Many people who die by suicide leave loved ones behind who suffer from a range of painful emotions.

When it happens to someone you know

Losing a loved one to suicide can be overwhelmingly painful for family members and friends. Unlike a death that occurs naturally from old age or illness, a death by suicide is usually sudden, unexpected, and sometimes violent. The shock and trauma for survivors is further complicated by the social stigma of suicide, possible police investigations, media coverage, lack of privacy, and judgment of others in the community.

How many people it impacts each year

Research shows that at least six people are directly affected by the death, including immediate family members, relatives, neighbors, friends, and co-workers.

Given that more than 43,000 people take their lives each year, approximately a quarter million survivors are left behind, traumatized by the loss.¹

Many people who die by suicide suffered from clinical depression or other mental health disorder. The survivors may also be at risk for depression and anxiety.

Common responses

The emotional pain of survivors can be complicated, intense, and prolonged. People may feel a sense of guilt and responsibility and blame themselves for not seeing the warning signs. They may feel a profound sense of betrayal, rejection, and abandonment. Other common responses are:

• Feeling a need to make sense of the death and understand why the person made the decision to die. Even if the person left a note or a message, there are often unanswered questions that can persist for years.
• Replaying the events that took place before the person’s death and constantly second-guessing different outcomes.
• Experiencing symptoms of post- traumatic stress disorder such as flashbacks and anxiety, particularly if they witnessed the suicide or discovered the body.
• Shame and anger due to the stigma of suicide and mental illness, and possible negative community responses.

Some individuals experience intense grief that does not heal with time.

The bereaved person may feel empty, preoccupied with the death and unable to resume the activities of daily life. This type of grief, known as complicated grief, can affect from 10 – 20% of the survivors of suicide loss. If left untreated, complicated grief often persists, resulting in significant impairment and poor health outcomes.

How you can help

Sometimes people struggle with what to say or how to help a family who has lost a loved one by suicide. Helping the survivors means being a good listener and avoiding any criticism or judgments. Try to:

• Be present and listen attentively without feeling the need to provide answers.
• Avoid speculating on the reasons for the suicide or the person’s state of mind.
• Be sensitive about what you say. Avoid clichés such as “I know how you feel” or “time will heal all wounds.”

Helping the survivors means being a good listener and avoiding any criticism or judgments.

• Be compassionate and understanding, and remember that grieving takes time.
• Take the initiative to be helpful. Bring a meal, mow the lawn, or pick up groceries for the family.
• Be aware of support groups and offer to find one if the family is interested.

The grief of suicide survivors is unique and complicated by the circumstances of the death. You can help by being present as a caring friend and sounding board. Let the family know you’re ready to listen if and when they want to share their thoughts and emotions.

Help is available. For additional information, visit MagellanHealth.com/MYMH

 

1. 2014 data, released December 2015, CDC Web Based Injury Statistics Query and Reporting System (WISQARS)

 

Sources: American Association of Suicidology; American Foundation for Suicide Prevention; Harvard Health Publications

 

As we observe National Suicide Prevention Week 2017, we sat down with Dr. Shareh Ghani, vice president and medical director at Magellan Healthcare who lead Magellan’s Driving Suicide to Zero Initiative.

Magellan Health Insights: Dr. Ghani, thank you for chatting with us today. Tell us about the work you did with the Driving Suicide to Zero Initiative
 Dr. Shareh Ghani: In some parts of the healthcare community, there is a view that suicide is something ‘that just happens’; that it is unavoidable and acceptable. The Driving Suicide to Zero Initiative sought to change that paradigm. Through our efforts in a public health program, we shifted the viewpoint to one that believes that suicide can be stopped and can be driven to zero.

MHI: You have lead a number of initiatives for Magellan, what was your interest in this particular program?

SG: I have been working in mental health since 1993. From 1993 to 1995, during my residency, I had a lot of experience with suicide prevention research, and again working in community psychiatry. There is a lot of good research on the how of suicide, but I want to understand the why.

MHI: You looked at a lot of data as a part of this initiative. Tell us about that.

SG: We were managing the behavioral health contract for Maricopa County between 2007 and 2012. At the time, Phoenix had the seventh highest suicide rate in the country. The suicide rate for those with mental health issues was even higher.

During that time, we reviewed every case of completed suicide to see what could have been done differently.

MHI: What was the Driving Suicide to Zero Initiative hoping to achieve?

SG: Of course, we were looking to significantly impact suicide rates in Maricopa County. But more than that, we were looking to develop a systematized, data-driven, reproducible model.

Part of that meant preparing the clinical workforce to confidently identify at-risk individuals and improve treatment access and engagement. It also meant incorporating family and community participation to better identify early warning signs, navigate the clinical system, and support members at risk.

Finally, there was the integration of a sustainable and replicable clinical and support model and program tools into an EMR [Electronic Medical Record] to ensure that healthcare providers can, from a single source, identify, manage and plan for zero suicides through the safe management of those at risk.

MHI: And what were the results of the initiative? Was it successful?

SG: The results were highly encouraging. Between 2007 and 2012, there was a 67 percent reduction of the suicide rate for the population. Furthermore, there was a 42 percent decrease in the suicide rate of people with serious mental illness.

MHI: You mentioned earlier that the suicide rate was much higher for those with serious mental illness?

SG: Yes, it is a fact that individuals suffering from severe mental illness are six to 12 times more likely to die from suicide than the general population.

MHI: If you could hope that people would take away one thing from the Driving Suicide to Zero Initiative what would it be?

SG: That employing a rigorous, data-driven, scalable and reproducible population health approach to address suicide prevention, and creating a sustainable ecology of support around the individual and the community, is possible.

The Magellan Driving Suicide to Zero Initiative successfully incorporated population surveillance, analytics, research, early detection, intervention and monitoring to shift the paradigm from crisis mitigation to early prevention of suicide.