A common question that has puzzled researchers for many years is whether suicide is “contagious”. At face value, this can seem like a strange idea – suicidality is not something that can be “caught” in the same way as a physical illness. However, in this context, researchers are referring to “social contagion”, where exposure to others’ suicidal thoughts and behaviours may influence one’s own.
Previous research (Maple et al., 2017) has confirmed such a relationship exists, particularly in young people (Insel et al., 2008), however to date there has been no quantitative synthesis of this relationship. This meta-analysis therefore aimed to investigate “the links between exposure to suicidal thoughts and behaviours in one’s nonfamilial social environment and one’s own suicidality, for both youth and adults” (Gavan et al., 2026, p. 2).
This review asks: if a friend is struggling with suicidal thoughts and behaviours, are you more likely to struggle with the same things?
Methods
The authors used a comprehensive search strategy that involved searching for relevant literature across six databases. Peer-reviewed, observational studies were included if they i) explored individuals exposed to any suicidal thoughts or behaviours in their social environment and ii) included a control group. Importantly, studies were excluded if they included only; i) familial exposure to suicide ii) media exposure to suicide or iii) self-harm outcomes.
All stages of screening and data extraction were completed independently by two authors. Risk of bias was also independently assessed using the National Institutes of Health quality assessment tools for case-control, and cohort and cross-sectional studies.
The authors conducted a three-level random-effects meta-analysis to account for dependency among multiple effect sizes reported within the same study. The authors also explored three primary moderators; 1) which suicidal thoughts and behaviours individuals were exposed to, 2) which suicidality outcomes they reported and 3) relational proximity.
Results
After screening, 65 publications from 59 independent samples were included in the review, reporting on 153 effect sizes from a total of 1,055,483 participants. Studies were primarily conducted in the US and the UK and were mostly cross-sectional. Only 7 studies were rated as good quality; 21 were rated as poor and 27 as fair quality.
Main findings were as follows:
- Exposure to suicidal thoughts and behaviours was associated with a 2.77 fold increase in one’s odds of experiencing suicidality.
- Relational proximity was a clear moderator of this relationship – exposure amongst friends was associated with the largest increase in risk (OR 3.22, 95% CI 2.73 to 3.79, p < .0001), followed by peers (OR 2.21, 95% CI 1.49 to 3.29, p = .0008). However, there was no significant increase in suicide risk when individuals were exposed to suicidal thoughts and behaviours in acquaintances.
- The strength of the association did not significantly differ based on whether the individual was exposed to death by suicide, suicide attempt, suicidal thoughts, ‘suicidality’ or self-harm.
- Exposure to suicidal thoughts or behaviours was associated with increased risk of suicidal thoughts, plans, attempts, self-harm and ‘suicidality’, but was not associated with a higher risk of death by suicide.
- Studies rated as ‘fair’ or ‘poor’ in quality produced similarly elevated odds to studies rated ‘good’ quality.
- Associations were strongest in adolescents, followed by adults then young adults.
Those exposed to suicidal thoughts and behaviours in their friends were more than twice as likely to experience suicidal thoughts and behaviours themselves.
Conclusions
This study found a significant, and robust, relationship between exposure to suicidal thoughts and behaviours amongst peers, and one’s own suicidal thoughts and behaviour. The authors conclude that:
suicidality is transmissible, not only among family members… but also among close friends and peers.
Gavan et al., 2026, (p. 7)
This meta-analysis concludes that suicidality is transmissible between close friends and peers, particularly in adolescents.
Strengths and limitations
This is a well-conducted systematic review and meta-analysis that clearly adheres to PRISMA guidelines (Moher et al., 2010). It answers a valuable question by synthesising an important and valued body of work. It would have been nice to see some lived experience involvement throughout the study – sometimes I fear that epidemiological or association type research in suicide prevention research risks undermining or downplaying the extremely difficult reality of having lived experience of suicidality, either personal or through bereavement.
I am curious about the authors’ decision to focus only on peers and friends. Whilst I appreciate the argument about not being able to separate social contagion from hereditary factors in familial relationships, this seems like more reason to synthesise and investigate these questions, rather than to exclude this literature altogether. Admittedly, this would likely be a whole other study in itself, but still, I hope somebody synthesises this deserving literature. Beyond this, it seems myopic to suggest that friends and peers are the only relationships that exist outside of familial relationships. What about the impact of exposure to suicidal thoughts and behaviours in a romantic partner? Or in a work colleague? Given this study’s findings on proximal relationship being a key moderator of the relationship, I would imagine there are important findings to be had here, particularly in the context of romantic relationships.
I am also curious about what the research shows about exposure to suicidal thoughts and behaviours and outcomes besides suicidal thoughts and behaviours. I know this study is about contagion specifically, but speaking from experience of supporting a partner through suicide, I can testify that although I may not have ‘caught’ suicidality myself, I sure as hell experienced other impacts to my mental health. This, in itself, is surely also a risk factor for suicidal thoughts and behaviours?
Finally, as is almost always the case in systematic reviews, the quality of this review is hindered by the quality of the research itself being synthesised. It is disappointing to see such a poor quality of research in this area, and I can’t help but wonder whether we can even take anything meaningful from these findings as a result. Indeed, what is reality?….
Though well-conducted, this review could benefit from an injection of lived experience to balance these stark numbers with some humanity.
Implications for practice
So, we know that exposure to suicide elevates risk – but so what? If the takeaway is that reducing suicide will in turn reduce exposure and downstream risk, this feels somewhat circular. Preventing suicide is already the goal, regardless of this mechanism.
For me, I think the clinical implications are likely more to do with the way in which we limit or respond to exposure. In some settings there are ways that this can be controlled – for instance there is work under way that aims to support young people at school bereaved by suicide, with the precise aim of preventing suicide clusters or contagion (Williams, Wexler & Mueller, 2024). But what about in adults, where it is harder to limit the exposure or ameliorate the effects of the exposure? How do we break the cycle then?
I am mindful of the cautions raised by the authors, particularly their suggestion that confiding in friends about suicidal thoughts may, in some circumstances, increase suicide risk. However, I am hesitant to endorse recommendations that could discourage individuals from seeking support from peers, given that friendships are a well-established source of support for those experiencing mental health difficulties, and indeed are often cited as a protective factor against suicidality (Pastor et al., 2025).
This brings to mind the #chatsafe guidelines (Catchpole, 2020; Robinson et al., 2023), which emphasise safe communication about suicide among young people online. Extending this principle, there may be value in developing broader guidance – beyond social media and beyond young people – on how to talk about suicide in ways that support individuals while minimising potential harm to others.
If suicide is contagious, then how do we limit the adverse effects of suicide exposure? Guidance on how to discuss suicide safely seems warranted.
Statement of interests
Laura Hemming has no conflicts of interest to disclose. AI was used for editing purposes and to generate a title for this blog.
Links
Primary paper
Gavan, L., van der Spek, N., Bergers, N., Breedvelt, J. J., Hellegers, F., Bosmans, G., & Bockting, C. (2026). Is suicidality contagious? The social transmission of suicidal thoughts and behaviors: A systematic review and meta-analysis. Comprehensive Psychiatry152691.
Other references
Catchpole Z. #chatsafe: helping young people communicate safely online about suicide. The Mental Elf, 6 May 2020.
Insel, B. J., & Gould, M. S. (2008). Impact of modeling on adolescent suicidal behavior. Psychiatric Clinics of North America, 31(2), 293-316.
Maple, M., Cerel, J., Sanford, R., Pearce, T., & Jordan, J. (2017). Is exposure to suicide beyond kin associated with risk for suicidal behavior? A systematic review of the evidence. Suicide and Life‐Threatening Behavior, 47(4), 461-474.
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & Prisma Group. (2010). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. International journal of surgery, 8(5), 336-341.
Pastor, Y., Pérez-Torres, V., Angulo-Brunet, A., Nebot-Garcia, J. E., & Gallardo-Nieto, E. (2025). School, family, and peer connectedness as protective factors for depression and suicide risk in Spanish adolescents. Frontiers in Psychology, 161547759.
Robinson, J., Thorn, P., McKay, S., Hemming, L., Battersby-Coulter, R., Cooper, C., … & La Sala, L. (2023). # chatsafe 2.0. updated guidelines to support young people to communicate safely online about self-harm and suicide: A Delphi expert consensus study. PLoS One, 18(8), e0289494.
Williams, D. Y., Wexler, L., & Mueller, A. S. (2022). Suicide postvention in schools: What evidence supports our current national recommendations?. School social work journal, 46(2), 23-69.
