context of the integrated motivational–volitional model of suicidal behavior. Suicide and Life-Threatening Behavior, 50(1), 6-21. https://doi.org/10.1111/sltb.12606
6. Jobes, D. A. (2023). Managing suicidal risk: A collaborative approach (3rd ed.). The Guilford Press. https://books.google.com/books?hl=en&lr=&id=PS7FEAAAQBAJ