The role of lived and living experience in evidence-based decision-making in suicide prevention.

Evidence-based decision-making in suicide prevention is shaped not only by research evidence but also by population needs, resources, and the implementation context. While lived and living experience is a core focus of contemporary suicide prevention policy and practice in Australia, little is known about how it is valued, integrated, and reconciled with other decision-making factors. The present study explored how lived and living experience knowledge informs evidence-based decision-making in suicide prevention, how factors that affect decision-making can be reconciled, and what resources are needed to improve it. Eighty-nine participants from the Australian suicide prevention sector engaged in a qualitative, participatory workshop at the 2025 Lived Experience of Suicide Summit. Participants included people with lived and living experience of suicide and those working across policy, service delivery, funding, and research. Data were collected through structured activities and analysed using reflexive thematic analysis and descriptive content analysis. Participants perceived lived and living experience knowledge to inform a small proportion of suicide prevention decisions. Findings indicated mixed effectiveness of current engagement practices, with tokenism and disengagement being key markers of ineffective engagement. Systemic issues, such as power dynamics and sector culture, were identified as factors that impact how knowledge and expertise are valued and integrated into decision-making. Strengthening the integration of lived and living experience into decision-making requires a paradigm shift that positions lived and living experience knowledge as a legitimate and integral form of evidence. This includes resources to support embedding engagement into suicide prevention approaches, structural supports, and increased implementation capacity.