Background:
Persistent suicidal ideation, self-harm behaviors, and suicide attempts constitute suicidality and are consistent predictors for future suicides. Research on what protects individuals from harming themselves is equivocal. While factors like impulsivity could increase risk of suicide, research is needed on what stops people from acting out on self-harm thoughts/suicidal ideation.

Aim:
To explore the help-seeking behaviors and other protective factors during periods of suicidality in individuals at risk of suicide.

Method:
This study aimed to explore help-seeking behavior and other protective factors that prevent or delay self-harm and suicide attempts during suicidality in individuals at risk. We used a qualitative study design and interviewed 15 participants comprising at-risk individuals, caregivers, and mental health professionals (MHPs). We used thematic analysis for deriving themes.

Results:
Themes in ‘at-risk individuals’ include mental state during suicidality, handling of oneself during suicidality, and seeking help from support systems. Themes from caregivers included handling of crises and the role of informal and formal support systems. Themes from MHPs included phenomenology of suicidality, handling of suicidality, help-seeking, and support systems.

Conclusion:
At-risk individuals handle suicidality by either managing themselves on their own or seeking help from informal sources and formal health systems. Caregivers appear to be crucial stakeholders in help-seeking during self-harm. The involvement of caregivers – in discussion with the at-risk individual – should be a necessary component of suicide risk management. Suicide prevention policies at institutional, regional, and national levels should include strategies to prevent burnout and other occupational health issues in MHPs.