Abstract
Suicide is defined as the act of intentionally taking one’s own life. Each year, approximately 800,000 individuals die by suicide. Despite a broad understanding of factors that may be involved in the suicidal trajectory, the reasons that individuals are drawn to such action are unique and complex. The aim of this research was to better understand why suicide-related outcomes may occur in university settings in Aotearoa (Studies 1 and 2) and consider how we can support students and reduce the likelihood that they may attempt suicide (Studies 3A, 3B, and 4).
In Study 1, I tested the Interpersonal Psychological Theory of Suicide in undergraduate university students (n = 374). Using hierarchical multiple linear regressions, I demonstrated partial support for the theory, finding evidence to support the individual effects of perceived burdensomeness, thwarted belonging, and fearlessness about death on suicide risk. However, I found no evidence to support higher-level interactions between these factors.
In Study 2, I examined the role of alcohol and cannabis use in the transition from suicidal ideation to attempt using data from Ten to Men: The Australian Longitudinal Study on Male Health. To mirror a student sample, I used data from participants aged 18 to 25 (n = 770). Alcohol and cannabis use were associated with greater odds of a suicide attempt. However, only cannabis use was longitudinally associated with an increased risk of transitioning from suicidal ideation to making a suicide attempt. Given the frequency of alcohol and cannabis use in Aotearoa university students, these findings have direct implications within this context.
In Study 3A, I explored Aotearoa university student’s perspectives and willingness to seek help when they were experiencing distress, considering that support service engagement may be a critical element of suicide prevention efforts (n = 373). Relatively few students reported that they “definitely would go [and seek help from]” available support services, citing reasons such as not considering their distress severe enough to warrant support and a desire for independence. To address this issue, in Study 3B, I conducted a small-scale pilot intervention (n = 133) that aimed to increase student’s help-seeking intentions. Compared to a control group, students exposed to an infographic about different support services had increased intentions to access support services. These students were also less likely to perceive that their issues were not severe enough to warrant support.
In Study 4, I continued the prevention focus initiated in Studies 3A and 3B and qualitatively analysed Reddit user’s reasons about why they did not engage in a suicide attempt. Reddit is a global social networking site most commonly used by young adults at an age when many would be attending university. Across 7,272 posts, I identified 11 different themes that prevented individuals from making a suicide attempt, which can be broadly summarised by connectedness, fear, and the time-limited nature of suicidal crises. These findings provide a broad overview of the proximal protective factors that directly stopped people from making a suicide attempt and allow inferences to be drawn for an Aotearoa university context.
Collectively, the studies included within this thesis offer a greater understanding of factors that may contribute to, and help prevent, suicide-related outcomes in Aotearoa university contexts. They also demonstrate the diverse range of methods that can be employed to assess various stages of the suicide trajectory. While parallels must be drawn at times to address the target population, appropriate inferences can be made to advance our limited knowledge in this area.