Understanding the influence of suicide bereavement on the cognitive availability of suicide: Qualitative interview study of UK adults.

Abstract

People bereaved by suicide are at increased risk of suicide. Potential explanations include changes in the cognitive availability of suicide after suicide bereavement, but this has been under-investigated. This study aimed to investigate how suicide bereavement influences thoughts about suicide, including methods considered. We interviewed 20 UK-based adultswho reported having been preoccupied by the suicide of a close contact, analyzing qualitative data using reflexive thematic analysis. We identified four main themes: divergent changes in views about suicide as an option; impact of the method used on consideration of own potential method of suicide (including an aversion to the same method); experience of suicidal ideation as a means of understanding the deceased's state of mind; and thoughts related to reunion with the deceased. Our findings suggest that the trauma of exposure to a close contact's suicide can modify the cognitive availability of suicide in divergent ways, including suicide being perceived as a more or less acceptable option, and a tension between the two. These insights assist clinicians in sensitive exploration of suicide bereavement and in risk mitigation. They suggest revisions to existing models of cognitive availability and the potential for psychological interventions that modify the cognitive availability of suicide.