There is a well-established bi-directional relationship between trauma and suicide: a history of trauma can increase the likelihood of experiencing suicidality; similarly, experiencing suicidality – either personally or through the distress or loss of others – can also be traumatic. Given the widespread prevalence of trauma in Australian communities, it is critical to explore how trauma-informed approaches (those that recognise and respond to the impacts of trauma and actively aim to prevent retraumatisation) can be embedded within suicide prevention strategies.
To better understand this, our team, comprising suicide prevention researchers with lived experience of suicide, conducted a scoping review to identify and map the existing literature. We were interested in the extent and nature of trauma-informed approaches to suicide prevention across all levels (universal, selective, indicated, and postvention), for all experiences of suicidality (including deaths, attempts, behaviours, ideation, and suicide-related distress), and across any population groups and settings.
Through a systematic search of seven academic databases, we identified 27 relevant papers for inclusion: one systematic review, two mixed-methods studies, eight qualitative studies, five quantitative studies, and 11 discussion papers. Most were published in the past five years and originated from the US. The majority focused on children and young people, particularly at the selective and indicated levels of prevention. A few studies explored postvention and multi-level strategies, while none were focused on the universal level. Papers examined a range of outcomes, with lived experience reflections being the most common, followed by psychological outcomes, suicide-related outcomes, program evaluation, and physiological outcomes. Notably, very few papers were led by or involved people with lived experience of suicide.
Our review highlights that the explicit integration of trauma-informed approaches to suicide prevention strategies is a relatively recent and underdeveloped area of research, particularly in the Australian context. While many promising approaches have been discussed, and the focus on children and young people to date is understandable, significant knowledge gaps exist. More work is needed to consider how a trauma-informed approach can be embedded in future Australian policy, practice, and research, across all levels of suicide prevention. Strengthening this evidence base has the potential to improve supports for individuals and communities, as well as the suicide prevention workforce.