Conference Agenda

This research aims to deepen the understanding of pre-suicidal suffering by exploring how suicidality emerges from the lived experiences of individuals. Rather than conceptualizing suicidality solely as a symptom of mental disorders, the study approaches it as a dynamic and cumulative process embedded in a person’s life history and phenomenological field. The research seeks to examine how prolonged psychological suffering develops, how suicidal crises arise, and what individuals experience as most lacking during the pre-suicidal stage.

The study is based on 12 in-depth qualitative interviews with individuals who have experienced suicidality. Data were analysed using a interpretative phenomenological analysis approach, allowing close attention to participants’ subjective meanings and experiential structures. The sample consisted of 12 participants (4 men, 1 person with a non-binary gender identity, and 7 women) who had attempted suicide no more than a year prior to the study and were receiving treatment at the Vilnius City Mental Health Centre.

The study identified 18 group experiential themes. The findings indicate that suicidality develops through a gradual process shaped by repeated traumatic and relationally violating experiences, leading to enduring feelings of profound lacking. To cope, individuals might form compensatory mechanisms that suppress psychache but become fragile over time. When these mechanisms collapse, an intense affective state emerges, in which suicidal thoughts arise rather automatically as an attempt to reduce unbearable suffering.

The findings indicate that pre-suicidal suffering closely corresponds to symptoms associated with complex post-traumatic stress disorder (CPTSD), including emotional dysregulation, negative self-concept, relational disturbances, and persistent threat perception. However, the study demonstrates that CPTSD symptomatology alone is insufficient to explain the trajectory toward suicidality. Instead, suicidality appears to emerge from the interaction between long-term traumatic suffering, collapsing psychological defenses, the meanings attributed to the ongoing events and suicide itself.

Background: Suicidal ideation is typically assessed as verbal or cognitive content. However, research increasingly indicates that suicidal ideation may also involve vivid mental images of suicide or death, commonly referred to as suicidal intrusions. While such intrusions have been associated with increased distress and suicide risk, their phenomenological characteristics and clinical relevance remain insufficiently described.

Methods: This cross-sectional mixed-methods study included adult psychiatric outpatients experiencing suicidal ideation (SIDAS ≥ 1), recruited from multiple mental health institutions in the Netherlands. Participants completed an adapted version of the Intrusion Interview, in which they described their most salient suicidal mental images and verbal thoughts. Qualitative data were analyzed using reflexive thematic analysis.

Results: Eight themes were identified: (1) content of the intrusion, (2) sensory and perceptual qualities, (3) emotional tone, (4) cognitive meaning and interpretation, (5) behavioral consequences, (6) protective or preventive elements, (7) triggers and contextual influences, and (8) perceived control and intrusiveness. Suicidal intrusions were commonly experienced as vivid and multisensory, and often described as highly realistic. Emotional responses were frequently ambivalent, combining distress with calmness, relief, or emotional numbing. Intrusions were associated with a range of behavioral responses, including suicidal planning, avoidance, and help-seeking, depending on the individual’s interpretation and perceived control.

Conclusions: These findings highlight suicidal intrusions as a clinically relevant experiential component of suicidal ideation that extends beyond verbal thoughts alone. Greater attention to suicidal imagery may improve understanding of suicide risk processes and support more nuanced clinical assessment and intervention

Some authors argue that suicidality is a manifestation of community ties. However, how these ties manifest in an individual's experience of the suicidal process remains unclear.

This study adopts a qualitative perspective and aims to investigate personal perceptions of the influence of communities on the emergence of suicidality. Semi-structured interviews and focus groups were conducted at the Vilnius City Mental Health Centre in Lithuania with patients who had lived experience of suicidality. A total of 14 participants (4 men and 10 women) took part in five small focus groups, sharing their experiences and insights. Thematic analysis was employed to analyse the data.

Eighth themes were formed. Communities are experienced as having specific functions. Communities are connected with suicidality through atmosphere and applied pressure, shaping how openly one can be themselves. At the end, connections with specific people matter most. As suicidal crisis approaches, communities and people fade from awareness — connections weaken. Weakening ties increase loneliness and force confrontation with an unpleasant inner self. Suicidality may become a crisis of meeting oneself, while meaningful connections can soften or cloak this experience. To receive closeness and support, one must be ready to accept it. Often, individuals feel unprepared. Shared experience of suffering can foster deeper bonds with the community as a whole and with its members.

These finding supports the idea that individuals with lived experiences tend to focus more on the experience of connection when reflecting on how suicidality and communities are linked. The study’s findings suggest that the primary role of communities in the context of suicidality is to provide individuals with opportunities for meaningful connection. However, as a crisis approaches, communities and people may fade from awareness, and connections might weaken.

The study was funded by the Lithuanian Research Council (LMTLT), contract No. S-MIP-24-77.

Suicide is a serious social issue. Understanding how social realities become unliveable is a fundamental question for suicide prevention. Durkheim’s social study of suicide observed differences across social groups, geographical areas, and developed a theory of social integration. Resonating today, highly integrated and fragmented areas relate to suicidality. Across systematic reviews, area-level deprivation is consistently associated with suicide. Chandler’s rapid qualitative review highlighted how emotions of shame and personal responsibility for socio-economic position can affect suicidality. Evidence syntheses consistently show psychological effects of urban built environments (e.g. housing quality, green space, upkeep). Rural areas are also linked to suicide, with farmers identified as a high-risk group. These reviews and meta-analyses indicate a connection between local area and suicidality. Despite this, there are opportunities for methodological development, with limited qualitative research exploring the spatial aspects of suicidality and embodied experiences of place.

Suicide and Place is an interdisciplinary PhD project exploring the connection between local-area and suicidality. In study 1, a meta-ethnography explores how local-area characteristics can affect suicidality, identifying forms of alienation as a potential mechanism. Study 2 uses embodied research with walking interviews in an area of Leeds, Yorkshire (north of England) with high suicide rates. Community members lead an immersive walking tour to explore physical, social and emotional experiences of place. Trinanglating interview transcripts, photographs, and GPS we develop a creative digital map. Study 3 explores the map with people directly affected by suicidality to understand the connection between suicide and place.

This presentation introduces a work-in-progress digital map visualising the spatial dimensions of suicidality, illustrating physical space and emotional geography. Reflecting on the methodological approaches, this presentation evaluates embodied approaches and digital creativity in suicide prevention research. This PhD contributes to a social understanding of suicide, offering methodological innovation, and experiential evidence for place based suicide prevention.

Background: Families are profoundly affected when a member attempts suicide. While research has largely focused on parents and adult carers, far less is known about how young people experience this trauma. Young people with a suicidal family member face unique risks, including heightened distress, guilt, disrupted roles, and increased risk of suicide themselves. Understanding their lived experiences is essential to informing effective, family-centred suicide prevention.

Methods: A qualitative phenomenological study was conducted with nine young people aged 17–30 who had experienced a suicide attempt by a close family member. Semi-structured interviews were conducted online and analysed using Interpretative Phenomenological Analysis. Participants represented diverse family relationships, including siblings, parents, and extended kin.

Results: Four interrelated themes were identified. Fundamentally rocked captured the attempt as a seismic life disruption, marked by shock, confusion, and adjustment to a “new normal.” I’m responsible, it’s up to me reflected young people’s sense of overwhelming responsibility for the safety of their family member and the emotional wellbeing of others, often at the expense of their own needs. Moving both towards and away from help (for me) described difficulties seeking support, with many delaying or disengaging from services despite significant distress. Finally, Families coming together highlighted that while avoidance of discussion was common, families who engaged in open communication or professional family support experienced improved connection and healing.

Conclusions and implications: This is the first qualitative study to centre young people’s voices following a family member’s suicide attempt. Findings point to an urgent need for co-designed, family-inclusive interventions that validate young people’s experiences, strengthen family communication, provide peer support, and ensure accessible, youth-friendly services across schools, aftercare, and digital settings.

Introduction: Autistic individuals face a higher risk of suicide than non-autistic individuals. Although prior research indicates that autistic individuals often encounter barriers to seeking help and are at increased risk of self-harm, there remains a limited in-depth understanding of the mechanisms underlying self-harm and their help-seeking experiences. This study aims to explore autistic individuals’ self-harm experiences, with a focus on the underlying mechanisms, and identify barriers and facilitators in their help-seeking process.

Methods: Six participants (aged 21 to 36 years) participated in this study between October 2024 and February 2025. After providing written informed consent, each participant completed an individual interview, with an average duration of 114 minutes (range 109 to 129 minutes). All interviews were transcribed verbatim and analyzed using the Framework Method.

Results: Self-harm behaviors often arose from internal stressors (e.g., sensory dysregulation, restricted behaviors, and distinctive patterns of emotional processing and communication) and external stressors (e.g., social stigma, limited resources, and challenging environments). The interplay of internal and external stressors contributed to social difficulties, challenges in emotion regulation, and reduced self-efficacy, which in turn could lead to self-harm behaviors. For autistic individuals, self-harm may serve multiple functions, such as self-soothing, self-punishment, or the expression of suicidal intent. Regarding help-seeking, participants described the challenges and supports they encountered before, during, and after engaging with medical services, and further identified individual, interpersonal, and societal factors that may hinder or facilitate their future motivation to seek help.

Conclusions: The findings shed light on potential mechanisms underlying the emergence of self-harm behaviors and identify key barriers and facilitators shaping help-seeking experiences among autistic individuals, with implications for need assessment and service improvement. Future research incorporating perspectives from autistic individuals with more diverse backgrounds, as well as family members and professionals, is needed to enhance support and reduce self-harm.