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SANE on Suicide

SANE on Suicide presents the findings from our suicide prevention research. We spoke with people who had attempted suicide, their close family and friends, and people bereaved by suicide.

Although suicide sometimes appears to be an impulsive or sudden act, we found that it is usually a process. As such it can be slowed down and stopped.

Who is SANE on Suicide for?

It’s for anyone affected by suicide or who’d like to know more about it – people who are or have been suicidal, family members and friends, professionals working with those who are or may be suicidal.

What is in SANE on Suicide?

Each section contains excerpts from interviews describing experiences of the process of suicide. Each experience shows the point of view of both the suicidal person and a family member or friend. There are suggestions for getting support, accounts of recovery and a space to share your story.

How do I use SANE on Suicide?

We have outlined the suicidal process and the key themes from our research – living without self-worth, loss of trust, and suicidal exhaustion. This helps to illustrate how it is possible to slow down or stop the process at any point.

Does it cover all experiences of suicide?

We found a lot of common ground in the stories of the people we spoke to. However, your story may be different and you may like to share it with us.

Find out more

Summary findings (PDF, 416KB)

Full report: Understanding the process of suicide through accounts of experience – A new focus for suicide prevention (PDF 7.84MB)

Summary of findings

Understanding the process of suicide through accounts of experience


For most of the time suicidal people are cared for by friends and relatives. Yet until now, no research project has attempted to support them by engaging with their collective experiences in order to develop a model of the suicidal process as it unfolds in the context of ordinary living.

Key findings

We interviewed 14 people who had attempted suicide and 15 of their friends/relatives, and 25 people bereaved by suicide.

In these accounts suicides appeared to arise from complex interactions of three factors: lack of inherent worth, lack of trust and suicidal exhaustion.

Lack of inherent worth is the sense that what is meaningful and valuable about the person or his/her life is entirely derivative of and dependent on something else, for example their ability to perform a role (for example, doctor, mother, ‘others’ idea of them’)

Lack of trust is the absence of an experience that allows people to function and build relationships regardless of the fact that their knowledge about self, others and future is incomplete. Lacking trust, suicidal people experience uncertainty as intolerable and they feel anxious and detached from others.

The absence of trust and inherent worth forces suicidal people to substitute for them through for example over-commitment to roles, goals or projects (e.g. continued performance regardless of mental or physical ill health) and over-emphasis on emotional and practical self-reliance (e.g. hiding difficult feelings and failing to share responsibilities).

Importantly, these substitution strategies place a heavy demand on mental resources.

Suicidal exhaustion is a special kind of chronic mental exhaustion that

1. Makes life seem incompatible with rest

2. Involves a sense that mental resources will continue to fall short of demand in the future

Suicidal exhaustion gives not just a motivation but a warrant to die. Exhausted and unable to sustain their worth-creating efforts, the suicidal person comes to think of themselves as ‘just a burden’ whose death would benefit everyone.

SANE on suicide will help the general public and professionals to draw on this research when they are preventing suicide and suicidal distress in their community.


This research highlights the importance of mental exhaustion in the process of suicide.

Friends and family members can reduce mental exhaustion by opening up opportunities for disclosing suicidal and other difficult feelings. However, they too should seek support to avoid exhaustion, which carries risks for them and the suicidal people they assist.

Support for trust relationships should therefore be at the forefront of suicide prevention. Researchers and treatment professionals should pay increased attention to the contribution sleep disorder makes to suicide.

These findings also warn against interpreting recovery from suicidal distress exclusively in terms of function (for example, return to work).

Where to find more information

You can contact SANE by emailing or by calling 0203 805 1790.

The Chief Investigator of this study is Outi Benson. She can be contacted by email at the University of Exeter

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