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Background: Suicide is a major public health concern. In 2017, the suicide rate in Canada was 11 per 100,000 inhabitants. According to literature, 1 in 5 people have experienced a death by suicide during their lifetime. The aim of this study was to describe the met and unmet needs of suicide-bereaved survivors and to provide postvention recommendations., Methods: Further to an exploratory mixed-method audit of 39 suicides that occurred in Montreal (Canada) in 2016, suicide-bereaved survivors (n = 29) participated in semi-structured interviews and completed instruments to discuss and assess potential pathological grief, depression (PHQ-9), and anxiety (GAD-7), as well as health and social services utilization. A panel then reviewed each case and provided recommendations. The mean age of participants was 57.7 years and 23 were women., Results: Although help was offered initially, in most cases by a health professional or service provider (16/29), 22 survivors would have liked to be contacted by telephone in the first 2 months post suicide. Four categories of individual unmet needs (medical/pharmacological, information, support, and outreach) and one collective unmet need (suicide pre/postvention training and delivery) emerged., Conclusions: Although Quebec provincial services have been developed and offered to suicide-bereaved survivors in the past decade, many dwindled over time and none has been applied systematically. Recommendations for different stakeholders (Ministry of Health and Social Services, coroners, NGOs, and representatives of suicide-bereaved survivors) outlined in this study could be an interesting first step to help develop a suicide pre/postvention strategy.

This study sought to explore the phenomenon of peer counseling in suicide bereavement by addressing the question, what are the lived experiences of suicide survivors who become peer counselors? Participants were 15 individuals bereaved through suicide who had been volunteering with others bereaved in the same manner. This research employed the interpretative phenomenological analysis (IPA) approach to provide a detailed description of participants' journeys that went from experiencing the suicide of a loved one, to the decision to become a peer counselor, to, finally, providing support to other survivors. The findings suggest that participants understand the provision of peer counseling as a transformative process. Being a peer counselor means actively challenging the silence around suicide by speaking out about suicide-related issues and offering other survivors a safe space to share their stories. The broader implications of these findings for suicide postvention research and clinical practice are addressed.

In what way is the bereavement process following suicide different from other types of bereavement? The participants were 30 survivors of suicide and 30 survivors of car accidents who were interviewed twice at an average of six months, and the second measure was taken at an average of nine months after the death, with standardized questionnaires to measure depression and grief reaction. Measures of shame, social support, family adaptation, psychological distress, and prior losses were also obtained during the second interview. All survivors were parents who had lost a son aged between 18 and 35 years. The results indicate that suicide survivors were more depressed than accident survivors at the first measure but this difference disappeared at the second measure. Survivors of suicide experienced greater feelings of shame and had experienced more life events after the death than did accident survivors. There was also a greater history of loss in parents bereaved by suicide. Parental bereavement after suicide appears to differ in several ways from other types of bereavement and appears to happen more often in vulnerable families.

Suicide-bereaved families have been described as more depression-prone and their bereavement process as more complicated and difficult. Few studies have aimed specifically to investigate the history of transgenerational childhood loss in suicide survivor families as an indicator of greater vulnerability. Childhood separation experiences are associated with difficulties in forming and maintaining attachments. Bonding difficulties are also associated with greater vulnerability to depression and may constitute a suicide risk factor. This exploratory study (n = 32) focused on two groups, each of 16 mothers who had lost a son to suicide and car accidents, respectively. History of loss and early separation experiences were investigated through a clinical interview of the bereaved mothers and through a psychological autopsy of the deceased sons. Results indicate significant transgenerational indices of loss, separation, and inadequate child-rearing. Pre-death life events and adversities in the family may be as important to bereavement outcome as post-death happenings. The cycle of these events, the role of fathers and the role of protective factors must be further studied using detailed life-course reconstructions.

Canada's national task force on suicide suggests that people who mourn a suicide make up a group that is itself at risk. Literature shows that mourners of a suicide have a suicide rate that is nine times higher than average. While some authors suggest that this type of mourning is more intense and of a longer duration that for other types of mourning, other authors doubt this hypothesis. But what happens in reality? Is suicide mourning truly different from other types of mourning? Is it really a unique mourning experience? These are some of the questions the authors of this article have attempted to answer. Following an in-depth review of studies on the matter, the authors conclude that the mourning of a suicide encompasses certain characteristics that manifest themselves especially in more vulnerable people.