Shared perceived causes of suicide among young men and violence against young women offer potential for co-designed solutions: Intervention soft-modelling with fuzzy cognitive mapping

Violence against young women (VAW) and suicide among young men are serious concerns in Botswana and elsewhere. We examined the overlap in locally perceived causes of these two forms of violence in Botswana using the results from separate studies that used fuzzy cognitive mapping (FCM) to explore perceived causes of the two outcomes. FCM depicts perceived causes of an outcome and their links to the outcome and each other, with weights denoting the perceived strength of each link. The two studies engaged groups of young women, young men, older women, and older men in rural communities. We grouped related concepts into broader categories, then combined category maps for each outcome into a single map including both forms of violence. Based on social network analysis, we calculated the out-degree centrality of each category indicating its influence within the network. Intervention soft-modelling explored the effects of removing individual categories on suicide and VAW. Of 24 causal categories in the combined map, six were shared between both outcomes, 10 were for suicide only, and seven were for VAW only. The six shared categories accounted for 60% of cumulative influence of all categories in the combined map. The three most influential shared categories were financial difficulties, conflict in relationships, and parenting and family issues. Based on local perceptions, avoiding conflict in relationships could reduce suicide by 4.8% and VAW by 18.5%. Eliminating parenting and family issues could reduce suicide by 3% and VAW by 5.4%. Preventing financial difficulties could reduce suicide by 9.3% and VAW by 2.9%. The findings support the idea that some interventions might reduce both personal and interpersonal violence among youth. Analysis of stakeholder perceived causes and soft-modelling of potential interventions could inform community-led co-design of strategies to reduce youth suicide and violence against young women in Botswana.