How many people are affected by a suicide? Not six.

Julie Cerel, Ph.D. of the University of Kentucky and colleagues have published a series of articles that address the extent to which people are exposed to suicide (Cerel et al., 2018, 2016, 2015; Feigelman, Cerel, McIntosh, Brent, & Gutin, 2018). Her research has determined that the widely held belief that six people are left behind following every suicide is not accurate. Dr. Cerel traces the origins of this long cited number to Edwin Schneidman, a pioneering suicidologist, who in the early 1970s made the estimate in a publication about suicide survivors. There was no empirical basis for the estimate but the number was widely cited in the years that followed. 

Dr. Cerel conducted a telephone survey of over 1,700 adult respondents and determined that nearly half (46.7%) knew someone who had died by suicide, constituting a suicide exposure during their lifetime (Cerel et al., 2018). Based on these results, it was estimated that for every U.S. suicide death 135 people are exposed to that suicide. In a separate study, Dr. Cerel and colleagues found that the nationally administered 2016 General Social Survey revealed that close to half (51%) of the respondents had experienced a suicide exposure during their lifetime (Feigelman et al., 2018). In addition to the updated exposure estimate, Dr. Cerel and colleagues found an association between poor psychiatric outcomes among those exposed to suicide and their perceived closeness to the decedent regardless of their familial relationship. These study results inform clinicians when inquiring about a patient’s suicide exposure history. The findings indicate that more people are exposed to suicide than previously thought and the psychiatric impact can be greater among those who perceive themselves close to the person who dies by suicide. The findings also inform suicide post-vention considerations such as monitoring impact of a suicide death within a military unit.

Read the publications associated with this MSRC-funded study


1. Cerel J, Brown M, Maple M et al. How Many People Are Exposed to Suicide? Not Six. Suicide and Life-Threatening Behavior. 2018. doi:10.1111/sltb.12450

2. Cerel J, Maple M, van de Venne J, Moore M, Flaherty C, Brown M. Exposure to Suicide in the Community: Prevalence and Correlates in One U.S. State. Public Health Rep. 2016;131(1):100-107. doi:10.1177/003335491613100116

3. Cerel J, van de Venne J, Moore M, Maple M, Flaherty C, Brown M. Veteran exposure to suicide: Prevalence and correlates. J Affect Disord. 2015;179:82-87. doi:10.1016/j.jad.2015.03.017

4. Feigelman W, Cerel J, McIntosh J, Brent D, Gutin N. Suicide exposures and bereavement among American adults: Evidence from the 2016 General Social Survey. J Affect Disord. 2018;227:1-6. doi:10.1016/j.jad.2017.09.056