Understanding Female Suicide: A Mixed Methods Approach to Enhance Targeted Prevention Strategies

Suicide remains a leading cause of premature death globally, with rates among young females showing a concerning upward trend, particularly in the UK (1). Despite this, research on female suicide remains limited, as much of the evidence has focused on male suicide. This study aims to address this gap by employing a mixed-methods approach to understand the drivers, risk factors, and protective elements associated with female suicide. The research will investigate how individual, social, and structural factors interact, particularly in light of societal changes such as the COVID-19 pandemic and economic austerity measures, to inform targeted prevention strategies. The study will be conducted in three phases. The first involves a systematic review of existing literature to summarise the evidence on female suicide, including risk and protective factors. Both quantitative and qualitative studies, as well as grey literature, will be included, ensuring a comprehensive synthesis of knowledge. The second phase will analyse 100 coroners' records of female suicides in Yorkshire using a mixed-methods sociological autopsy approach (10). Quantitative analysis will identify recurring drivers and risk factors, while qualitative framework analysis will explore the narratives within each case. This dual approach will provide a nuanced understanding of the systemic and individual-level influences on female suicide. The third phase will involve interviews with up to 15 women who have experienced suicidal ideation or attempts. These interviews will explore their lived experiences, focusing on the factors contributing to suicidal thoughts, the protective elements that prevented completion, and their views on effective interventions. This study incorporates significant patient and public involvement (PPI), with people with lived experience and public health practitioners shaping the research design, tool development, and dissemination strategies. Their input ensures that the findings are grounded in real-world relevance and contribute to meaningful, actionable outcomes. The anticipated outputs include a PhD thesis, peer-reviewed publications, and conference presentations, alongside practical tools for public health practitioners, such as enhanced methodologies for analysing coroners' records. Findings will also be disseminated to the public and professionals through accessible formats like infographics and blogs, ensuring broad impact. By identifying gender-specific drivers and protective factors, this research aims to inform the development of tailored interventions and policies that address the rising rates of female suicide. Its innovative mixed-methods design and inclusion of lived experience perspectives will contribute to a deeper, more holistic understanding of female suicidality, ultimately supporting more effective prevention strategies.