Abstract
INTRODUCTION: This study examines the self-reported life impact of exposure to someone else's suicidal thoughts and behaviors on the participants, including what type of suicidal thought and behavior exposure (nonsuicidal self-injury, ideation, suicide death, or attempt), incident details, and personal characteristics influence the impact. METHODS: Data were collected from 4,981 adolescents and young adults, aged 13-22 years, between June 13, 2022 and October 30, 2023. Of these, 94.7% (n=4,701) knew someone with a suicidal thought or behavior; youth reported up to 2 unique exposures, which resulted in data about 8,133 unique incidents. RESULTS: There were significantly higher odds of feeling a greater life impact (i.e., level of disruption it had on their life) in incidents where the person with the suicidal thought or behavior was a romantic or dating partner (AOR=1.62, p=0.01) or a family member (AOR=1.62, p=0.01). The closer the participant said they were to the person, the higher the odds of more life impact (AOR=1.75, p<0.001). The more additional concerns the participants knew that the person was struggling with, the higher the odds of more life impact (AOR=1.11, p<0.001). Deficits in social determinants of health, specifically economic instability (AOR=1.18, p<0.001) and barriers to mental health care (AOR=1.03, p=0.002), were also related to more life impact. CONCLUSIONS: The findings indicated a wide variety of exposures in their social network, and these variables affect the adversity burden associated with knowing someone who is struggling with suicidal thoughts and behaviors. Designing prevention and intervention strategies that address the impact of exposure is an important direction for public health innovations.