Why Suicide?

Suicide is a complex phenomenon, and no two suicides are ever the same. While current theoretical models of suicide are heavily informed by first-rate epidemiological and clinical knowledge, little research has qualitatively investigated the motivation for a suicide attempt, from the personal perspective of the person who makes the attempt. These perspectives are particularly absent for youth, whose cognitive interpretation and reasoning skills are less likely to be adequately established than those of adults, and who may need to be approached differently to adults to ensure their reported reasons are genuinely reflected in the published literature. This study sought to identify and examine past qualitative research which has investigated motivating factors for suicide attempts among youth aged 12–25. MEDLINE, EMBASE, and PsycINFO databases were searched and a systematic narrative review of qualitative studies was undertaken. Independent raters assessed comprehensiveness of reporting of included studies. Thematic networks analysis was used to analyze the data. From 17 studies involving 613 participants, basic and organizing themes were identified and grouped into four major themes: intrapersonal, sociocultural, interpersonal and historical factors, as those directly attributed to suicide attempts. Comprehensiveness of reporting among studies was assessed, and particular subdomains identified as inadequately reported, i.e., relationships with participants, theoretical frameworks, and design and implementation of studies. We conclude that more robust and comprehensive theoretical frameworks could enhance the knowledge base of the complex and multiple factors that motivate youth to take their own lives. These findings revealed that comprehensive qualitative inquiry is essential in effectively identifying central themes which may otherwise be minimized or missed in clinical and epidemiological studies.