Trajectories of despair: Understanding the social determinants of suicidality through differential vulnerability

Suicide is a major public health issue. There are over 700,000 deaths globally and rising levels of suicidal ideation are reported. While epidemiological research has demonstrated associations between social factors and suicide, further attention is needed to understand the processes through which these factors combine, accumulate and shape vulnerability over time. Drawing on 28 qualitative interviews with third sector suicide prevention practitioners in the East of England, this study deploys the concept of differential vulnerability to examine how deprivation, isolation, trauma, substance use and other factors interact over time within what we term ‘trajectories of despair.’ The study suggests that suicidality is rarely attributable to single events – but instead emerges through the complex interplay of interwoven disadvantage and adversity that can reshape the social, material and relational contexts and resources available to individuals. In this way, the research contributes to understanding suicidality as socially shaped, cumulative and unevenly distributed.