Support received after bereavement by suicide and other sudden deaths: a cross-sectional UK study of 3432 young bereaved adults

Objective: To test the hypothesis that people bereaved by suicide are less likely to receive formal or informal support than people bereaved by other causes of sudden death. Design: National cross-sectional study. Setting: Adults working or studying at any UK Higher Education Institution (HEI) in 2010. Participants: 3,432 eligible respondents aged 18-40 bereaved by the sudden death of a close friend or relative, sampled from approximately 659,572 bereaved and non-bereaved staff and students at 37 of 164 UK HEIs invited to participate. Exposures: Bereavement by suicide (n=614; 18%), by sudden unnatural causes (n=712; 21%) and by sudden natural causes (n=2106; 61%).Main outcome measures: Receipt of formal and of informal support post-bereavement; timing of valued support. Results: 21% (725/3432) of our sample of bereaved adults reported receiving no formal or informal bereavement support, with no evidence for group differences. People bereaved by suicide were less likely to have received informal support than those bereaved by sudden natural causes (adjusted odds ratio (AOR) = 0.79; 95% CI=0.64 to 0.98), or unnatural causes (AOR=0.74; 95% CI=0.58 to 0.96), but did not differ from either comparison group on receipt of formal support. People bereaved by suicide were less likely to have received immediate support (AOR=0.73; 95% CI=0.59 to 0.90) and more likely to report delayed receipt of support (AOR=1.33; 95% CI=1.08 to 1.64) than people bereaved by sudden natural causes. Associations were not modified by gender, or age bereaved, but became non-significant when adjusting for stigma. Conclusions: People bereaved by suicide are less likely to receive informal support than people bereaved by other causes of sudden death, and are more likely to perceive delays in accessing any support. This is concerning given their higher risk of suicide attempt and the recommendations within suicide prevention strategies regarding their need for support. Study registration: http://www.ucl.ac.uk/psychiatry/bereavementstudy/