Int J Qualitative Stud Health Well-being EMPIRICAL STUDIES Relational hopes: A study of the lived experience of hope in some patients hospitalized for intentional self-harm HENNING HERRESTAD, Dr Philos1 & STIAN BIONG, Dr PH2 1National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway and 2Department of Health Sciences, Buskerud University College, Norway Abstract Hopelessness is a well-established predictor of suicide, and inspiring hope is an important goal in mental health care, but there are few studies of hope among persons with suicidal behavior. The aim of this study was to interpret the lived experience of hope in some patients hospitalized for intentional self-harm. Twelve persons that had engaged in suicidal behavior by ingesting an overdose of medication were interviewed shortly after hospitalization and asked to narrate about their hopes. The transcripts were analyzed using a phenomenological hermeneutic method inspired by Ricoeur’s theory of interpretation. The na¨ıve reading was one of hope being relational. The structural analysis identified three themes: hopes for life, hopes for death, and the act of hoping. We interpreted the common theme of the interviews as being definite and indefinite relational hopes for life and death. For clinicians, expressions of indefinite hopes may raise concerns about the low likelihood of fulfillment. However, the expression of indefinite hope may serve to avoid experiencing failure, disappointment, and hopelessness. Key words: Hope, suicidal behavior, intentional self-harm (Accepted: 5 September 2009; Published: 9 February 2010) Introduction Hope is a movement of appetite aroused by the perception of what is agreeable, future, arduous, and possible of attainment. (Thomas Aquinas, Summa Theologica, paraphrased by Day, 1991) The World Health Organization (WHO) estimates that each year one million people die in suicide, and it is estimated that the number of suicide attempts are at least 10-fold that of completed suicides (Fleischmann & Bertolote, 2002), hence suicidal behavior is a major threat to health and well-being. Many countries have responded to the WHOs call for more research and new national policies to prevent suicide and suicidal behavior; most recently Sweden, whose national plan for suicide preven- tion was confirmed by parliament 2008 (National Program for Suicide Prevention, 2008). Hopelessness, i.e., absence of hope, is a docu- mented mediator between depression and suicidal behavior, and a predictor of suicide (Beck, 1986; Beck, Weissman, Lester, & Trexler, 1974). Addres- sing hopelessness and inspiring hope are important aims in mental health care for suicidal patients (Cutcliffe & Barker, 2002; Collins & Cutcliffe, 2003), but empirical evidence on the predictive power of hope in mental health is lacking (Schrank, Stanghellini, & Slade, 2008). There are few studies about hope among persons with suicidal behavior (Farran, Herth, & Popovich, 1995; Grewal & Porter, 2007). We use ‘‘suicidal behavior’’ as intentionally putting one’s life in danger (Silverman, Berman, Sanddal, O’Carroll, & Joiner, 2007). The persons interviewed in this study had exhibited suicidal behavior by being hospitalized after ingesting an overdose of medication one to seven days before the interview. Suicidal behavior or suicide attempt is not a clinical diagnosis. Intentional self-harm is the diagnostic category of the International Classifica- tion of Diseases version 10 that has replaced suicide Correspondence: H. Herrestad, National Centre for Suicide Research and Prevention, University of Oslo, Sognsvannsveien 21, 0372 Oslo, Norway. Tel: 47 22923476. Fax: 47 22923958. E-mail: henning.herrestad@medisin.uio.no #2010 H. Herrestad & S. Biong. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 1 Citation: Int J Qualitative Stud Health Well-being 2010, 5: 4651 - DOI: 10.3402/qhw.v5i1.4651 (page number not for citation purpose)