Research Roundup – December 2025
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This is a summary of the latest significant Canadian (
) and international suicide research we collected in the past month.
Jacquet, C. et al. (2025). Coping with suicide bereavement: A focus-group study of adaptation processes over time. Death Studies, 1-15. https://doi.org/10.1080/07481187.2025.2551378
21 individuals, bereaved by suicide for at least 14 months, participated in focus groups exploring their experiences using various coping strategies and resources.
Abstract – This qualitative study explored the coping resources mobilized by individuals bereaved by suicide and examined how these processes evolve over time. Twenty-one participants, bereaved for at least 14 months, took part in five semi-structured focus groups. Data were analyzed using thematic analysis, allowing the identification of key themes and temporal dynamics. Two major phases emerged from participants’ narratives. Initially, participants relied on survival strategies and sought meaning through routines, social support, and information-seeking. Over time, participants reported engaging in deeper restructuring processes: reorganizing their daily lives, redefining their identity, and reshaping the bonds with the deceased. Emotionally salient moments—such as anniversaries—were described as both challenging and potentially meaningful. The findings highlight the complexity and non-linearity of suicide grief, with multidimensional processes unfolding over time. These findings offer valuable insights into the lived experiences of people bereaved by suicide and suggest the need for flexible, tailored clinical support.
Alansari, A, et al. (2025). Risk factors for suicide among children and adolescents in Arab countries: A systematic review and meta-analysis. Public Health, 249. https://doi.org/10.1016/j.puhe.2025.106038
This is a systematic review of 21 studies examining risk factors for suicide among children and adolescents in various Arab countries.
Abstract – Methods: A literature search of PubMed, Scopus, Cochrane Library, and Web of Science was conducted till May 2025. Using STATA version 18, a meta-analysis of proportions was conducted to estimate pooled prevalence rates with 95 % confidence intervals (CIs), using a random-effects model. Results: A total of 21 studies conducted across various Arab countries were included, the majority of which were cross-sectional. The most prevalent risk factors were low self-esteem (49 %), family conflict (31 %), psychiatric disorders (28 %), bullying (24 %), and psychosocial problems (24 %). The pooled prevalence of suicidal ideation and attempts was 22 % and 10 %, respectively. Self-poisoning (58 %) and hanging (38 %) were the most common suicide methods. Substantial heterogeneity was observed across analyses. Conclusions: Suicide among Arab youth represents a significant and underrecognized public health challenge, driven by psychological, familial, and social stressors. Strengthening culturally tailored mental health services and school-based prevention strategies is urgently needed to address this growing crisis.
() Fleury, M. et al. (2025). Care trajectories among patients with substance-related disorders in the 3 years before their last suicide attempt. Suicide and Life-Threatening Behavior, 55(6), E70065. https://doi.org/10.1111/sltb.70065
3-year care trajectories of individuals with substance-related disorders were tracked before they died by suicide. Data from Quebec medical databases were used for this study.
Abstract – Objectives: Among patients with substance-related disorders (SRDs) and suicide attempts in 2014–2021, we identified care trajectories within a 3-year period preceding their last suicide attempt (index date). We also determined associations between care trajectories and patients sociodemographic and clinical characteristics, quality of care received, and risk of death in the following year. Methods: Using Quebec (Canada) medical databases, we produced Group-based Multi-Trajectory Modeling, Multinomial Logistic Regression, and Cox Proportional Hazards models. Results: We identified five care trajectories (profiles) among the 2297 study patients. Profile 1 (31%, reference profile) had low outpatient care with late increase in acute care use. It included more men, younger patients and individuals with overall better conditions. Profile 2 (22%) received high physical healthcare and had more chronic physical illnesses. Profile 3 (19%), with more serious mental disorders, and Profile 4 (16%), with more polysubstance-related disorders, used more outpatient mental health (MH) or SRD care, decreasing before index date. Profiles 2, 3 and 4 increasingly used acute care before index date. Profile 5 patients (12%) had more health problems, and so showed the highest overall care use and highest risk of death. Conclusion: Tailored interventions are suggested for all profiles, with improved screening and SRD-MH care.
Madrzoska, M. (2025). Child maltreatment, mental health disorders, and health risk behaviors in people with diverse gender identities. Journal of Interpersonal Violence, 40(9-10), 2281-2306. https://doi.org/10.1177/08862605241270077
Australian Child Maltreatment Study (ACMS) data were used in this study to examine rates of mental health disorders and health risk behaviours in people with diverse gender identities and associations with five types of child maltreatment.
Abstract – This study examined rates of mental health disorders and health risk behaviors in people with diverse gender identities and associations with five types of child maltreatment. We used data from the Australian Child Maltreatment Study (ACMS), a nationally representative survey of Australian residents aged 16 years and more, which was designed to understand the experience of child maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, exposure to domestic violence). Mental disorders—major depressive disorder, generalized anxiety disorder (GAD), alcohol use disorder, post-traumatic stress disorder (PTSD), and health risk behaviors—smoking, binge drinking, cannabis dependence, self-harm, and suicide attempt in the past 12 months were assessed. People with diverse gender identities who experienced child maltreatment were significantly more likely to have GAD (43.3%; 95% CI [30.3, 56.2]) than those who had experienced child maltreatment who were either cisgender men (13.8%; [12.0, 15.5]) or cisgender women (17.4%; [15.7, 19.2]). Similarly, higher prevalence was found for PTSD (21.3%; [11.1, 31.5]), self-harm (27.8%; [17.1, 38.5]) and suicide attempt (7.2%; [3.1, 11.3]) for people with diverse gender identities. Trauma-informed approaches, attuned to the high likelihood of any child maltreatment, and the co-occurrence of different kinds may benefit people with diverse gender identities experiencing GAD, PTSD, self-harm, suicidal behaviors, or other health risk behaviors.
Alfaro, E. et al. (2025). Surviving families: Experiences of losing a family member to suicide. Revista Latino-Americano de Enfermagem, 33, e4614. https://doi.org/10.1590/1518-8345.7676.4614
This study gathered families who had lost a family member to suicide to engage in semi-structured interviews. The aim was to analyze how different families coped with the experience(s).
Abstract – Objective: to identify the interactional processes that allow surviving families to cope with the death by suicide of one of their members, to restructure themselves as a unit and transform the experience into a learning experience. Method: a qualitative, exploratory study, guided by the concept of Family Resilience, in which eight families, who experienced the suicide of one of their members participated. Data were collected through semi-structured interviews and the data were submitted to thematic analysis. Results: the results were organized into four thematic groups and revealed grief, despair, and perplexity of family members who could not understand the reasons for such a radical act; the feelings of pain due to the loss, overlapped with anger, relief and guilt. Blame was shared with other people and the social and health services; and the lessons that the experience provides. Conclusion: nurses and other healthcare professionals can help surviving families to restructure themselves after the suicide of one of their members, implementing care actions based on repeated assessments of the repercussions of suicide on the family as a whole and on its members individually; identifying the most compromised dimensions of family life; individual and family needs; and family resilience processes.
Watkeys, O. et al. (2025). Trajectories of adverse childhood experiences and subsequent adolescent suicidal ideation and self-harm. Journal of Adolescent Health. https://doi.org/10.1016/j.jadohealth.2025.09.014
The goal of this Australian study was to determine any trajectories of adverse childhood experiences (ACE) in the general population from “the prenatal period up to age 12 years (through the early and middle childhood) and examine their associations with self-harm and/or suicidal ideation in adolescence (age 12–18 years).”
Abstract – Purpose: To investigate the extent to which different trajectories of adverse childhood experiences (ACEs) between the prenatal period and middle childhood are associated with suicidal ideation and self-harm during adolescence. Methods: Participants were 73,833 children followed from birth to ∼18 years within an Australian population cohort study (the NSW Child Development Study) conducted via multiagency recordlinkage. Service contacts for self-harm/suicidal ideation (≥12 years) were identified in health (inpatient and outpatient) and nonhealth (child protection and police) administrative records. Indices representing 17 ACEs were derived from parent and child records for the prenatal, early childhood, and middle childhood developmental periods (<12 years). Trajectories of cumulative ACE scores were identified using k-means clustering for longitudinal data. Results: Six trajectories of ACE exposure were identified, representing differences in the severity and persistence of adversity experienced across development. Approximately 73% of children with a record of self-harm/suicidal ideation had elevated ACEs in at least one developmental stage, and around 13% of the sample (representing two trajectories) had high ACE exposure in early-middle childhood. All five trajectories representing elevated ACE exposure were associated with self-harm/suicidal ideation, with particularly strong associations when ACE scores were persistently elevated across early-middle childhood.
McKay, S. et al. (2025). The Bud app: A protocol for a randomized controlled trial with an internal pilot phase targeting modifiable risk and protective factors for suicide among international students. Contemporary Clinical Trials Communications, 48, 101578. https://doi.org/10.1016/j.conctc.2025.101578
This is a protocol for a randomized controlled trial (RCT) gauging the “effectiveness, acceptability, engagement, and safety” of Bud. This is a mobile app designed to help address the challenges of accessing timely and culturally responsive treatments for mental health issues and suicidal behaviours. The proposed study will involve international students enrolled at Australian post-secondary institutions.
Abstract – International students face elevated risk for mental health problems and suicide, yet encounter multiple barriers to accessing timely and culturally responsive treatments. Key challenges include high rates of psychological distress, low mental health literacy, and reduced help-seeking, often compounded by perceived burdensomeness, a lack of belonging, and difficulties with emotion regulation. Bud is a self-guided, co-designed mobile app developed to address these challenges through an accessible digital intervention. This paper outlines a protocol for a randomized controlled trial evaluating the effectiveness, acceptability, engagement, and safety of Bud among international students enrolled at Australian tertiary institutions. The trial also includes an internal pilot phase to ensure the feasibility of the trial procedures, with benchmarks for recruitment, retention, and engagement. A community sample of 302 participants will be randomly assigned to either the intervention group (Bud app) or the active control group (online mental health fact sheets) for four weeks. Assessments will be completed online at baseline, two weeks, and four weeks post-baseline. The primary outcome is psychological distress, with secondary outcomes including help-seeking intentions, perceived burdensomeness and belonging, emotion regulation, mental health literacy, and suicidal ideation. Acceptability and engagement will be assessed using self-report and objective measures. Interviews will be conducted with a subset of 20 participants to explore their views on Bud further. This trial will provide the first evaluation of a suicide prevention tool specifically for international students. If effective, Bud could offer a scalable and culturally relevant solution to improve student mental health and reduce service access barriers.
Demoss, Z. et al. (2025). Prescription opioid misuse and the perceived likelihood of future suicidal behavior: Considering the role of suicide capability dimensions. Suicide and Life-Threatening Behavior, 55(6), e70069. https://doi.org/10.1111/sltb.70069
There have been an increasing number of suicide deaths involving opioids in recent years. This study investigates the relationship between prescription opioid misuse and subsequent suicidal behaviours, and whether suicide capability (habituation to the method) has a role.
Abstract – Introduction: In the past two decades, suicide attempts and deaths involving prescription opioids have sharply increased. Research is needed to understand how prescription opioid misuse may increase suicide risk. Contemporary suicide theories suggest opioid use may increase suicide capability by increasing pain tolerance, altering fears related to death, or increasing one’s understanding of lethal doses and/or access to means. This study examined the role of these dimensions of suicide capability in the association between prescription opioid misuse and self-reported likelihood of future suicidal behaviors. Methods: Individuals with chronic pain, past year depression, and a current prescription of opioids for pain (N = 166) completed assessments of opioid misuse, suicide capability (i.e., fearlessness about death, pain tolerance, and suicide preparation and rehearsal), and suicidal behaviors. Results: Analyses demonstrated significant indirect relations of prescription opioid misuse to the perceived future likelihood of suicide planning and attempts (both in general and involving opioids specifically) through suicide capability in the form of suicide preparation and rehearsal, controlling for suicide attempt history. Conclusion: Findings suggest that prescription opioid misuse may increase suicide risk by increasing familiarity with a potential suicide method, consistent with extant literature highlighting the role of practical suicide capability in suicide risk.
() Plamondon, K. et al. (2025). ‘Resilience is action taken together’ results of a dialogue-based study on community factors shaping resilience in the context of youth suicide prevention. Critical Public Health, 35(1). https://doi.org/10.1080/09581596.2025.2582908
Voices representing school-aged youth, emerging adults, caring adults, and community service providers were brought together to gauge their perspectives on community factors that enhance and promote resiliency among youth.
Abstract – Suicide is a leading cause of death among children and youth around the world, and is centred within the Sustainable Development Goals. While research consistently shows the importance of external, intersecting factors that shape youth resilience, much work in this field remains vague and focused downstream. Situated within a community-based partnership and grounded in critical pedagogies, this research invited young people and caring adults into deliberative dialogues about how resilience-promoting communities look and feel. Our goal was to centre youth voices, illuminating their ideas about wellness and suicide prevention. The study brought 31 people into four dialogues: four school aged youth (15–18); nine emerging adults (19–24); nine caring adults; and nine community service providers. Contributors described resilience as a set of collective actions involving three mutually-reinforcing actions: cultivating belonging; cultivating connection; and promoting a positive social climate. These concepts were the essence of how resilience-promotion looks and feels. People in all four dialogues explored this idea of resilience as action taken together, reinforcing these three conditions as points of intervention to promote collective thriving and invest in upstream prevention of suicidality. This relational and upstream conceptualization of resilience-as-action serves to shift the ways communities organize around youth suicide prevention. Shifting conceptualizations of resilience upstream and toward resilience-promoting communities opens new ways of conceptualizing interventions to promote youth mental health. Doing so requires us to embrace solidarity, collective and population-level strategies, and place-based interventions that disentangle knots of social and structural determinants of health.
Holzman, T. & Savulescu, J. (2025). When is suicide a public health issue? Journal of Medical Ethics. https://doi.org/10.1136/jme-2025-111201
This commentary explores why suicide is a public health issue. The authors consider this through three possible approaches to suicide prevention: (1) suicide prevention as the prevention of death, (2) suicide prevention as the prevention of wrongful death, and (3) suicide prevention as the prevention of bad death.
Abstract – On 24 June 2025, the Australian Productivity Commission (PC) released an interim report evaluating the National Mental Health and Suicide Prevention Agreement. While the PC’s recommendations are certainly important components of a robust national strategy for mental health and suicide prevention, they remain incomplete. A more fundamental question is when suicide is even a public health issue. We need to identify what is bad about suicide and articulate why and when it should be prevented. In this article, we will consider three possible approaches to suicide prevention: (1) suicide prevention as the prevention of death, (2) suicide prevention as the prevention of wrongful death and (3) suicide prevention as the prevention of bad death. We will ultimately demonstrate that only the third approach is adequately equipped to achieve what should ostensibly be the goals of a national suicide prevention scheme.