Understanding risk and protective factors for suicidal behaviour in a military context: A concept mapping approach

• The risk factors for suicidal behaviours in military aligned with the social-ecological model. • Adverse military experiences were the most important factors associated with suicidality. • The most feasible factors for Defence to address were clustered as workplace culture. • Concept mapping is a novel approach in suicidology overcoming limitations of a Delphi study. There are increasing efforts to better understand suicidal behaviour among current and former military personnel in Australia. More research using innovative methodologies is needed to identify risk and protective factors that could be addressed within the military. To better understand perceived risk and protective factors associated with suicidal behaviour within the military context. Three groups of stakeholders were recruited: people with lived experience of suicide in a military context, military mental health clinicians, and researchers with expertise in suicide in a military context. Using concept mapping, participants individually generated risk and/or protective factors for suicidal behaviour in a military context, before organising and rating all statements. Data were collected, analysed, and visually represented using the GroupWisdom platform. In total, 57 stakeholders participated in at least one stage of the study (i.e., brainstorming, sorting and/or rating). Brainstorming generated 97 perceived risk-factors and 63 perceived protective factors, which were thematically grouped by participants. A multidimensional scaling and hierarchical cluster analysis generated a 7-cluster solution for risk factors and a 5-cluster solution for protective factors. Most of the risk and protective factors rated highly both in terms of importance and feasibility for the military to address were from workplace-related clusters. The risk and protective factors for suicidal behaviours within a military context were identified on three social-ecological levels: workplace (community), relational, and individual. The results of this study may inform future suicide research and prevention activities targeted to military personnel.