Is there still a place for psychological autopsy in suicide research? A literature review of methodological limitations and recommendations for future development.

Psychological autopsies refer to retrospective interviews between researchers and informants who were close to a person who died by suicide, to explore and better understand the circumstances and contributing factors to that suicide. However, several issues persist with psychological autopsy as a methodology. We assessed the academic literature regarding psychological autopsies and extracted key themes about methodological limitations and weaknesses. The aim was to formulate recommendations and present suggestions for future methodology that would protect the benefits of psychological autopsy, particularly the personal narratives, while addressing methodological limitations. A literature review of nine relevant healthcare research databases yielded twenty-two relevant papers. Each of these publications were reviewed and themes regarding methodological limitations of psychological autopsies were identified and collated. Limitations identified from the review included issues of validity and reliability, lack of standardisation, biases, control variables, cultural considerations, ethics, and data handling. New limitations regarding cultural nuance, modern communication channels, and 'invisible informants' were identified. Recommendations for the future development of the psychological autopsy method include embracing modern communication methods and 'invisible informants', cultural intersections, safeguarding of reliability and validity, and the use of feasibility trials. The emphasis remains upon collating the raw narratives at the core of these interviews which make the psychological autopsy such a unique and insightful tool.