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MENTAL HEALTH CRISIS RESPONSE PRINCIPLES APPLY TO AFTERMATH OF SUICIDE

3/2/2013

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Grief is the normal human reaction to loss -- it is not a mental illness -- yet helping people who have experienced a traumatic loss, such as when someone dies by suicide, can be informed by the principles that guide mental health practice. I believe an excellent set of guiding principles for responding to a suicide fatality, in fact, can be found in the booklet "Practice Guidelines: Core Elements for Responding to Mental Health Crises." The guidelines clearly apply to suicide loss, first of all, because they address
mental health crises [that] may include intense feelings of personal distress (anxiety, depression, anger, panic, or hopelessness), obvious changes in functioning ... or catastrophic life events.
Secondly, the guidelines -- though focused on mental health crises -- were developed to promote two goals that also are essential to responding to a suicide on behalf of those who might be affected by the death:
• Ensure that standards consistent with recovery and resilience guide ... crisis interventions.
• Replace today's largely reactive and cyclical approach to ... crises with one that works toward reducing the likelihood of future emergencies and that produces better outcomes.

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'LIVE OUT LOUD' WRITER TELLS OF TRANSFORMATION AFTER HUSBAND'S SUICIDE

2/20/2013

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In my recent post about blogs that are written by survivors of suicide loss, I'm sure I missed more than one, and I am very glad that Molly Green's blog Live Out Loud came to my attention.

Molly, whose husband died by suicide in 2010, most recently wrote in "Transformation" about attending the screening of the documentary film Transforming Loss , which features her story, along with the stories of five other bereaved people. According to a story in the Detroit News:

"Transforming Loss" documents the grief journeys of six ... people who, in the face of devastating losses, were able to transform themselves and their pain through helping others ... [Filmmaker Judith] Burdick's vision, which began as a book and evolved into a film, was to provide "an intimate view of grief that would force people to really feel and experience the whole process: from grief to healing to transformation."
Burdick, whose husband died 22 years ago in a scuba diving accident, became a psychotherapist specializing in helping the bereaved. Then she was inspired to write, produce, and direct Transforming Loss to share her discovery that "loss can fuel 'a new energy which feeds the broken parts,'" according to a Detroit Free Press article. That is certainly Molly Green's story, who sees her blog as a part of her healing journey as well as a chance to help others with their grief:
"I feel like I'm the perfect person for people to talk to about this [grief] ... It takes time, but you learn lessons of strength, compassion and acceptance. There is some joy back in my life."

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SURVIVORS TURNED BLOGGERS SHARE STORIES OF LOVE, LOSS, PAIN, HEALING 

2/11/2013

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My favorite definition of peer support suggests that survivors of suicide loss are helpful to one another because we "feel a connection":
This connection, or affiliation, is a deep, holistic understanding based on mutual experience where people are able to "be" with each other without the constraints of traditional (expert/patient) relationships.

In part, I write this blog (and do the other things I do that put me in touch with survivors) because I believe in our connection with one another as a healing force in our grief. In today's post -- to do what I can to widen the circle and hopefully strengthen that connection -- I'd like to identify some other blogs written by survivors. Below are brief descriptions of more than half a dozen blogs from people bereaved by suicide, along with a quote from one of the posts in each blog.

The Alliance of Hope for Suicide Survivors Blog is a reflection of Ronnie Walkers' commitment to spreading the word about the needs of the suicide bereaved and about the help that's available to meet those needs (Ronnie, AOH's executive director, lost her stepson to suicide). There are several fresh posts by a variety of authors every week on the AOH blog, such as "Learning along the Journey" by Susan Futterman Paroutaud, who writes only six months after the suicide of her husband:
I've learned still more since his death ... that I could have only done what seemed appropriate at the moment, and no more. I could not have controlled him nor would I have wanted to. And I have come to realize that an infinite number of crossroads stretched before the both of us.

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HERE IS THE BEST BRIEF INTRODUCTION TO SUICIDE BEREAVEMENT

2/7/2013

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Anyone who quickly needs to know (or share with someone else) the most essential information about suicide bereavement can do so in one click with this introduction to suicide grief support. (To link people to this post, use the short address bit.ly/suicidebereavement.)

The introduction is free and has been reviewed by experts in the field. It covers
• recommendations on how to be helpful to someone who has lost a loved one to suicide (for example, promote a sense of calm by listening patiently to the survivor);
• descriptions of the most common issues and emotions survivors face in the aftermath of a suicide (for example, distress over questioning why this happened);
• symptoms of possible reactions to trauma (for example, being "on the lookout" for danger, which is called hypervigilance);
• indicators of when a survivor might need to seek professional help (for example, if someone is coping by using alcohol or other drugs);
• the key needs suicide bereaved people have after the initial crisis has passed (for example, help with activities to remember and honor the deceased); and
• information and resources on what to do if a survivor is at risk of suicide (for example, use the National Suicide Prevention Lifeline, 1-800-273-TALK/8255).

Not only is the introduction to suicide grief support authoritative and brief, but also all of its content can be downloaded for free as a slideshow or PDF document and used in presentations or as a handout (as long as credit is given to its developer). The content of the introduction was developed in collaboration with a work group of the Consumer-Survivor Subcommittee of the the National Suicide Prevention Lifeline that included a dozen crisis centers specializing in supporting the suicide bereaved.
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FREE ONLINE TOOL POINTS TO TOP SUICIDE GRIEF RESOURCES

1/17/2013

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Expert information about grief after suicide -- plus links to nearly a hundred of the top resources for survivors of suicide loss and those who care for them -- are available from the Suicide Grief Support Quick Reference. The free online tool features content that is up-to-date and dependable, including:

• Introduction - Suicide Grief Support: Explains survivors' experiences and needs, describes reactions to trauma, and covers how to be helpful
• Resources for Survivors: Links to websites, booklets, and handouts designed for survivors, and offers information on support groups, school and community postvention, and special populations (such as the military and people of color)
• Resources for Children: Lists websites, materials, and information about how to help children after a suicide
• Online Support for Survivors: Provides links to discussion forums, listservs, chat rooms, and blogs especially for survivors of suicide
• Guidance for Caregivers: Points to information on key principles as well as to resources for survivors who are also caregivers

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LEADING THINKER ON GRIEF DISCUSSES 'COMPASSION'S EDGE STATES'

1/14/2013

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In "Compassion's Edge States: Roshi Joan Halifax on Caring Better" (American Public Radio, On Being), program host Krista Tippett interviews Halifax, Abbot of Upaya Zen Center in Santa Fe, N.M., who has devoted a lifetime of work to palliative care. In the program, Halifax offers her insights on the nature of grief and on the effects caregivers experience from working with the bereaved.

The experience of grief is profoundly humanizing and ... we need to create conditions where we are supported to grieve and where we're not told, "Why don't you just get over it?" Or, "It's time" ... [There is a] loss that all of us will face in anticipation of death. It is something that brings great depth and meaning into our lives and also helps us to articulate internally our priorities. What is really important for us? So for me as a human being and not identified as a Buddhist or a woman or a Western person, but as a simple human being, I value the experience of grief.
The "Compassion's Edge State" webpage links to a more complete discussion of Halifax's ideas about "edge states" of compassion among caregivers in a talk she presented at the Library of Congress in 2011. Halifax calls one of those edge states "pathological altruism" (which is also known as "compassion fatigue," a term Halifax believes is inaccurate):

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SURVIVOR COUPLE ADVOCATES FOR THE BEREAVED IN NEW BOOK AND FILM

1/8/2013

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"Couple Hopes to Help the Suicide Bereaved" (Annette Hinkle, Sag Harbor Express) highlights Bill and Bev Feigelman's efforts to spread the word about the needs of survivors of suicide loss. The Feigelman's son Jesse died by suicide in 2002 when he was 31 years old, and his parents are now dedicated to the cause of helping people bereaved by suicide.

The article tells of the Feigelman's advocacy on behalf of people who have lost a loved one to suicide, including their "mission to convince medical schools and continuing healthcare education programs to train doctors about the importance of reaching out to the newly bereaved and offer appropriate referrals."

They are also the authors of a recent book on suicide bereavement titled Devastating Losses: How Parents Cope with the Loss of a Child to Suicide or Drugs (with co-authors John Jordan and John McIntosh), which is based on data from the largest survey ever conducted of parents surviving a child's suicide or other traumatic death.


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HELPING SURVIVORS STARTS WITH DOING 'THE LITTLE THINGS'

9/9/2012

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Don't miss Elana Premack Sandler's recent post, "Showing Support to Suicide Survivors," on her Psychology Today blog, in which Sandler, who is a survivor of her father's suicide, recounts her mother's observations about how to be helpful to people who have lost a loved one to suicide.

The kinds of things my mom shared were simple, human: a neighbor took all three of us kids into their home while my mom dealt with the EMTs and police; the EMTs and police “didn’t make it worse"; people from our synagogue helped by bringing food and assisting with funeral arrangements; a friend helped my mom sell my dad’s car and arrange for a death certificate so that she could access life insurance and survivor’s benefits.
Sandler adds her own observation about how to be helpful:
Be there. Do the little things. Don’t say something to make yourself feel better, but say something to make the person who’s just lost someone feel better. Sometimes, you don’t have to say anything at all. Let the person who’s lost someone be angry. Let her feel abandoned, which, as my mom said so thoughtfully, is “a different form of anger.” Don’t be too quick to help look for a “silver lining.”
She closes by noting that "it’s much easier to say, 'Talk about suicide' than it is to actually talk about suicide" and reminding everyone that "there’s truly no time like right now to just talk."
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'GRIEF AFTER SUICIDE' IS A 'MUST READ' FOR CAREGIVERS

8/31/2012

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Grief after Suicide: Understanding the Consequences and Caring for the Survivors, edited by John R. Jordan and John L. McIntosh, is a groundbreaking book featuring in-depth coverage of every aspect of suicide grief support. The book's goals, according to its editors,

are to establish not only what is known about suicide survivors and postvention efforts to assist them, but also to draw attention to vital information that is not known but would help us to better understand and assist survivors of suicide ... [including] recommendations for future research and postvention goals for the future.

The editors and more than 40 contributors to the book's chapters solidly accomplish those goals, covering in-depth and comprehensively the most up-to-date information about an impressive range of topics of interest to people working with the suicide bereaved. The editors begin by asking and attempting to answer several fundamental questions:



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U.S. PRACTITIONERS CALLED UPON TO IMPROVE SUICIDE GRIEF SUPPORT NATIONALLY

5/28/2012

 
Note: Anyone who works in the field of suicide grief support is invited to read the "Suicide Bereavement Caregivers Statement of Purpose" and comment on it here.

This Memorial Day -- in honor of all of who have died by suicide and those who mourn their loss -- a call to action, the "Suicide Bereavement Caregivers Statement of Purpose," is being delivered to grief practitioners across the United States, including
  • funeral professionals, 
  • clergy, 
  • law enforcement personnel, 
  • emergency medical services workers,
  • crisis workers, 
  • mental health practitioners, 
  • grief counselors, 
  • support group facilitators, 
  • educators, 
  • researchers, 
  • physicians, and 
  • military personnel.
Designed as a rallying cry "to make certain that people bereaved by suicide receive the help they need, when and where they need it, in ways that increase their capacity and opportunity to live full and fruitful lives," the Statement of Purpose outlines what it will take to establish strong suicide grief support services across the country: 
  • Suicide bereavement "programs, policies, and services" must be included in "a comprehensive national response to suicide."
  • Communities' postvention efforts must be strengthened through "collaboration among everyone with a stake in suicide bereavement services."
  • Community-based suicide grief support that is "accessible, proactive, age-appropriate, culturally sensitive, effective, and sustainable" must be implemented nationally.
  • Research must be pursued to develop "an evidence base for effective grief interventions and other tools" to help survivors of suicide loss.
  • The public must be educated through information that accurately depicts the causes of suicide and its impact on individuals, communities, and society.
The document was authored by practitioners who have spoken out for years on behalf of improved services for survivors, several of whom now serve on the Survivors of Suicide Loss Task Force of the National Action Alliance for Suicide Prevention, which is a newly formed group with the following goal:
Develop consensus guidelines for the creation and implementation of effective, comprehensive support programs for survivors of suicide loss. The Guidelines will serve as a crystallizing benchmark for organizations, communities, states, and the nation for the development of a support infrastructure for survivors of suicide loss.
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