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.

Development of an Online Resource for People Bereaved by Suicide: A Mixed-Method User-Centered Study Protocol

Introduction: Suicide bereavement is known to be highly distressing and is frequently associated with mental health problems. Despite high-level of need regarding mental and physical health, people bereaved by suicide display low level of help-seeking and perceived support in the aftermath of the loss. The lack of accessibility and reliability of face-to-face counseling resources is notably reported by suicide survivors. Online resources can enhance early access to help and support for people bereaved by suicide. The primary objective of the study is to design and implement an innovative and adaptive online resource for people bereaved by suicide according to their needs and expectation regarding online solutions dedicated to suicide bereavement.Methods: The ESPOIR2S study is a mixed-method user-centered study. ESPOIR2S seeks to build the resource from the perspectives and needs of both people bereaved by suicide and professionals or volunteers working in the field of postvention. The Information System Research (ISR) Framework is used to guide the design of the study through a 3-step research cycle. The structure of the ESPOIR2S study relies on a simultaneous collection of qualitative and quantitative data which will be collected and analyzed during (a) the Relevance cycle through an online questionnaire and focus groups; (b) the Design cycle through focus groups; and (c) and the Rigor cycle through an online questionnaire and semi-structured interviews. The user-centeredness will be ensured by the active participation of people bereaved by suicide, members of associations for bereaved people and professionals of postvention.Discussion: The mixed-method and user-centered design of the ESPOIR2S study will offer an in-depth collection of the needs and expectation of suicide survivors regarding online resources. Through the implementation of an adaptive online solution, we aim to enhance the access to help and support for suicide survivors which are highly correlated with well-being and recovery.

Life After Death: Suicide, Care, and Responsibility

<p>This thesis focuses on suicide bereavement, particularly of those parents who have lost children to suicide while in care of the state. I argue that, for these parents, action taken following the suicide of their children is an extension of the care that was given throughout their child’s lives. For parents of those suffering with mental health issues, care is fraught with confusion and tension. This is no more apparent than when they and their children are seeking professional care. Care is inextricably linked with responsibility, which as I will show, is a very important concept in understanding suicide prevention. Governance of regimes of care shapes bereavement through biopolitical responsibilisation. The conflict found within understandings of care lays the foundation for the conflated tensions that arise in suicide bereaved parents’ search for recognition and accountability of and for their child’s suicide. In this thesis I explore these actions to understand the motives and desires of these parents. In exploring these, meaning becomes a useful analytical lens, for meaning, care, and the projects that my participants undertake in search of answers were all intimately linked. Through understanding the actions of bereaved parents as an extension of the care for their children we can understand how these actions are shaped by the governance and regimes of care within New Zealand.</p>

Life After Death: Suicide, Care, and Responsibility

<p>This thesis focuses on suicide bereavement, particularly of those parents who have lost children to suicide while in care of the state. I argue that, for these parents, action taken following the suicide of their children is an extension of the care that was given throughout their child’s lives. For parents of those suffering with mental health issues, care is fraught with confusion and tension. This is no more apparent than when they and their children are seeking professional care. Care is inextricably linked with responsibility, which as I will show, is a very important concept in understanding suicide prevention. Governance of regimes of care shapes bereavement through biopolitical responsibilisation. The conflict found within understandings of care lays the foundation for the conflated tensions that arise in suicide bereaved parents’ search for recognition and accountability of and for their child’s suicide. In this thesis I explore these actions to understand the motives and desires of these parents. In exploring these, meaning becomes a useful analytical lens, for meaning, care, and the projects that my participants undertake in search of answers were all intimately linked. Through understanding the actions of bereaved parents as an extension of the care for their children we can understand how these actions are shaped by the governance and regimes of care within New Zealand.</p>

Silence after suicide: A phenomenological study of young men's experience of losing a close male friend

<p>Losing a close friend to suicide can significantly increase the risk of dysfunction, depression and suicide in young people. Previous studies of suicide bereavement have focused on parents, parentally-bereaved children, young adolescents’ experiences of peer suicide and female college-students. A paucity of qualitative research exists that examines young men’s experiences of suicide bereavement. This lack of research has meant that their grief may go unnoticed, be minimized, or even misunderstood. The purpose of this research was to explore the experiences of eight young New Zealand men (aged 17-25 years) who lost a close male friend to suicide. Repeated in-depth phenomenological interviews were used to gain new insights into the conceptualisation of this event in the young men’s lives through an exploration of their experiences. Interviews were audio recorded and transcribed for analysis. The inductive, descriptive approach of the phenomenological method was used to explore and describe the essence of their lived experience and led to seven themes: Being gutted, stoicism, grieving in silence, being silenced, breaking the silence, being in silence and analytic silence. The overarching essence of their experience and the phenomenon was silence. The silence the men experienced after suicide was ubiquitous. The findings suggest losing a close male friend to suicide implicates men to suffer, grieve, live through and transform in silence. Participants experienced four types of silence: personal, private, public and analytic silence. The men were gutted and personally unable to talk about their experience. They chose to keep quiet, be stoical, suppress their emotions and keep their grief private. They grieved in silence and were silenced by others. They broke their silence with people they could trust and who provided presence support and care. They sought quiet spaces where they could reconnect, reflect on their experience. Their navigation of silence fostered new values, priorities and identities, acceptance of their loss and helped them move on with their lives. This study has brought new understandings of men’s experiences of suicide bereavement and silence. Their experience suggests that health professionals, families/whānau and friends need to learn to see, listen to and interpret the silence of men in order to better understand their experience and needs for care and support. Recommendations are made for intervention, health care practice and future research.</p>

Ethnic Minority Groups’ Experiences of Suicide Bereavement: A Qualitative Exploratory Study

It is estimated that between 36,000 and 360,000 people are affected by suicide every year in the UK, and a proportion may develop depression and post-traumatic stress disorder, or engage in high-risk behaviours. Recent systematic analyses have revealed a clear gap in research on suicide bereavement in minority ethnic groups. This study aimed to understand the experiences and support needs of individuals from ethnic minority backgrounds bereaved by suicide and was the first in the UK to investigate this matter. The study was a secondary analysis of data. Participants were 7158 people residing in the UK who completed an online survey about their experiences of suicide. Free-text qualitative responses of 227 participants who did not identify as White British were analysed using thematic analysis. Four themes were identified: maladaptive coping strategies, emotional processes following suicide, lack of support from agencies, and the importance of mental health awareness. Ethnic minority groups reported a lack of support despite attempts to engage with services, noted the prevalence of stigma within ethnic minority groups, and expressed a need to tackle this. These preliminary results suggest that ethnic minority individuals require visible and accessible services that can successfully engage with and support them.

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.

Spirituality and Religiosity during Suicide Bereavement: A Qualitative Systematic Review

A loved one’s loss to suicide can be a traumatic experience and trigger a difficult grief process, identity changes, a loss of the sense of meaning and a spiritual crisis. Spirituality and/or religiosity (S/R) can be both an important resource and a source of stigmatisation during suicide bereavement. This study aims to synthesise the extant findings about S/R during suicide bereavement in qualitative studies. After an exhaustive selection of articles, the current review utilised a total of 484 citations and seven studies. A thematic synthesis yielded five major themes related to S/R during suicide bereavement: the need to be helped by the religious community without being judged; S/R-related experience of the deceased as a figure who continues to exist; S/R experienced without a conscious choice; conscious reach towards S/R themes; not relating to S/R during suicide bereavement. These findings indicate that the role of S/R during suicide bereavement is complex and varies from providing help to serving as a source of suffering. Hence, practitioners and religious communities should be mindful of the S/R themes during suicide bereavement.