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Individuals bereaved by suicide experience substantial emotional distress and are at risk for poorer mental health, substance use concerns, and suicidal behaviors. This study aimed to explore whether those bereaved by suicide reported different coping styles compared to those bereaved by sudden death in the first six months. It also aimed to determine whether a previous mental health diagnosis (PMHD) and experiencing stigma and/or shame impacted the utilization of adaptive and maladaptive coping. The sample was constituted by individuals bereaved by suicide ( n = 142) compared to those bereaved by sudden death ( n = 63), six months after loss. The study included immediate family members who were 18 years or older and understood the English language. After controlling for demographics there were no significant differences in coping styles between bereavement types. Regardless of bereavement type, having a PMHD was associated with increased avoidant and problem-focused coping, and stigma and shame were each associated with increased avoidant coping. Women were also more likely to report using adaptive coping. Findings demonstrate no difference by bereavement type and have implications for the tailoring of grief/postvention supports that are sensitive to perceived stigma/shame to better facilitate utilization of adaptive emotion-focused coping, particularly for men and those with pre-existing mental health problems.

Bereavement by suicide is a unique form of grief characterized by features such as stigma, shame, and rejection that may complicate the grieving process and place people at heightened risk for specific mental health disorders, suicide attempts, and dying by suicide. To better understand the unique support needs of the suicide-bereaved and how these can be met, this Australian study qualitatively explored the experiences of people bereaved by suicide. Fifteen individuals who had lost a spouse or partner or a family member to suicide formed three focus groups across different locations in Queensland, Australia. Analysis identified four dominant themes: changing support needs, difficulties navigating services, experiences of stigma and social isolation, and connecting with others. The results from this study provide a powerful insight into the experiences and specific needs of the suicide-bereaved and could inform further development of suicide bereavement support services.

Limited research exists on the experiences of parents bereaved by suicide. Our earlier qualitative analysis examined the experiences of parents' suicide bereavement at 6 and 12 months after their loss. The current study aimed to extend the analysis over 24 months, outlining the key themes of parents' suicide bereavement experience. In the frames of a longitudinal study of suicide bereavement in Queensland, Australia, parents were interviewed at 6, 12, and 24 months after their loss. Thematic analysis was used to further explore new themes and three key themes identified in earlier analyses: searching for answers and sense-making, coping strategies and support, and finding meaning and purpose. Results at 24 months revealed a clearer differentiation between strategies adopted by mothers and fathers. Anger and blame had changed towards feelings of depression. A polarization was observed between parents still oscillating in brooding rumination and those who have shifted towards sense-making. The former more frequently reported depression symptoms, and the latter reported a more positive attitude towards life and acceptance of their loss. Consistent with the dual-process model, parents managed to reach acceptance after oscillating between sense-making and meaning making. Findings provide insights how suicide loss affects parents, with implications for postvention.

Objective: Grief reactions change over time. However, only a limited number of studies, and none in Australia, have analysed changes in individual grief reactions longitudinally. The aim is to examine changes in grief reactions, mental health and suicidality of close family members bereaved by suicide, 6, 12 and 24 months after their loss compared with those bereaved by other forms of sudden death, adjusting for confounding factors., Method: Participants were 142 adult family members bereaved by suicide and 63 by other sudden death, followed up at 6, 12 and 24 months in Queensland, Australia. The Grief Experience Questionnaire, Depression Anxiety Stress Scale and Beck Scale for Suicide Ideation were used as main outcomes. Mixed-effects linear and logistic regressions were utilized for statistical analyses., Results: There were significant differences in rejection, stigmatization, shame and responsibility between the suicide and sudden death bereaved over the 2-year period, after adjusting for potential confounding factors. Rejection, stigmatization, search for explanation, somatic reactions and symptoms of depression and anxiety (Depression Anxiety Stress Scale) declined significantly over time in both groups. Rejection and somatic reactions showed group-by-time interaction effects, with a decrease in the suicide bereaved and no change in the sudden death bereaved. Loss of social support and suicidal ideation did not show a group or time effect., Conclusion: Although our findings confirm that there are several common dimensions to experiencing a sudden death of a family member, several differences were found between the suicide and non-suicide sudden death bereaved including significantly higher levels of rejection, stigmatization, shame and responsibility remaining in the suicide compared to sudden death bereaved 2 years after their loss. These findings should be considered in clinical practice and when designing postvention services in Australia.

This interpretative phenomenological analysis explored the key issues in the grief experiences of seven young adults bereaved by the youth suicide of a sibling. We conducted semi-structured phone interviews from which we derived four themes describing the participants' experiences of: (a) the process of grief, (b) grief interactions (within families and outside), (c) continuing bonds, and (d) meaning-making and growth through grief. The stories highlight the impact of family relationships on the grieving process in siblings and the need for support to help family members better communicate, understand, and respect each other's needs as they process their grief.

The death of a child by suicide is a severe trauma, placing parents at greater risk of psychological morbidity and physical health problems compared to other causes of death. However, few studies have examined the aftermath and bereavement experience for parents following the death of a child to suicide, limiting the ability to guide effective postvention services through empirical research. The current study, which was part of a larger longitudinal investigation of suicide bereavement in Queensland, Australia, examined the individual experiences of both mothers and fathers bereaved by suicide over time, specifically at the six month and 12 month time points after their loss. Bereaved parents who had provided written consent to be contacted for research purposes were identified through the Queensland Suicide Register, and took part in individual, semi-structured interviews. Generic qualitative analysis identified three key themes: searching for answers and sense-making, coping strategies and support, and finding meaning and purpose. Some participants showed indications of meaning-making and post-traumatic growth at 12 months after the suicide. According to the dual process model of bereavement, it is likely that participants were still oscillating between sense-making and meaning making, indicating that adapting to bereavement is a dynamic and fluctuating process., Competing Interests: The authors declare no conflict of interest.

Objectives: The pilot study were (1) to test the technical and administrative feasibility of a full-scale study, including recruitment process, response and retention rate, questionnaire design for an investigation to improve understanding of the suicide bereavement processes compared with bereavement by sudden deaths and (2) to present the differences and changes in the main outcomes-grief reactions of close relatives exposed to suicide and sudden death over 2 years., Design: A longitudinal prospective study comparing bereavement by suicide to other types of sudden deaths over time (6, 12 and 24 months)., Setting: Queensland, Australia., Participants: 25 suicide-bereaved and 15 sudden-death-bereaved persons., Outcome Measures: Grief reactions (measured with the Grief Experience Questionnaire)., Results: The response rate was 52.1% in the suicide bereaved and 45.5% in the sudden-death group. There was a small number of dropouts, with the retention rate over 85% for both groups. Linear mixed modelling for repeated measures showed a significant group effect (higher in suicide bereaved) for total grief, responsibility, rejection and unique reactions. A significant time effect (reduction) was measured for total grief, somatic reactions, general grief reactions and search for explanation. One significant time and group interaction was measured; rejection showed a decline in suicide and an increase in sudden-death bereaved., Conclusions: The pilot study presented the appropriateness of the study methodology. This type of study has implications for counselling and treating people bereaved by suicide and for designing postvention activities., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Background: When a person with alcohol use disorder commits suicide, do the immediate family members (parents, spouses, and children) react differently from the relatives of non-alcohol-related suicides?, Methods: From a series of 427 psychological autopsies conducted in Estonia we selected 261 cases of suicide where the key informants were close relatives. Of the 261 suicides, 148 met the DSM-IV criteria for alcohol use disorder (alcohol abuse and alcohol dependence), while 113 did not. Unconditional logistic regression was used to estimate the association in terms of emotions., Results: The spouses of alcohol misusing suicides were significantly more likely to react with anger than those when alcohol did not complicate the picture (adjusted OR=3.8, 95% CI=1.4-0.4). The children of persons with alcohol use disorder, who committed suicide were less likely to feel guilty (adjusted OR=0.2, 95% CI=0.1-0.8) or abandoned (adjusted OR=0.2, 95% CI=0.1-0.7) than children of non-alcohol-related suicide victims. There were no statistically significant differences in surviving parents' emotions., Conclusions: Alcohol use disorder before suicide changes affective responses in spouses and children who are left behind. Bereavement counsellors should be alert for complex grief and mourning responses among this group of suicide survivors.