Using Rule-based system analysis to investigate social support and help-seeking among Italian suicide bereaved

Background: Suicide survivors are a fragile population that would need tailored and timely support; however, there is limited research over survivors who have not approached or were not able to access services. Aims: This cross-sectional study explores the psychological state and perceived social support of Italian survivors, including those who have not sought for help, and investigates differences for gender or kinship with the departed. Methods: Rule-based system (RBS) analyses identified relationships between social support and reported formal and informal help-seeking behavior. One-hundred thirty-two (103 females and 27 males) suicide survivors (53 having never sought for support) answered an anonymous online survey. Measures of life satisfaction, wellbeing, perceived social support and suicidal ideation were collected, as well as ad-hoc questions on the informal and formal help-seeking styles. Results: On average, respondents appeared in rather poor psychological conditions. General obstacles to reaching for support were the fear of being not understood, costs of services, and the lack of specific training of professionals. RBS analysis identified different help-seeking behaviors: survivors experiencing low level of social support may avoid going to a psychologist and resolve to GPs, look for advice in online forums and rely on people out of their narrower informal network such as coworkers. Overall, perceived social support, life satisfaction and wellbeing appeared to be related in this sample of suicide bereaved individuals. Conclusion: These unique study’s results offer insight in identifying which specific areas would be fruitful to investigate while assessing social support in bereaved individuals.