Despite suicide prevention being a NHS priority, little is known about the experiences of those bereaved by suicide. Existing work suggests that they are three times more likely to die by suicide than the general population and are vulnerable to a number of adverse sequelae. There is a lack of evidence regarding the services that should be provided for this group. Given that suicide by young adults has doubled in the last two decades, further research into the experiences of those bereaved by suicide is needed.
The main aim of this study was to assess the level of functioning, access to support and specific grief responses of parents whose child has died by suicide.
A qualitative study was carried out. Nineteen parents (mothers n=11, fathers n=8) of twelve deceased males aged between 19-32 years who had died in the Greater Manchester area between October 1997 to October 1999 and had either a suicide (n=8) or open verdict (n=4) returned at inquest, participated in the study. Parents were identified from the deceased’s inquest file and were all white, aged between 40 years to 67 years, and had been bereaved between one to two years. Parents were interviewed using a semi-structured interview schedule. Interpretative phenomenology was used to analyse the data.
Findings suggested that parents’ needs and grief responses begin not with the death but while caring for their suicidal child. Their high levels of distress were responses to several traumatic events including, experiences prior to the death, the death itself, assaults on their assumptive world, severe and direct challenges to their belief and attribution systems or psychological constructs – especially about their role as parents, beliefs about health services and support systems. Their coping responses varied and were not always successful, in preventing further risk of mental or physical illness. Five key themes were identified for both suicide and open verdicts: trauma, attachment, health, coping with uncertainty and the role of professionals. Based on the current findings, a parental suicide bereavement model was developed which addressed the grief responses to the loss of a child, as well as the responses to the trauma of the self-inflicted death. This study demonstrates the potential contribution that qualitative research methods could make in future suicide prevention research. It has identified issues related to the verdict returned, the deceased being unidentifiable, discrepancy between the recorded and actual date of death, paternal bereavement and a vivid insight into linking objects. It has also highlighted a number of methodological and ethical issues.
Five key themes were highlighted and a parental suicide bereavement model was proposed. An aspect of intervention might be to try and ensure that parents remain engaged with health professionals after their child’s death. Further research in different settings using a variety of methodological approaches, will help to inform treatment approaches and service provision for those bereaved by suicide.
NHS Research and Development Research Fellowship