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Background: Suicide is a major public health issue that increases the risk of suicide for those bereaved by suicide themselves. There is a lack of evaluation of the effectiveness and acceptability of suicide postvention services supporting those bereaved by suicide. Aims: This review aimed to assess evaluations of postvention services supporting those bereaved by suicide and the acceptability of methods of postvention. Methods: Searches of peer-reviewed literature identified 36 studies for inclusion. 22 studies evaluated specific postvention services, 14 evaluated models of postvention. Results: Using the Mixed Methods Appraisal Tool, mixed-methods and qualitative postvention evaluation and acceptability research produce high-quality studies. Studies rated as low quality reflect poor reporting, rather than ineffective services. Conclusion: Further evaluation of community-based postvention services within the UK is needed. This would evidence that services in the UK are effective in supporting those bereaved by suicide. Evaluation would benefit services in accessing funding, improve service development and provide holistic support. [ABSTRACT FROM AUTHOR]

AbstractLosing a loved one to suicide is often traumatizing. Those left behind to bear the loss do so under a shroud of stigma, shame, blame, and regret, alongside other complex emotions. Due to the misconceptions surrounding suicide, individuals closest to the bereft often do not know how to respond to the loss, leaving the survivor to grapple with arguably one of the most challenging events of their life alone. Yet, evidence suggests that suicide survivors may find meaningful group support and ways to integrate the loss into their lives through postvention resources. Drawing inspiration from Pieper’s contemplative leisure, and in collaboration with suicide survivors, we explore leisure’s potential in a co-created suicide bereavement support group. Our findings indicate that leisure as a contemplative act helped facilitate healing within a participatory action research postvention. [ABSTRACT FROM AUTHOR]

This article reports on a two-year study of a community-based suicide postvention support service in the UK. Attention centres on the implementation of four integrated elements within the service model: multi-agency working with real-time suicide surveillance, persistent pro-active contact; volunteer-led support; continuous open-ended support. Our approach involved analysing utilisation data and qualitative techniques, including in-depth interviews with a diverse group of stakeholders. The study is the first of its kind to provide an in-depth examination of an innovative approach focusing on the integrated model and its constituent components. Our findings offer evidence-based examples of collaborative service efforts in implementing real-time interventions, with agencies working together to provide timely, co-ordinated, proactive responses and support with the potential to alleviate suffering and prevent loss of life. The value of volunteer-led support and open-ended access and associated challenges are emphasised. Findings hold promise for international impact with policy implications for services worldwide. [ABSTRACT FROM AUTHOR]

Objectives: This review answers the following questions: (1) What is the potential role of social work in prevention, intervention, and postvention in dealing with suicide? (2) What factors limit social work involvement? Methods: A sample of 84 peer-reviewed articles selected via PubMed, Scopus, and Google Scholar were analysed using content analysis. Findings: Results indicate that the role of social work in suicide prevention, intervention and postvention has been primarily established as a clinical or mental health social worker's task. However, generalist social workers can also effectively use their training in dealing with suicide at individual, family, organisational, and community levels. The study revealed that social work intervention in suicide prevention is reduced by several factors, including limited social work research interests in suicide, lack of education and training of social workers in dealing with people with suicidal ideation, and professional anxiety caused by clients' suicides. Conclusion: Incorporating suicide content into social work education, increasing social workers' training, and utilising generalist social workers' potential are required to increase social work contribution. [ABSTRACT FROM AUTHOR]

The problem of suicide is usually confronted by the implementation of measures aimed at reducing attempts and deaths through prevention, intervention, and postvention. However, there is a tendency to overlook the fact that the application of these measures relies on strategies of the governance of subjectivity that belong to the hegemony of clinical practice and mainstream psy disciplines. Accordingly, this research analyses four guides in Spanish, three international and one national (Spain), that set a series of practices and technologies of the self that tend to place the responsibility of (self)containment on the mainly affected by suicide: survivors. Therefore, this text presents a recently developed perspective that problematizes the governance of suicide and its therapeutical logics. [ABSTRACT FROM AUTHOR]

The medical and spiritual-religious institutions perceive the postvention as a social responsibility in relation to both the mourning family and the local community. While suicide has been paid to increased attention both theoretically and in terms of prevention activities and actions, the postvention was and is still harder to manage, especially because of its multidisciplinary component, which, together with psychiatric and psychological conventional support offered on request, emphasizes especially the social, community and religious support. In this analysis, we synthetically offer the current and own perspective of the recommended practical means in the postvention of the mourning persons following a suicidal act. The perspective analysis can provide immediate and medium-term solutions that can be available to medical-psychiatric, psychological and religious professionals. [ABSTRACT FROM AUTHOR]

Fatal and non-fatal accidents and suicides at work pose a substantial threat to workers' physical and psychological safety, particularly within the construction industry. Managing these incidents is an essential component of workplace health and safety (WHS). Additionally, a formal program to support workers and provide feedback to improve the existing WHS management system is increasingly important. However, knowledge of the factors contributing to an effective critical incident (CI) or postvention response is limited by the lack of published evidence-based interventions, especially for occupations and industries that are exposed to higher rates of fatal and non-fatal injuries due to accidents and suicides. In addition, broader concerns surrounding the effectiveness of conventional critical incident programs highlight the need to develop innovative and evidence-based critical intervention and postvention responses addressing acute stress symptoms arising from exposure. This research outlines the development of the MATES Respond Training Program, a component of the WHO-endorsed MATES in Construction program, which is a charity charged with the task of improving mental health and suicide prevention in the construction industry in Australia and New Zealand. Development of the MATES Respond Training Program was informed by the following three key sources: a rapid literature review, interviews with 11 workers trained in peer support suicide prevention interventions, and an analysis of site notes on 193 critical incident and postvention construction site attendances by MATES in Construction field officers, case managers and social workers. Insights and recommendations obtained from these sources, along with the resulting program, are discussed in this paper. [ABSTRACT FROM AUTHOR]

Introduction: Each suicide affects about five close family members, potentially heightening risk for psychopathology and suicide. Communication style is a key factor in mental health and psychosocial wellbeing of families. Family communication after suicide, however, is insufficiently conceptualised and studied. This study aimed to identify different factors of familial communication after suicide of a relative and to develop a questionnaire assessing the functionality of familial communications following the suicide of a family member.Method: Through literature review, categories for the functionality of family communication after a familial suicide were developed. Items assessing family communication strategies were formulated and reviewed for comprehensibility and classification. Based on this review, the FCSQ (Family Communication on Suicide Questionnaire) was then tested in a multistep exploratory factor analysis on a cohort of suicide-bereaved relatives, utilising principal axis factor extraction. Construct validity of the FCSQ was assessed through correlation analysis and internal consistency via coefficient alpha.Results: Fifty-nine participants were enrolled in the study. Psychometric analyses indicated that family communication after a suicide can be divided into three factors, Honest and Emotional, Derogatory, and Stigmatising. Honest and Emotional formed functional communications, while Derogatory and Stigmatising communications formed two dysfunctional dimensions.Conclusions: The FCSQ is a first-of-a-kind questionnaire to assess functionality of family communications after suicide. Factor analysis indicated good factor structure and internal consistency, especially regarding functional communication patterns, while the Derogatory factor requires further analysis. This questionnaire has the potential to fill a crucial gap in clinical and research practice and can help to identify families and family members at risk after the experience of a family suicide.

Although exposure to the suicide death of a military colleague has been shown quantitatively to increase suicide risk factors among veterans, there are very few studies where veterans have been asked about this experience. This article presents a qualitative analysis of 38 interviews with U.S. veterans with exposure to the suicide death of a military colleague in past war operations. Participants described the impact of exposure in relation to the military context and official response to the death, which had long-term ramifications. Our findings suggest suicide prevention and postvention responses for veterans should be informed by the lived experience of veterans, including those for whom this experience occurred significantly in the past, as the impacts of different military policies and practices in response to suicide deaths over time are relevant to the impact of exposure to death of a military colleague in the short and long term. [ABSTRACT FROM AUTHOR]

In Portugal, the suicide in the Security Forces has reached values higher than those of the general population, which reflected a need to seek solutions. This study aimed to understand the problem of suicide in the Republican National Guard through the identification of causes and consequences, the understanding of the intervention carried out in this field, and the identification of the post-vention as a prevention axis. Using the qualitative approach, through interpretative phenomenological analysis, nine semi-structured interviews were conducted with military personnel of the Republican National Guard and external entities. As conclusions, there was a greater focus on strengthening the institutional response in terms of suicide prevention, especially in post-vention. However, there is a need to optimize resources for training and post-intervention. [ABSTRACT FROM AUTHOR]

IntroductionApproximately one in five people will experience a death by suicide during their lifetime. Struggling to understand their experiences, people bereaved by suicide often require formal support including support groups, online resources and discussion forums. While previous research has focused on examining experiences of grief, little is known about the implementation of support programs for people bereaved by suicide.MethodsAdhering to PRISMA-ScR guidelines, eight databases were searched for peer-reviewed studies that focused on the strategies or evaluation of the implementation of suicide postvention programs.ResultsSixteen studies met the eligibility criteria. A narrative synthesis of study findings mapped to the Proctor implementation framework shows that a variety of implementation outcomes have been assessed by different studies; however, there is limited use of formal implementation frameworks to guide analysis.DiscussionRecommendations from this review indicate the need for consistent terminology and better utilisation of implementation frameworks to guide postvention research and provide a well-rounded view of implementation. Increasing the use of reliable and validated tools to measure implementation outcomes will also increase the rigour of implementation research in this field.Systematic review registrationhttps://doi.org/10.17605/OSF.IO/4RB92.

Suicide is a critical public health issue in the United States, recognized as the tenth leading cause of death across all age groups (Centers for Disease Control and Prevention, 2020). Despite the Islamic prohibition on suicide, suicidal ideation and suicide mortality persist among Muslim populations. Recent data suggest that U.S. Muslim adults are particularly vulnerable, with a higher attempt history compared to respondents from other faith traditions. While the underlying reasons for this vulnerability are unclear, it is evident that culturally and religiously congruent mental health services can be utilized to steer suicide prevention, intervention, and postvention in Muslim communities across the United States. However, the development of Suicide Response toolkits specific to Muslim populations is currently limited. As a result, Muslim communities lack a detailed framework to appropriately respond in the event of a suicide tragedy. This paper aims to fill this gap in the literature by providing structured guidelines for the formation of a Crisis Response Team (CRT) through an Islamic lens. The CRT comprises of a group of individuals who are strategically positioned to respond to a suicide tragedy. Ideally, the team will include religious leaders, mental health professionals, healthcare providers, social workers, and community leaders. The proposed guidelines are designed to be culturally and religiously congruent and take into account the unique cultural and religious factors that influence Muslim communities' responses to suicide. By equipping key personnel in Muslim communities with the resources to intervene in an emergent situation, provide support to those affected, and mobilize community members to assist in prevention efforts, this model can help save lives and prevent future suicide tragedies in Muslim communities across the United States. [ABSTRACT FROM AUTHOR]

Suicide among American Muslims is understudied, despite recent research highlighting increased suicide attempts among this population. While suicide is forbidden in Islam, formal guidelines for addressing and responding to suicide within Muslim communities did not exist until recently. The Stanford Muslim Mental Health and Islamic Psychology Lab has responded to a number of suicides in Muslim communities across North America and implemented an original model for suicide response and community healing. This approach incorporates Islamic principles and values to create a culturally and religiously congruent response to suicide that can support loss survivors and steer impacted communities toward healing. The Muslim Postvention Community Healing session described in this paper aims to provide a safe space for individuals impacted by suicide to come together and process their emotions, while also using Islamic teachings to guide the healing process. This unique model has the potential to serve as a valuable resource for Muslim communities across North America, and beyond, in addressing and responding to suicide. [ABSTRACT FROM AUTHOR]

This paper highlights the role of school social workers and other school-based mental health professionals in postvention activities, supports and services provided by the school following a student's suicide death. Reflecting the traumatic nature of the unexpected death of a student in the school community, the described postvention activities use SAMHSA's trauma-informed principles to frame the school's decision-making, actions, and supports for youth. Although best practice guidelines are available, most social workers have little training or practice experience in these types of services. This paper uses the authors' practice experiences supporting schools following a suicide death, postvention guidelines, and trauma-informed principles to describe a social worker's role in supporting students, staff, and the community following a death. A case study is used to illustrate this approach and provide a deeper understanding of a social worker's role following an unexpected death. This paper can support social workers in learning more about postvention needs, considering their role in postvention services, and framing a suicide death as an experience needing a trauma-informed response. [ABSTRACT FROM AUTHOR]

Survivors' adaptation to a suicide loss is likely influenced by their attitudes toward suicide and their respective sociocultural contexts. Our study aimed to compare suicide attitudes and their association with depressive symptoms and sense of community safety in Japanese and American suicide loss survivors. A total of 193 Japanese survivors and 232 American survivors completed online surveys. The results show that Japanese survivors tended not to consider suicide as an illness or to recognize that others understood their experience but were more likely than American survivors to consider suicide as justifiable. Regression analyses indicated that taking suicide as a right was associated with depressive symptoms. Further, their sense of being understood by others was positively correlated with perceived community safety in both samples, but justifying suicide and considering it to be an illness was positively related to perceived community safety only among Japanese survivors. [ABSTRACT FROM AUTHOR]

Fatal and non-fatal accidents and suicides at work pose a substantial threat to workers’ physical and psychological safety, particularly within the construction industry. Managing these incidents is an essential component of workplace health and safety (WHS). Additionally, a formal program to support workers and provide feedback to improve the existing WHS management system is increasingly important. However, knowledge of the factors contributing to an effective critical incident (CI) or postvention response is limited by the lack of published evidence-based interventions, especially for occupations and industries that are exposed to higher rates of fatal and non-fatal injuries due to accidents and suicides. In addition, broader concerns surrounding the effectiveness of conventional critical incident programs highlight the need to develop innovative and evidence-based critical intervention and postvention responses addressing acute stress symptoms arising from exposure. This research outlines the development of the MATES Respond Training Program, a component of the WHO-endorsed MATES in Construction program, which is a charity charged with the task of improving mental health and suicide prevention in the construction industry in Australia and New Zealand. Development of the MATES Respond Training Program was informed by the following three key sources: a rapid literature review, interviews with 11 workers trained in peer support suicide prevention interventions, and an analysis of site notes on 193 critical incident and postvention construction site attendances by MATES in Construction field officers, case managers and social workers. Insights and recommendations obtained from these sources, along with the resulting program, are discussed in this paper.

In this paper, we introduce a novel method for the synthesis of qualitative data and co-production in the development of evidence-based guidelines. The call for evidence-based practice in healthcare settings has been dominated by a focus on patient groups, overlooking the need for robust guidelines to inform the delivery of support or developmental interventions for staff members. We propose an eight-step method that brings together primary and secondary qualitative data with co-produced data. Data is synthesised at two of the eight stages. This method generates robust findings and recommendations which are well suited to informing written guidelines. We present our experience of implementing this method in the development of postvention guidelines for the support of National Health Service (NHS) staff following the death by suicide of a colleague. This worked example illustrates the application of the method to the generation of evidence-based, co-produced practice guidelines. We discuss the application of qualitative data and co-production in the development of fit for purpose guidelines, and the lack of transparent reporting of methods in existing guidelines. We recommend that guidelines should be underpinned by empirical evidence and developed in consultation with stakeholders and end-users, including those who will implement and those who will receive treatment or intervention. For transparency and to inform end-users, we conclude that written guidelines should always detail the methods employed in their production. [ABSTRACT FROM AUTHOR]

Suicide is a major public health issue worldwide, with approximately 46,000 individuals dying by suicide each year in the United States alone. To prepare a mental health workforce to work effectively with individuals with suicidal thoughts and behaviors, schools of social work must teach students to use evidence-based practices for suicide prevention, intervention, and postvention. This descriptive study includes undergraduate and graduate practice instructors (N = 267) at accredited American colleges and universities. Participants described their level of knowledge about 21 suicide competencies (e.g. safety planning, evidence-based interventions, means safety conversations) and then completed a survey of evidence-based practices in suicide prevention. While high levels of perceived knowledge were found in some areas, there were differences between undergraduate and graduate instructors perceived knowledge, and knowledge levels were low in areas such as culture, working with loss survivors, and means safety. Knowledge of evidence-based practices was inconsistent, with as many as half endorsing several non-evidence-based practices. Implications for schools of social work are discussed, including the need for increased leadership in suicide prevention from national social work organizations, more support for practice instructors to teach suicide content, and an increased focus on suicide postvention skills. [ABSTRACT FROM AUTHOR]

There is a collective call from the field of suicide research for studies on the individual dynamics of suicidality in order to understand the deadliness of the suicidal process. This study examines the deceased next of kin's ('survivor's) experience of the suicidal process in order to gain perspectives that can be used in the preventive care of suicidal patients. The aim of this study was to explore the suicide process through the suicide survivor's experience. The study is designed and conducted through a phenomenological, reflective lifeworld approach. Twelve in‐depth interviews concerning lived experiences of a suicide were conducted. The suicide process is described as the emerging of an obscured transformation of self, and an aligning to this changing understanding of self that forms a unique suicidal death course. This death course contains the co‐occurrence of life and death orientations. Survivors' collected knowledge of a suicidal trajectory helps us understand the life conditions of a suicidal person that has ended their life. Life orientation and experiences of self‐governance are critical parts of a suicidal trajectory and can have great preventive potential for care and assessments during suicidality. The Consolidated Criteria for Reporting Qualitative Research (COREQ) were used for the reporting structure of this article. [ABSTRACT FROM AUTHOR]

Background : Suicide rates for children and adolescents have been increasing over the past 2 decades. In April 2023, the National Institute of Mental Health (NIMH) convened a two-day workshop to address child and youth suicide. Purpose : The workshop focus was to discuss the state of the science and stimulate a collaborative response between researchers, death investigators, and data collection teams to build a science to service and service to science approach toward understanding - and ultimately preventing – this growing problem of child and youth suicide. Highlights : Topics that meeting participants highlighted as worthy of further consideration for research and practice were: increasing awareness among death investigators, medical examiners, and coroners that child suicide deaths under age 10 years do occur and should be investigated and documented accordingly; emphasizing the value of science based protocols for child and youth death investigations to enhance consistency of approaches; and articulating needs for postvention services to suicide loss survivors. Outcomes : The importance of collecting an accurate and complete cause and manner of death (i.e., unintentional, suicide, homicide, undetermined) among all child decedents, and demographic information such as race, ethnicity, and sexual/gender minority status was underscored as critical for enhanced surveillance. For prevention efforts, approaches to assessing and understanding suicidal thoughts and behaviors among diverse groups of children, and the variability in proximal and distal risk factors are needed to inform opportunities for preventive interventions for diverse communities. The need for consistent measures and processes to improve death investigations, fatality review committees, and coordination between data collection systems and agencies was also raised. Practical applications : Collaborations among researchers, death investigators, and data collection teams can help to fully describe the child and youth suicide crisis and provide actionable information for new research, and prevention and response efforts. [ABSTRACT FROM AUTHOR]

Background: Bereavement after a life partner's suicide can be a complex experience marked by a grieving process and post-traumatic reactions. Transforming the continuing bond after such a loss is a difficult but important task. Little is known about how spirituality can function in the context of continuing bonds during suicide bereavement. This study aimed to reveal how women bereaved by their life partners' suicide experience a spirituality-related continuing bond with the deceased. Methods: The sample consisted of 11 women who lost their life partners due to suicide 2–5 years ago. Participants attended semi-structured interviews. Results were analyzed using reflexive thematic analysis. Results: Five themes were generated: Feelings towards the deceased—a tribute to his life; Spirituality provides methods to continue the bond; Continuing bonds in the context of the afterlife; Continuing bonds through spiritual experiences; Spirituality as a way to not continue the bond. Conclusions: The findings reveal the complex nature of spirituality-related experiences of continuing bonds after a life partner's suicide. Spirituality, if important for the bereaved, influences how the continuing bonds are perceived and maintained. The postvention strategies should consider spirituality's role in the process of grief and continuing bonds. [ABSTRACT FROM AUTHOR]

Suicide bereavement is a significant public health concern. Using nationally representative survey data, we quantify sexual orientation differences in frequency of suicide exposure and suicide exposure-related emotional distress among US adults. We used cross-sectional data from the 2016 General Social Survey (GSS) and included sexual minority (i.e., lesbian, gay, bisexual; (n = 74, 5.3%) and heterosexual (n = 1,207, 94.7%) adults. The GSS asked several questions related to suicide exposure including number of lifetime suicide exposures, emotional distress related to suicide exposure, time elapsed since suicide exposure, and relationship(s) and perceived closeness to the person(s) who died. We use descriptive statistics to describe differences in suicide exposure characteristics across sexual orientation. Among those who were exposed to at least one suicide (n = 698, 51.1%), a weighted multivariable logistic regression model examined the association between sexual orientation and suicide exposure-related emotional distress adjusting for confounders. Sexual minorities reported a similar number of lifetime suicide exposures and were not significantly different from heterosexuals on other suicide exposure characteristics. However, sexual minority, compared to heterosexual, respondents experienced 3.14 greater odds of severe emotional distress related to suicide exposure (95% CI = 1.42–6.94, p =.005). Perhaps due to stigmatizing mourning experiences, sexual minority adults are particularly vulnerable to severe suicide exposure-related emotional distress. Future research to understand the scope of sexual minority-specific bereavement support services and public policies (e.g., bereavement leave) as well as intervention development to support sexual minority adults' coping in the wake of suicide exposure is warranted. Approximately half of sexual minority US adults report a lifetime suicide exposure Sexual minority adults experience more severe suicide exposure-related emotional distress Postvention care should be tailored to meet the needs of sexual minority adults [ABSTRACT FROM AUTHOR]

Adolescent suicide is a public health issue with 15 percent of adolescents experiencing the suicide loss of a classmate, acquaintance, or friend. This article reports findings from an online survey of individuals (N = 40) who lost a peer to suicide in middle or high school. The most frequently provided school-based postvention responses were school counselors, outside grief counselors, education on depression and suicide, and assemblies. Participants identified the following student needs from schools following a student suicide death: genuineness and sincerity of response, easy-to-access supports, recognition that students need help and support, awareness that students have different needs following a death, opportunities for commemoration, and flexibility in terms of academic requirements and expectations. Implications for schools are discussed, including the importance of resources for teachers and other staff supporting students, a trauma-informed response, and the careful consideration of the balance of suicide prevention and grief. Most important, it is essential for schools to recognize the magnitude of the impact of a suicide death on students, and that students need help and support from the school. [ABSTRACT FROM AUTHOR]

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 (N¼13) 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. [ABSTRACT FROM AUTHOR]

Copyright of Klinisk Sygepleje is the property of H. Aschehoug & Co. (W. Nygaard) AS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Fifteen percent of adolescents lose a peer to suicide. Suicide exposure elevates an adolescent’s risk of depression, anxiety, posttraumatic stress disorder, and suicidality. After a death, schools are faced with the task of supporting students’ grief while simultaneously preventing adverse outcomes, including suicide. Although social media is an integral component of modern adolescent life, little is known about its impact on suicide loss survivors. This mixed-methods study (N = 34) explored adolescents’ perspectives on the role of social media following a peer’s suicide death. Thematic analysis identified four themes related to social media: communication about the death, commemoration of the deceased, support and comfort, and the cause of additional challenges. Implications for schools and clinicians include the need for safe messaging, responsive communication, and education about suicide grief and self-care. [ABSTRACT FROM AUTHOR]

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Given the high prevalence rate of suicidal ideation amongst medical students, medical lecturers and specialists as gatekeepers should be well-trained in suicide prevention. There is a need for validated measures to assess gatekeeper training gains for suicide prevention. The psychometric properties of the Advanced C.A.R.E. Suicide Prevention Gatekeeper Training Questionnaire (AdCARE-Q) were evaluated for a sample of medical lecturers and specialists in Malaysia. A total of 120 participants completed 24 items in the AdCARE-Q. Analysis of variance of perceived knowledge scores was performed. Exploratory factor analysis (EFA) was conducted. Reliability was calculated. The AdCARE-Q was reduced to 15 items that fit into two factors, “self-efficacy” and “declarative knowledge.” Overall internal consistency was good with Cronbach’s alpha = 0.84. The intraclass correlation coefficient between groups from the psychiatry department and non-psychiatry departments was good at 0.80. The oldest age group and participants from the Psychiatry department scored significantly higher than other groups in perceived knowledge of suicide prevention. This study found that the AdCARE-Q has adequate psychometric properties to assess suicide prevention gatekeeper training gains amongst medical lecturers and specialists. Confirmatory factor analysis is recommended for future studies. [ABSTRACT FROM AUTHOR]

Background: Examine the impact of suicide on staff, current workplace responses and the efficacy of a new, systemic model of workplace postvention. Aims: Examine the impact of suicide on staff, current workplace responses and the efficacy of a new, systemic model of workplace postvention. Method: Every participant had experienced the suicide of a client or colleague and reported a range of short- and long-term negative impacts, including suicidal ideation. This contrasted with the overall lack of workplace postvention, which increased the risks of psychosocial harms to staff. The new model was effective in tailoring a systemic approach to workplace postvention. Results: Every participant had experienced the suicide of a client or colleague and reported a range of short- and long-term negative impacts, including suicidal ideation. This contrasted with the overall lack of workplace postvention, which increased the risks of psychosocial harms to staff. The new model was effective in tailoring a systemic approach to workplace postvention. Limitations: The small size of the sample limits generalizability; however, the prevalence of exposure to suicide and lack of workplace preparedness were strikingly consistent. Conclusion: The impact of suicide on staff is significant and current workplace responses are ineffective and potentially harmful. The new model improves staff and workplace preparedness through tailored and co-designed training, governance and supports.

BackgroundPostvention is a core component of suicide prevention strategies, internationally. However, the types of supports provided to people impacted by suicide vary widely. This study examines the perceived effectiveness of the Primary Care Navigator (PCN) model for people bereaved by suicide. The PCN model was implemented in response to a suicide cluster. It is an active outreach postvention intervention, initiated by police in response to a suspected suicide and links individuals to support in the immediate aftermath of their loss.MethodsA retrospective cross-sectional mixed methods approach was used to (1) identify the reach of the PCN model, (2) describe the type of support provided to people bereaved by a suspected suicide and (3) identify the perceived effectiveness of the PCN model from the perspective of WA police, postvention stakeholders and individuals bereaved by suicide. Quantitative data was used to examine the characteristics of suicide in the region, the characteristics of people who received bereavement support, and the types of support that were provided. Interviews with police, postvention stakeholders, and people bereaved by a suspected suicide were conducted to identify the perceived effectiveness of the intervention.ResultsBetween 1 January 2019 and 31 March 2021 there were 80 suspected suicides. Active outreach was provided to 347 bereaved individuals via the PCN model. Just under half of those who were offered outreach accepted further support (N = 164) in the form of suicide bereavement information (98%), mental health or clinical support (49.6%), specialized postvention counseling (38.4%), financial assistance (16%) and assistance with meals (16%), followed by housing assistance (14%) and referral to community services (11%). Police, stakeholders, and people with lived experience of a suspected suicide perceived the PCN model to be effective at connecting them to the community, linking people to support, and preventing suicide.ConclusionThe results provide evidence supporting the perceived effectiveness of an active outreach approach to postvention that provides acute support to people bereaved by suicide. Findings highlight important practical areas of support such as providing referral pathways and information on grief and suicide loss in the immediate aftermath of a suicide loss.

Background: Those bereaved by suicide are a high‐risk group of adverse health outcomes and suicidal behavior, yet little is known about the experiences and support needs of these individuals in the UK. Methods: We conducted a national cross‐sectional study using an online survey and analyzed the experiences of 7158 participants who had been bereaved or affected by suicide. Results: Suicide had a major impact on 77% of participants, including those who had lost a friend and those exposed to suicide at a professional level. Mental and physical health problems linked to the suicide were reported in half. Adverse social outcomes and engaging in high‐risk behaviors following the suicide were common. Over a third reported suicidal ideation and 8% had attempted suicide as a direct result of the suicide loss. Most had not accessed support services, with the majority viewing provision of local suicide bereavement support as inadequate. Conclusions: Our results highlight the need for a multi‐disciplinary approach in postvention and the provision of proactive outreach to support those bereaved by suicide. Postvention efforts need to acknowledge the death of a friend by suicide as a significant loss. [ABSTRACT FROM AUTHOR]

India has a significant number of people exposed to suicide. The traumatic effects of these experiences, and the healing process of suicide survivors are poorly understood. We investigated suicide survivors’ experiences and post-suicide healing. Interviews were conducted with suicide survivors who received different types of support—home visits before COVID-19 and telephonic outreach during lockdown. Two researchers used “active listening” and “human capacity for response” theory for deductive and inductive coding. Personal and socio-cultural factors affect recovery after suicide. Protective factors include religious or spiritual beliefs, as well as a sense of life purpose. Factors that hinder recovery include lack of social support, unmet need for compassionate understanding, insufficient acknowledgment of personal struggles, and social stigma. Interventions for suicide survivors should consider personal and cultural factors, including psychological and religious needs. Interventions should create safe environments that allow individuals to draw on personal and social resources for healing. [ABSTRACT FROM AUTHOR]

The loss of a friend or family member to suicide, i.e., surviving suicide, can be devastating. Yet, little is known regarding the support received by survivors of suicide. We aimed to examine the characteristics of survivors of suicide who sought counseling from a Danish volunteer organization. Data on all users of the Danish Network for those Affected by Suicidal Behavior (NASB) were obtained during 2012–2018. Information on age, sex, relation, time of loss, municipality was analyzed, and geographical driving distances calculated. Altogether, 1,268 survivors of suicide (mean age 43.3; 29.8% of all suicides) received counseling from NASB. In all, 81.8% of service users had lost a partner or first-degree relative; those being spouses/partners (15.3%), parents (28.5%), children (19.0%), and siblings (15.4%). Female service users (71.1%) outnumbered males (28.7%). A third of users sought counseling within 6-months of the death. A help-seeking rate of 6 users per 10 suicide deaths was found within close proximity to a counseling venue; equivalent of 5.5 (95% CI: 5.0–6.0) users per 100,000 inhabitants. Each additional 10 km of driving distance was associated with a 15% lower rate of use (b: −0.015; 95% CI: 0.027 to 0.003; p = 0.013). Geographical proximity to help centers was important and could suggest that support might be lacking in some parts of the country. It seems likely that more than 0.6 persons per suicide might seek counseling from volunteer organizations if services were available within short driving distance. More than one out of three who sought support after a suicide death were partners or first-degree relatives and only a third of users who sought counseling did so within 6-months of the death. Also, female sought counseling more frequently than males. Approximately 5.5 people per 100,000 inhabitants sought help after a suicide in areas where a counseling venue was within short driving distance. Based on the region with most counseling venues, 6 survivors would seek support per 10 suicide deaths. [ABSTRACT FROM AUTHOR]

Youth suicide continues to be a significant public health issue, with especially elevated levels of suicide thoughts and behaviors experienced by marginalized students across race/ethnicity, gender, sexual orientation, and age demographics. This article highlights the importance of contemporary research informing and advancing professional efforts and also introduces a special topic section including eight articles that focus on key gaps in the literature related to mitigating suicide risk among youth in schools. Four survey studies and one systematic review aim to identify risk and protective factors for marginalized and understudied populations, with strong emphasis on cultural considerations around youth suicide; two studies center on the development and evaluation of school-based suicide prevention programs, with a focus on warning signs, professional development, and social validity; and the final paper focuses on learning from student perspectives to improve postvention. This special topic section represents the complexity of youth suicide prevention and postvention and offers school psychologists knowledge and strategies to prevent and intervene to reduce youth suicide. The introduction closes with several recommendations for further advancing science, practice, and policy related to mitigating suicide risk among youth in schools. IMPACT STATEMENT Prevention of youth suicide requires contemporary research and program development. School psychologists can play a critical role in preventing youth suicide through culturally relevant studies, evidence-based training and curriculum, and postvention strategies. Collectively, articles in this special series strengthen the literature for guiding school psychologists in mitigating suicide risk among youth in schools. [ABSTRACT FROM AUTHOR]

This narrative recounts the experience of two social workers who lost a client to suicide. Our similar experiences with grief and loss, shifts in professional identity, and tipping points towards healing are discussed. Through sharing two independent stories, we the authors hope to impart insights gained from these experiences and prepare both new and seasoned social workers as we treat high risk clients. The healing process is one which includes reflection, acceptance, and finding intrapersonal resolution. Recommendations for the surviving clinician and the broader field are shared to continue the conversation within the profession about surviving client suicide. [ABSTRACT FROM AUTHOR]

Mental health social workers often work with clients experiencing suicidal ideation. It is not uncommon for social workers to experience the suicide of a client. Social workers may experience guilt, shame, anxiety, and depression following a client suicide. Agencies play a prominent role in influencing how social workers will cope with a client suicide. This paper reflects on my experience when my client died by suicide. Agencies can ensure a supportive environment by having a clearly developed plan in place before a client suicide occurs. Agency policies and procedures should outline what steps to take and how to provide support to staff during a client suicide crisis. Social work leaders can decrease adverse reactions of social workers who have experienced a client suicide by implementing recommended procedures. Agency policies that focus on supporting the social worker after a client suicide influence how staff cope and promote a positive workplace culture. [ABSTRACT FROM AUTHOR]

Objectives: People bereaved by suicide represent a vulnerable population, but postvention still lacks evidence-based resources to support them. Mindfulness and self-compassion–based interventions have proven effective in countering depression, PTSD symptoms, and traumatic bereavement, and may also be beneficial in suicide postvention. To assess the effectiveness of Panta Rhei, a short, intensive, mindful self-compassion-based intervention for people bereaved by suicide, we evaluated baseline and follow-up levels of psychological distress, mindfulness, and self-compassion in participants and a control group. Methods: The intervention was a non-randomized trial conducted with 147 people bereaved by suicide of whom 97 participated in a short 16-h intensive experiential intervention. Each of them completed the Self-Compassion Scale (SCS), Five-Facet Mindfulness Questionnaire (FFMQ), and Profiles of Mood States (POMS) 4–6 days prior to and after the intervention. Results: Psychological distress significantly decreased in all areas evaluated by POMS. Participants also showed a significant increase in the FFMQ subscales Observe, Describe, Non-judge, and Non-react, in the SCS Self-Kindness subscale, and in overall Self-Compassion as inferred from significant group*time interaction effects. Sociodemographic, grief-related variables, SCS, and FFMQ at baseline did not correlate with changes in participants' psychological distress. Conclusions: Despite being limited by the lack of randomization for ethical reasons and the high prevalence of highly educated females in the control and intervention groups, this study illustrates the effectiveness of a short, intensive, mindful self-compassion-based intervention for a self-selected group of people bereaved by suicide. [ABSTRACT FROM AUTHOR]

Suicide is a leading cause of death for school-aged preteens and adolescents and a growing risk for younger children. Schools are the ubiquitous institutional context serving this age group. These trends suggest a need for knowledge and guidance related to school postvention efforts, yet the available research is limited. Focusing on postvention, or the period after a peer suicide occurs, is critical to youth suicide prevention because this is a time of elevated suicide risk for youth. Targeted postvention interventions in schools can mitigate youth suicide risk and limit contagion within a school's student body. This article explores the scientific literature related to school-based suicide postvention, describing the strength and limits of research supporting common recommendations for suicide postvention in schools. It identifies widespread recommendations for school postvention that have only preliminary supportive evidence and notes several areas in need of additional research. With clearer postvention best practices to guide their suicide crisis preparedness plans and postvention procedures, schools can better support students, families, and the community as a whole in order to prevent further tragedies. [ABSTRACT FROM AUTHOR]

Abstract 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.

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Family members of a person who has died by suicide are at an increased risk of experiencing depression, post-traumatic stress disorder, suicide ideation, and suicide. However, despite the experience of losing a family member to suicide, most families continue to function and even live well following this difficult experience. This study sought to understand and describe the transformation process that occurs in family member survivors using a grounded theory approach. Seven families, who experienced the loss of an adolescent in their family by suicide, participated in this qualitative study that used a grounded theory methodology. The results describe the transformation process experienced by the family, one of growth and learning, even though the wound from their tragic loss was still present. According to the grounded theory developed in this study, the suicide is a cataclysm, followed by a sinking period that is tempered by the presence of lifebuoys, which are supports that can be found within the families or from people around them. It is necessary for family nurses to understand this transformation process to better support surviving family members and improve suicide postvention care. [ABSTRACT FROM AUTHOR]