Investigating the social determinants of suicide among young people in the UK: A mixed methods study

Suicide is a leading cause of death among young people globally (Liu et al., 2022). The UK has seen a steady rise in youth suicide rates over the last decade (ONS, 2021). Suicide and suicidal behaviour are complex and linked to a build-up of vulnerabilities from multiple risk factors. They are often rooted in social adversity like poverty, bullying, unemployment, and intergenerational trauma; however, our understanding of social influences on youth suicide is limited and fragmented. It is crucial to understand (a) which young people are at the highest risk for suicide-related behaviours; and (b) the interplay between social determinants (SDs) (e.g., social and economic policies, cultural and societal values) and individual risk factors (e.g., gender identity, mental illness, family history of suicide). From this, we can start to develop effective evidence-based interventions and policies to address social inequalities and prevent youth suicide at a population level (Shand et al., 2020).
This project has two main objectives:
1. To investigate how individual risk factors interact with a range of SDs to confer vulnerability for, or protect against, suicide and suicidal behaviour amongst young people aged 12-25 in the UK.
2. To understand young people's perspectives of how different SDs impact suicidal experiences at an individual level.
The PhD will use an explanatory mixed methods design, combining big data analysis and qualitative research to explore the role of SDs on a population level and individual level nuances.
Phase 1: A cohort study using data from UK birth cohort studies (e.g., Millennium Cohort Study, ALSPAC) and the Northern Ireland National Registry of Self-Harm and Suicide Ideation will examine the relationship between suicidal outcomes in young people (attempted suicide, suicide death, self-harm), with various SDs (e.g., social connectedness, housing), and individual risk factors (e.g., history of mental illness, parenting) across childhood. This aims to identify contextual moderators and mechanisms of suicide and suicidal behaviour in young people.
Phase 2: A qualitative study involving interviews with approximately 30 young people with lived experience of suicidal behavior will explore how the SDs identified in Phase 1 influence their experiences on an individual level. Sample selection will consider factors such as study aim, sample specificity, and established theory (Malteraud et al., 2016). Template analysis will be used for deductive and inductive coding of the interview data (Brooks et al., 2014).
Phase 3: Findings from Phases 1 and 2 will be synthesised, reviewed, and interpreted using the Pirkis et al. (2023) conceptual framework. This will inform theory about how SDs operate across different levels and relate to suicide and suicidal behaviour. The PhD will offer recommendations for developing theory-based universal and selective interventions and policies in youth suicide prevention. Beyond gaining a greater understanding of which young people are at the highest risk for suicide-related behaviours and the interplay of SD and individual risk factors, there are also methodological and practical implications. Firstly, it will contribute to the expanding body of literature employing mixed methods in psychological research, combining both quantitative and qualitative data. Moreover, on a practical level, it hopes to contribute towards informing the development of evidence-based interventions and policies that can address social
inequalities and, in turn, prevent youth suicide within the UK.