After a Suicide Death in a High School: Exploring Students' Perspectives

By the time they leave high school, 17% of adolescents will have experienced the suicide death of a friend, peer, or classmate. While some will be unaffected or experience a brief period of distress following the death, for others the death will cause significant disruption and distress, even increasing their risk of suicidal thoughts and behaviors. It is essential for social workers to be able to support at-risk adolescents after this type of loss. To do this, it is critical to understand the ways that adolescents experience the death, grieve, and recover from the loss. This qualitative study explored adolescents' experiences with grief and loss following an adolescent suicide death in the United States. Thematic analysis of semi-structured interviews with young adults (N = 13) who had been exposed to the suicide death of a peer, classmate, or friend while in high school examined themes about their processing of the death, yielding four themes about sense-making and making meaning about the death. Implications for social workers, schools, and suicide postvention researchers are identified and discussed.

A Loss by Suicide: The Relationship Between Meaning-Making, Post-Traumatic Growth, and Complicated Grief

Meaning making has been found useful in processing grief, yet individuals who have experienced a loss by suicide may have difficulty with post-loss adjustment due to the traumatic nature of their loss. Through quantitative study, this article acts as an initial exploratory study and examines the relationship between meaning-making, post-traumatic growth, and complicated grief symptoms in 81 college students from a large university in the United States who have experienced the loss of a loved one to suicide. The results of this study indicated that meaning-making serves as a mediator in the relationship with post-traumatic growth and complicated grief. This finding sheds light on the importance of meaning-making as a possible avenue of interventions for clinical use in bereavement from loss by suicide to treat grief symptoms and lead to post-traumatic growth.

Perceived Determinants of Disclosing Suicide Loss

Background: People who lost a loved one to suicide (i.e., suicide loss survivors, SLS) often struggle to talk about their experiences. However, previous studies suggest beneficial effects of disclosure among this group. Aims: This study aimed to identify determinants of disclosing suicide loss. Method: We conducted qualitative interviews with 22 female SLS focusing on determinants of disclosing suicide loss. Interviews were transcribed and analyzed using qualitative content analysis. Results: We identified contextual factors, perceived risks, and perceived benefits as determinants of disclosing suicide loss. Contextual factors included social settings and characteristics of conversation partners. Perceived risks included emotional distress among oneself and others as well as stigma-related risks of disclosing. Perceived benefits included participants' desire for authenticity and social support, as well as positive effects for grieving and fighting suicide stigma. Limitations: Findings are limited to the current female sample. Conclusion: SLS need support in identifying safe places for disclosure and in developing coping strategies to deal with suicide stigma and emotional distress experienced by themselves and others. Future research should investigate the general public's ability and attitudes to provide support after suicide loss and investigate disclosure decisions among male SLS.

Exploring the mental health correlates of overdose loss

Despite the exorbitant rise in overdose-related deaths, little is known about the mental health burden associated with this form of loss. Using validated self-report instruments, the present study investigated the prevalence of pathological symptoms of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), major depressive disorder (MDD) and generalized anxiety disorder (GAD), and suicide risk among a sample of overdose loss survivors (n = 115). Comparison groups consisting of other sudden loss survivors (suicide and sudden-natural loss) were employed to illuminate any shared or unique mental health challenges. Consistent with this study's primary hypothesis, results indicated that the overall mental health burden of overdose loss is substantial. Specifically, after controlling for a number of covariates, overdose loss survivors were approximately three times more likely to meet the symptom severity threshold for PGD, PTSD, and MDD compared to sudden-natural loss survivors. Overdose loss survivors also appeared to be at risk for GAD symptoms and suicide, but differences were non-significant after accounting for a number of covariates. Overall, this study is the first to examine this particular constellation of mental health outcomes associated with overdose bereavement, underscoring the need for additional empirical and clinical attention placed on this burgeoning population.

Exploring experiences of supports for suicide bereavement in Ireland: protocol for a national survey

Background A suicide death impacts upon the wellbeing of close family members and friends but has also been shown to affect many people outside of this immediate circle. This will be the first large-scale national study of adults bereaved or affected by suicide in Ireland, using a cross-sectional online survey. The overarching aim will be to gain insight into the experiences of supports received by people bereaved or affected by suicide and to identify the barriers to engagement following their loss. Methods A cross-sectional survey will be conducted among adults in Ireland who have been bereaved or affected by suicide. This project will seek to represent people with different demographics and backgrounds in the Irish population using a multifaceted approach to survey recruitment. A range of validated measures will be used to examine participants' current wellbeing and grief experience. A combination of closed and open-ended questions will provide participants the opportunity to share their individual experiences, the services and supports available to them, and barriers and enablers to accessing supports. Results Quantitative data will be analysed using descriptive statistics. Chi-squared tests will be used to compare subgroups within categorical data items, and multivariable regression models will be used to examine differences in psychosocial and physical wellbeing across key groups. Qualitative content analysis will be used for qualitative responses to open-ended questions. Conclusions The survey will provide an in-depth understanding of the psychosocial and mental health impacts of suicide bereavement in Ireland; insight into the range of informal and formal supports accessed; and will identify unmet needs and challenges of accessing appropriate and timely supports. The findings will inform current national actions aimed at ensuring the standardisation and quality of the services and supports for those bereaved or affected by suicide.

Examining bereavement-related needs and outcomes among survivors of sudden loss: A latent profile analysis

OBJECTIVE

Recognizing important bereavement-related needs among sudden loss survivors (e.g., suicide, overdose)-a population that is burgeoning and at risk for deleterious outcomes-is a critical task as needs may reflect modifiable grief-related variables that can assist with post-loss adjustment.

METHODS

Latent profile analysis was used among 347 sudden loss survivors to (a) identify distinct patterns of needs among survivors of sudden loss, (b) assess predictors of such profiles, and (c) investigate differences in profiles in terms of bereavement outcomes.

RESULTS

Four classes of bereavement-related needs were identified: a low needs class, a moderate needs-spiritual class, a moderate needs-relational class, and a high needs (HN) class. Clear differences emerged between need classes with the HN class evidencing the greatest level of grief and mental health sequelae.

CONCLUSION

Tending to bereavement-related needs is critical, as they indicate the degree of distress and reflect modifiable therapeutic variables.

Using Multiple Regression Analyses to Uncover Patterns of Correlates of Grief Problems, Depression and Suicidal Ideation Among Suicide Bereaved Individuals

This analysis of a convenience sample survey of 195 suicide bereaved adults focuses on predictors of three important highly interrelated experiences among the suicide bereaved: grief problems, depression and suicidal thinking. Although each of these three experiences can be explained by a unique set of predictors, they share many commonalities. Several predictors stood out especially in either aggravating or alleviating these experiences: personal (or post-traumatic) growth, perceived social support, feelings of blameworthiness, perceived suicide stigma, years since loss and a respondent's mental health difficulties experienced prior to their suicide loss. We also review the clinical implications of these results.

What Is the Experience of Practitioners in Health, Education or Social Care Roles Following a Death by Suicide? A Qualitative Research Synthesis

Recent research has highlighted that the number of people impacted by a death by suicide is far greater than previously estimated and includes wider networks beyond close family members. It is important to understand the ways in which suicide impacts different groups within these wider networks so that safe and appropriate postvention support can be developed and delivered. A systematic review in the form of a qualitative research synthesis was undertaken with the aim of addressing the question ‘what are the features of the experiences of workers in health, education or social care roles following the death by suicide of a client, patient, student or service user?’ The analysis developed three categories of themes, ‘Horror, shock and trauma’, ‘Scrutiny, judgement and blame’, and ‘Support, learning and living with’. The mechanisms of absolution and incrimination were perceived to impact upon practitioners’ experiences within social and cultural contexts. Practitioners need to feel prepared for the potential impacts of a suicide and should be offered targeted postvention support to help them in processing their responses and in developing narratives that enable continued safe practice. Postvention responses need to be contextualised socially, culturally and organisationally so that they are sensitive to individual need.