A step forward in conceptualizing psychological closeness/ distance to suicide methods: A qualitative approach

Introduction Suicide is a leading cause of death, making suicide prevention a major public health priority. Increasing understanding of factors influencing suicidal behavior is paramount. Previous research has implicated psychological closeness, characterized by perceptions of how close/distant or attached/detached one feels to a particular object, as a cognitive factor that influences suicidal behavior. However, a better understanding of how psychological closeness to suicide methods is conceptualized by relevant populations is needed to improve its assessment and understand how it may confer risk for suicide. Methods The goal was to refine the conceptualization of psychological closeness to suicide methods by incorporating feedback from relevant populations. We conducted 30 interviews with those primarily identifying as having lived experience of suicide (n = 10), clinicians who work with suicidal patients (n = 11), and suicide researchers (n = 9). A rigorous thematic approach using NVivo software was used to uncover common themes. Results Primary themes included familiarity, comfort, and attachment, with one emerging theme of symbolism. We define these themes, provide context to their meaning, and share exemplary quotes across diverse participants. Conclusion We consider clinical, research, and policy implications from an interdisciplinary lens and discuss the strengths and limitations of this study.