One of the most unsettling statements in the recently released U.S. national guidelines Responding to Grief, Trauma, and Distress After a Suicide* is this:
Hardly any research has investigated treatments specifically tailored to suicide loss survivors.
It is unsettling because more than 40,000 people die by suicide in the United States every year (more than a million fatalities worldwide), and it seems clear that
• experiencing another's death by suicide can have an inordinately negative impact on survivors and
• the experience of bereavement for many people is uniquely shaped by a suicide.
The guidelines' Strategic Direction 4 does outline a thoughtful approach and priorities for the research that is sorely needed on behalf of loss survivors. In addition, the overarching research strategy for suicide prevention does mention the suicide bereaved as potentially worthy of study regarding interventions for suicide risk (but does not touch upon research related to the grief support needs of survivors).
Another hopeful avenue of pursuit is called for in the guidelines, which state that one of the three high-priority challenges is to "strengthen suicide postvention with proven grief support principles and practices":
Suicide grief support is an emerging field of practice poised to gain strength from newer understandings of bereavement adaptation in thanatology, for example, Dual Process Model, Two-Track, and meaning reconstruction models ... and from the growing evidence base that supports them ... It is essential to advance purposeful communication and collaboration among all disciplines working to support the bereaved -- especially those focused on addressing the effects of every manner of sudden or traumatic death.
Even if the foundation is being laid for progress both in research on interventions to help survivors cope with grief after suicide and in allying suicide grief support efforts with the field of bereavement support in general, there is still a gap between the state of knowledge and practice and the recommendation from the guidelines "that services for the suicide bereaved [be] implemented based on evidence of their effectiveness.” The guidelines attempt to take that gap into account, at least to some degree, by asking caregivers to ensure that “where evidence-based practices are lacking ... services are congruent with widely accepted principles” (see the graphic, above).
The guidelines support service providers and program developers in making such assurances by providing an appendix with a comprehensive list of principles to guide practitioners in their work with the suicide bereaved. The principles -- based on sources such as the U.S. Center for Mental Health Service's Practice Guidelines: Core Elements for Responding to Mental Health Crises -- provide a thorough checklist of qualities that ought to operative in services designed for survivors of suicide loss.
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