Protective factors for suicidality: a qualitative follow-up of the youth and mental health study cohort

Background Understanding suicidality requires a lifespan perspective, yet knowledge of protective factors spanning from adolescence into adulthood remains limited, particularly when examined through qualitative approaches. Our study bridges this gap by exploring retrospective experiences of protective factors for suicidality, as expressed by adults who have faced suicidal ideation (SI) and/or suicide attempts (SA) in their adolescence, and in some cases, later in life. Methods Participants were recruited from the Norwegian Youth and Mental Health Study, a representative population-based cohort. Inclusion criteria were prior self-reported SI or SA during adolescence and participation in the latest cohort follow-up (2012). Fourteen individuals evenly distributed by gender aged 38 to 40 participated in this study. Semi-structured interviews were conducted, and reflexive thematic analysis was used. Results Four overarching protective factor themes were identified: meaningful relationships and connectedness, support from external sources, positive changes in social-environmental context, acceptance and enhanced understanding. Participants described social and environmental protective factors as particularly influential, shaping individual resilience and adaptive responses, highlighting their significance in suicide prevention efforts across developmental stages. Conclusions This study advances the understanding of suicidality from adolescence to adulthood by capturing the lived experiences of those affected. The role of social and environmental protective factors was paramount in shaping adults' reflections of suicidality and its long-term impacts. It underscores the need for early interventions and further research on protective factors' evolvement over time.