Exposure to suicide in Australia: A representative random digit dial study

BACKGROUND: Exposure to the suicide death of another may lead to distress and increase the risk of suicide in those connected to the deceased. Yet, the extent of this exposure across the population is ill-defined. This paper utilises representative data to quantify the extent of exposure to suicide in the Australian community and the reported effect of this exposure. METHODS: A random digit dial, computer-assisted telephone interview survey was undertaken to understand how Australian's may assist someone in severe distress or at risk of suicide. Embedded within this survey were questions on exposure to suicide and the impact of this exposure. RESULTS: Among a representative sample of 3002 Australians, 58% reported exposure to the suicide of someone known to them in their lifetime and 18.5% of exposed individuals reported their own suicidal thoughts in the past-year. Higher perceived impact of the suicide and concern for another person were associated with increased likelihood of current suicidal thinking. LIMITATIONS: Survey design limitations resulted in unknown psychological harms beyond past-year suicidal thinking in respondents. CONCLUSIONS: Our findings demonstrate a high level of exposure to suicide death among Australians, with multiple exposures common. How and why suicide manifests in some exposed to suicide and not others remains unknown and requires further research. However, these findings suggest suicide prevention efforts need to expand to include a focus on suicide exposure, and mental health clinicians should consider exposure to suicide in risk assessment to better understand an individual's vulnerability to suicide following exposure