Date of Award

January 2022

Document Type


Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Ashley Hagaman


Background: Of all the global reported suicides, 78% of them occur in low and middle-income countries and 39% specifically occur in the Southeast Asia region. Nepal’s suicide rate was ranked 8th in the world by WHO estimates in 2014, with the third-highest suicide rate for females. While we know of certain suicide risk factors pertaining to Nepal, we have yet to understand how individuals make meaning of life following suicide experiences. Purpose: This study uses a narrative thematic analysis approach to understand how adults with lived experiences of suicide (ALES) navigate their internal and interpersonal lives following their suicide experience. Methods: Fourteen semi-structured interviews were conducted in Kavre District, Nepal with adults who had a suicide experience between two and six months prior to the interview. We combined phenomenological and hermeneutic approaches within our narrative analysis to elicit notable themes to address the aim of the study. Findings were derived using iterative discussions and analysis of interview transcripts. Results: ALES experienced tension between developing an internal change despite external inertia in circumstances, contributing to their radical acceptance and resignation to life. They found purpose, rooted in familial responsibility, which became a reason to live. Support structures shaped help-seeking practices which helped or hindered the recovery process. Finally, the experienced and anticipated stigma surrounding suicide deeply shaped their approach to recovery. Conclusion: We found that ALES developed an ambivalence to both living and dying following a suicide experience. They fostered a resignation to their unresolved circumstances and attempted to find reasons to live despite them. This understanding has implications for the development of suicide prevention and intervention strategies specific to the post-suicide period and incorporating social and cultural understandings of suicide in Nepal, and other similar settings.


This thesis is restricted to Yale network users only. It will be made publicly available on 05/19/2024