A common question that has troubled researchers for many years is whether suicide is “contagious.” At face value, this may seem like a strange idea – suicide is not something that can be “caught” like a physical illness. However, in this context, researchers are referring to “social contagion”, where exposure to others’ suicidal thoughts and behaviors can have an impact on one’s own.
Previous research (Maple et al., 2017) has confirmed that such a relationship exists, particularly in young people (Insel et al., 2008), although there has been no quantitative synthesis of this relationship to date. Therefore, this meta-analysis aims to examine “The association between exposure to suicidal thoughts and behaviors in one’s non-family social environment and one’s own suicide for both youth and adults” (Gavan et al., 2026, p. 2).
This review asks: If a friend is struggling with suicidal thoughts and behaviors, are you more likely to struggle with the same things?
methods
The authors used a comprehensive search strategy that included searching for relevant literature in six databases. Peer-reviewed, observational studies were included if they i) explored individuals exposed to any suicidal thoughts or behavior in their social environment and ii) included a control group. Importantly, studies were excluded if they included only; i) familial risk for suicide ii) media exposure for suicide or iii) consequences of self-harm.
All steps of screening and data extraction were completed independently by two authors. The risk of bias was also independently assessed using National Institutes of Health Quality Assessment Tool For case-control, and cohort and cross-sectional studies.
The authors conducted a three-level random-effects meta-analysis to account for dependencies between multiple effect sizes reported in the same study. The authors also discovered three primary mediators; 1) what suicidal thoughts and behaviors individuals experienced, 2) what suicide outcomes they reported, and 3) relational closeness.
Result
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. The studies were conducted mainly in the US and UK and were mostly cross-sectional. Only 7 studies were rated as good quality; 21 were rated as poor and 27 as fair quality.
The main findings were as follows:
- Exposure to suicidal thoughts and behaviors increased a person’s likelihood of experiencing suicide by 2.77 times.
- Relational closeness was a clear mediator of this relationship – contact between friends was associated with the greatest increase in risk (OR 3.22, 95% CI 2.73 to 3.79). P <.0001), followed by equivalence (OR 2.21, 95% CI 1.49 to 3.29, P = .0008). However, when individuals encountered suicidal thoughts and behaviors in acquaintances, there was no significant increase in suicide risk.
- The strength of the association did not differ significantly depending on whether the individual was exposed to suicide, suicide attempt, suicidal thoughts, ‘suicide’ or death by self-harm.
- Exposure to suicidal thoughts or behaviors was associated with an increased risk of suicidal thoughts, plans, attempts, self-harm, and ‘suicidality’, but No Associated with higher risk of death by suicide.
- Studies rated ‘fair’ or ‘poor’ in quality yielded uniformly higher probabilities than studies rated ‘good’ quality.
- The association was strongest in adolescents, followed by adults and then young adults.
People who were exposed to suicidal thoughts and behaviors in their friends were more than twice as likely to experience suicidal thoughts and behaviors themselves.
conclusion
This study found a significant and strong association between exposure to suicidal thoughts and behaviors among peers and one’s own suicidal thoughts and behavior. The authors conclude that:
Suicidal tendencies spread not only among family members, but also among close friends and associates.
Gavan et al., 2026, (p. 7)
This meta-analysis concludes that suicidal ideation is widespread among close friends and peers, especially among adolescents.
Strengths and limitations
This is a well-conducted systematic review and meta-analysis that clearly follows PRISMA guidelines (Moher et al., 2010). It answers a valuable question by synthesizing important and valuable work. It would have been nice to see some lived experiences included throughout the study – sometimes I fear that epidemiological or association type research in suicide prevention research runs the risk of overestimating or minimizing the extremely difficult reality of the lived experience of suicide, either personally or through bereavement.
I’m curious about the authors’ decision to focus only on companions and friends. Although I appreciate the logic of not being able to separate social contagion from hereditary factors in family relationships, it seems More Reason for synthesizing and examining these questions, rather than excluding this literature altogether. Granted, this would probably be another study in itself, but still, I hope someone will synthesize this worthy literature. Furthermore, it seems short-sighted to suggest that friends and coworkers are the only relationships that exist outside of family relationships. What about the impact of exposure to suicidal thoughts and behaviors in a romantic partner? Or in a work colleague? Given the findings of this study on closeness being a major mediator of relationship intimacy, I think there should be important findings here, especially in the context of romantic relationships.
I’m also curious about what the research shows about suicidal thoughts and behaviors and outcomes apart from Suicidal thoughts and behavior. I know this study is specifically about contagion, but based on the experience of supporting a partner through suicide, I can testify that although I haven’t ‘caught’ suicide myself, I sure have experienced other effects on my mental health. This, in itself, is surely also a risk factor for suicidal thoughts and behaviors?
Finally, as is almost always the case in systematic reviews, the quality of the review itself is constrained by the quality of the research being synthesized. It’s disappointing to see such a poor quality of research in this area, and I can’t help but wonder whether we can take anything meaningful from these findings as a result. Actually, what is reality?…
Although well-conducted, this review could have benefited from an injection of lived experience to balance these grim numbers with some humanity.
Implications for practice
So, we know that exposure to suicide increases the risk – but so what? If the conclusion is that reducing suicide will reduce risk and downstream risks, then this seems somewhat circular. Regardless of the mechanism, preventing suicide is already the goal.
To me, I think the clinical implications are more likely to be in the way we limit or respond to exposure. In some settings there are ways in which this can be controlled – for example, there is work underway that aims to support youth affected by suicide in school, with the precise aim of preventing suicide clusters or contagion (Williams, Wexler, & Mueller, 2024). But what about adults, where it is more difficult to limit exposure or ameliorate the effects of exposure? Then how do we break this cycle?
I am mindful of the cautions raised by the authors, particularly their suggestion that telling friends about suicidal thoughts may, in some circumstances, increase the risk of suicide. However, I am hesitant to endorse recommendations that might discourage individuals from seeking support from peers, given that friendship is a well-established source of support for people experiencing mental health difficulties, and indeed it is often cited as one of the most important sources of support for people experiencing mental health difficulties. protective factors Against suicide (Pastor et al., 2025).
This brings to mind #ChatSafeGuidelines (Catchpole, 2020; Robinson et al., 2023), which emphasizes safe communication about online suicide among young people. Expanding on this theory, there may be value in developing comprehensive guidance – beyond social media and beyond young people – on how to talk about suicide in ways that support individuals while minimizing potential harm to others.
If suicide is contagious, how can we limit the adverse effects of suicide risk? Guidance on how to safely discuss suicide appears needed.
Statement of Interests
Laura Hemming has no conflicts of interest to disclose. AI was used for editing purposes and to generate headlines for this blog.
Link
primary paper
Gavan, L., van der Spek, N., Bergers, N., Breedveldt, J.J., Hellegers, F., Bosmans, G., and Böckting, C. (2026). Is suicide contagious? 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., and Gould, M.S. (2008). Impact of modeling on suicidal behavior of adolescents. Psychiatric Clinics of North America, 31(2), 293-316.
Maple, M., Searle, J., Sanford, R., Pearce, T., and Jordan, J. (2017). Is exposure to suicide beyond kin associated with risk of suicidal behavior? A systematic review of the evidence. suicide and life–threatening behavior, 47(4), 461-474.
Mohr, D., Liberati, A., Tetzlaff, J., Altman, DG, and the Prisma Group. (2010). Preferred reporting item for systematic reviews and meta-analyses: PRISMA statement. International Journal of Surgery, 8(5), 336-341.
Pastor, Y., Pérez-Torres, V., Angulo-Brunet, A., Nebot-Garcia, J.E., and Gallardo-Nieto, E. (2025). School, family, and peer engagement as protective factors for depression and suicide risk in Spanish adolescents.. boundaries in psychology, 161547759.
Robinson, J., Thorne, P., Mackay, S., Hemming, L., Battersby-Coulter, R., Cooper, C., … and La Sala, L. (2023). #ChatSafe 2.0. Updated guidelines to help young people communicate safely online about self-harm and suicide: a Delphi expert consensus study. one more, 18(8), e0289494.
Williams, DY, Wexler, L., and Mueller, AS (2022). Suicide prevention in schools: What evidence supports our current national recommendations? School Social Work Journal, 46(2), 23-69.
