The benefits and risks of asking research participants about suicide: A meta-analysis of the impact of exposure to suicide-related content

Abstract

One obstacle potentially hindering research on suicide is the assumption that assessing suicide may make individuals more likely to engage in suicidal thoughts or behaviours; a concern expressed by ethics committees, researchers, and clinicians. However, decisions which are overly cautious and restrictive when approving research proposals will hinder important research in this area. The present aim was to conduct a meta-analysis to examine whether asking about suicide or exposure to suicide-related content in research studies led to changes in participants' levels of distress, suicidal ideation, or suicide attempts. A systematic search of peer-reviewed and unpublished literature from 2000 to 2017 identified 18 studies. Exposure to suicide-related content led to significant, albeit small, reductions in suicidal ideation (g = -0.13, p < .001) and a lower likelihood of engaging in suicidal behaviour (OR = 0.714, p < .05). The reduction in suicidal ideation was moderated by age such that adolescents showed nearly twice as large a reduction in suicidal ideation from pre- to post-exposure as adults did. Thus, evidence to date suggests that asking research participants about suicide does not increase risk, and may be associated with small benefits. Ethics review boards should calibrate their consideration of the risks associated with participation based on the available evidence and relative to the cost of depriving potential participants of any benefits that participation may offer.

Keywords: Ethical framework; Institutional review boards; Risk-benefit assessment; Suicide research; Vulnerable research participants.