Coming out to talk about suicide: gay men and suicidality.

International studies report increased rates of mental health problems and subsequent suicidality among homosexual populations. While international health-care policy is concerned with reducing suicide among young people, important research findings relating to gay people and suicidality remain unacknowledged in the Suicide Prevention Strategy for England. This qualitative study, utilizing single case studies, was used to gain an in-depth understanding of the life experiences contributing to the suicidality of four gay men. The methodology was psychoanalytically informed, using free association narrative interviewing. The initial data analysis involved interpretation of each of the case studies and a subsequent analysis exploring the shared experiences found in each of the individual narratives. Thematically, these are described as 'knowing and not knowing', 'the centrality of the father-son relationship', 'the loneliness of outsiderness', 'leading a double life', and 'crime and punishment'. The significance of the life experiences these themes illustrate reveal why some gay men might not only experience long-term mental health problems, but also engage in suicidality. Individually and collectively, the analyses provide important insights for mental health nurses becoming more attuned to provide sensitive mental health care to those who have a gay sexual orientation.