It has long been stated that six people are left behind following every suicide. Despite a lack of empirical evidence, this has been extensively cited for over 30 years. Using data from a random-digit dial survey, a more accurate number of people exposed to each suicide is calculated. A sample of 1,736 adults included 812 lifetime suicide-exposed respondents who reported age and number of exposures. Each suicide resulted in 135 people exposed (knew the person). Each suicide affects a large circle of people, who may be in need of clinician services or support following exposure.

In each of the participating countries, the GSHS received ethics approval from the Ministry of Education or a relevant Institutional Ethics Review Committee, or both. Only adolescents and their parents who provided written or verbal consent participated. As the current study used retrospective publicly available secondary data, we did not need ethics approval from any Institutional Ethics Review Committee. Suicidal ideation, suicide planning and suicide attempts among 229 129 adolescents in 59 low-andmiddle-income countries: a population-based study Abstract Background: Suicide is a major global health challenge and a leading cause of death among adolescents. Research related to suicide has concentrated on high-income countries with little evidence from low-and middle-income countries (LMICs). Methods: We used data from the Global School-based Student Health Survey conducted among schoolchildren aged 13-17 years (52% female) between 2003 and 2015 in 59 LMICs across six WorldHealth Organization regions. Using a meta-analysis with random effects, we computed the sex and agebased estimates of regional and overall prevalence of suicidal ideation, suicide planning and suicide attempts. Findings:The overall prevalence of suicidal ideation, suicide planning and suicide attempts in the 12 months preceding survey completion was 16•9% (95% CI: 15•0-18•8), 17•0% (14•8-19•2), and 17•0% (14•7-19•3), respectively. The African region had the highest prevalence of suicidal ideation and suicide planning, and the Western Pacific region had the highest prevalence of suicide attempts. The lowest prevalence of ideation, plan, and attempts was in the South-East Asian region. Females had higher prevalence than males for suicidal ideation [18•5% (16•4-20•6) vs. 15•1% (13•4-16•7)], suicide planning [18•2% (15•8-20•6) vs. 15•6% (13.7-17.6)], and attempts [17•4% (15•0-19•8) vs. 16•3% (14•0-18•6)]. Adolescents aged 15-17 years had higher prevalence than those aged 13-14 years of suicidal ideation [17•8% (15•8-19•8) vs. 15•9% (14•1-17•6)], plan [17•8% (15•7-20•0) vs. 16•3% (14•7-17•9)], and attempts [17•6% (15•2-20•0) vs. 16•2% (13•8-18•5)].Interpretation: Suicidal thoughts and behaviours are prevalent among adolescents in LMICs, in particular in the African and the Western Pacific regions, and among females and those aged 15-17 years. Customised suicide prevention initiatives are needed in LMICs, taking into account the diverse range of cultural and socio-economic backgrounds of the countries.

The study offers a holistic explanation of life factors influencing the turnover intention of early-career health professionals working in public health services in rural NSW. These findings and the turnover intention risk matrix are thought to be suitable for use by Australian public health services and governments, as well as in other highly industrialised countries, to assist in the development of policies and strategies tailored for individual health professionals' work-experience level and life stage. By adopting such a whole-of-person approach, health services and governments will be better positioned to address the life aspirations of rural-based, early-career health professionals and this is likely to assist in the reduction of avoidable turnover.

Exposure to suicide is pervasive and occurs beyond family; as such, it is imperative to identify those with perceived closeness to the decedent. This hidden cohort of suicide-exposed people is at elevated risk for psychopathology and suicidal ideation.

In light of prevailing confusion over the meaning of the term "suicide survivor," we propose a more exact terminology for designating different levels of impact on those left behind by suicide, ranging on a continuum from those exposed to suicide through those who are affected by it and finally to those who are bereaved by suicide in the short- or long-term, as a function of their loss of a close emotional attachment through this tragic form of loss. We briefly note the possible utility of this terminological specificity in promoting more clearly targeted research and intervention efforts, and call for closer investigation of various categories of "survivorship" in future studies.