What does it mean to be exposed to suicide?: Suicide exposure, suicide risk, and the importance of meaning-making.

Current research indicates that exposure to suicide is a risk factor for suicidality; however, we know little about the mechanisms through which exposure confers this risk. In this study, we address this gap by examining the role of meaning-making after a suicide death in moderating individual's vulnerability to suicide. We draw on interview data with suicide bereaved individuals in the USA (N = 48), the majority of whom engaged in intense meaning-making processes after their loss. Many reported an increased awareness of suicide as a 'something that actually happens,' a realization that impacted their lives and relationships with others (N = 37). For 7 participants, all women, their loss appeared to trigger increased suicidality, as they not only felt overwhelmed by grief, but also came to see suicide as something they, too, could do. However, for 19 participants, witnessing the profound impact of suicide on others made them feel that suicide was something they could never do. Thus, in our data, how exposure impacted vulnerability was tied to how individuals made sense of and experienced their loss. For some, suicide was re-framed as more of an option, while for others it was re-framed as not just the killing-of-oneself, but as the harming-of-others through grief and trauma, which in turn diminished their view of suicide's acceptability. Collectively, our findings suggest that exposure to suicide itself is not inherently risky, though it may be inherently distressing; instead, whether it results in increased vulnerability depends on the meaning an individual makes of the experience and likely the context surrounding the death. We discuss the implications of our findings for theories of suicide contagion, suicide itself, and suicide prevention.