Electronic supplementary material
Study design and participants
Basic response characteristics
Suicide as a more tangible option
“Knowing that if things get to be too difficult there's a way out” (19 year old female, 9 years since uncle’s suicide)
“If anything, it made it easier for me to consider and attempt suicide. If he had not done it, I probably would have not considered it in my lowest moments.” (25 year old male, 9 years since brother’s suicide)
“I think about it every so often, gives me an urge to know what it feels like.” (20 year old male, 3 years since friend’s suicide).
“I feel almost certain that I will commit suicide one day. I think my body is too dramatic just to die naturally.” (20 year old female, 4 years since friend’s suicide).
“After his death I didn't think anyone around me was capable of doing that, now I realise it can happen to anyone, especially after my attempt, I fear that I will end up dying in the same manner.” (18 year old female, 1 year since friend’s suicide).
“ I've never had suicidal thoughts, but I have often had very anxious feelings of having been 'contaminated' by violence, of having had my boundaries of what is normal completely crashed …. it is essentially a fear that results from having 'seen too much' about how dark life can get and worrying that it will draw me in and take control of me”. (31 year old female, 6 years since brother’s suicide).
“following [his] death it reared its ugly head that I too could do this ….. sometimes it still comes into my mind when I hear of a suicide but it is much less frightening than before as I know it is not a choice I want.” (39 year old female, 10 years since brother’s suicide).
“I just worry about other people dying. I don't want to feel that level of pain and sadness again.” (32 year old female, 15 years since friend’s suicide).
“Not at all. I am just worried about how easy my uncle could do this to himself. He seemed a self-controlled, financially secure, confident, loving, family man who enjoyed life. Finding no real reason is difficult. I now worry that it could happen to anyone in my life.” (19 year old female, 8 months since uncle’s suicide).
Identification with the deceased and awareness of shared vulnerabilities to suicide
“After studying psychology at A Level I know her psychological disorder can be genetic and this scares me” (21 year old female, 10 years since mother’s suicide).
“To quite a serious extent. I have a very similar personality to my father with identical interests and similar character traits. I have experienced depression on a moderate scale on a handful of occasions and do fear that I have inherited a gene that would make me more prone to suicide. I worry that even if there is no biological inheritance other factors, for example being brought up with similar values and expectations, may make me more prone to suicide” (23 year old male, 4 years since father’s suicide).
“He killed himself because of the personal horrors he suffered. I suffered something similar, so sometimes wonder if I will become desperate too.” (22 year old female, 6 years since friend’s suicide).
Personal determination to avoid suicide
“Her death has made me value life more and want to live life for as long as possible.” (20 year old female, 2 years since friend’s suicide).
“I will not commit suicide because I see what it can do to whole family circles. I don't think it's a selfish thing to do, sometimes people can't cope but it gives me strength.” (21 year old female, 6 years since cousin’s suicide).
“It's made me think that it's an option, but knowing what it does to those around you stops me doing it.” (27 year old female, 7 years since friend’s suicide).
“His suicide was quite violent … and if anything this strengthened the feeling that I would not want to, or be prepared to, die in the same way.” (32 year old female, 2 years since friend’s suicide).
“It has not. It made me realise that I am not really able to understand how you can be desperate enough not to think anymore that better days will come” (30 year old female, 1 year since cousin’s suicide).
“I made a decision in the months following his death. I sat all night and made the decision to keep living with all that entailed - old age, death by bus….cancer, murder, loneliness - so if ever my thoughts return to the way he died I remember that long night and the promise I am keeping every day of my life no matter how hard it is.” (36 year old female, 10 years since partner’s suicide).
Beliefs regarding safeguards against suicide
“…I sometimes think about how I may get stuck into the same thought process later on in life but on the other hand I keep to a focus and know what feelings and thoughts to avoid as I have a point of reference with what happened to my father.” (23 year old male, 2 years since father’s suicide).
“Not at all- I know that if I ever felt sad, I could talk to my friends and brother and change my situation so that I felt happy again. If I ever felt depressed, I would ask for help before things got that bad because I know how suicide affects people close to you.” (20 year old male, 5 years since father’s suicide).
“Not really, but has made me more aware of making sure that anyone in a similar situation gets the help they need” (22 year old male, 1 year since brother’s suicide).
“Their suicide was committed through an overdose of medication. For 5 years after the death I refused to take any medication fearing that I would accidentally take too much and end up ill.” (20 year old female, 8 years since cousin’s suicide).
“…I have a greater fear that [death by suicide] might happen if I have children, & this is one of the big reasons why I am terrified to have children - in case they are mentally unwell &/or die like that. Having watched what happened to my parents & my aunt & uncle, I could never do that.” (26 year old female, 8 years since cousin’s suicide).