"Sorry to call."-a narrative approach to overcoming help-seeking barriers among suicidal men

Background: Suicide rates among men remain disproportionately high, in part due to traditional masculine norms that discourage emotional expression and help-seeking. Narrative-based interventions may offer a promising strategy to address these gendered barriers, notably by fostering identification through shared lived experiences. This study aimed to co-design, disseminate, and evaluate lived-experience stories to promote use of the French national suicide prevention helpline (3114). Methods: We conducted a fivephase action-research protocol grounded in co-design principles: (1) semi-structured interviews with men who self-reported a positive experience with 3114 (n = 5); (2) collaborative rewriting and validation of their stories; (3) online dissemination via the 3114 website and social media; (4) follow-up interviews with new male readers (n = 7) to explore perceived impact; and (5) narrative optimization. We collected web analytics and qualitative data, which were thematically analyzed to examine the influence of masculine norms on help-seeking and the impact of the narratives. Results: The co-design process enabled the creation of ethically sound, adaptable prevention materials grounded in lived experience. All participants highlighted the negative impact of hegemonic masculine norms on help-seeking, citing fears of being seen as illegitimate, feelings of shame, and the prioritization of others' needs over their own. Male readers strongly identified with the narrators, particularly through shared experiences tied to masculinity. This identification fostered a greater sense of legitimacy, self-efficacy, and readiness to seek help. Notably, some participants reported contacting 3114 after reading the stories. Conclusions: Narrative interventions can reduce gendered barriers to help-seeking among suicidal men by presenting alternative masculine narratives that normalize vulnerability and reframe help-seeking as a legitimate and relatable response to distress. This gender-sensitive approach offers a scalable model for integrating lived experience into suicide prevention strategies. Future research should assess long-term effects and broader applicability.