Assistance from local authorities versus survivors’ needs for support after suicide

“The superiority of cognitive behavioral therapy over nonspecific therapies in preventing chronic PTSD has previously been demonstrated (Bryant et al., 1998).”

“However, earlier studies have shown that the non-participants might even be worse off than those who do participate in such studies (Paykel, 1983; Dyregrov, 2002).”

“Rates of primary care physician contact have been reported at 55% to 60%.(60,63) Therefore, the rates reported in the current study are likely an underrepresentation of the true population prevalence and could thus affect the representativeness of the findings, although it is unknown whether this would have preferenti…”

“Only a minority (approximately 25%) of survivors find their way to support groups or therapy in countries where this support is available (Dyregrov, 2002; Provini et al., 2000; Saarinen et al., 1999).”

“upon which this article is based was part of the study “Support and care for bereaved after suicide, SIDS (Sudden Infant Death), and accident: Evaluation of recipients and providers of care” (Abbreviated: “The Support and care study”) (Dyregrov, 2002; Dyregrov, Nordanger, & Dyregrov, 2003).”

“, [32].”

“PhD Thesis Parents of children dying suddenly Postal questionnaire survey Not applicable – PhD thesis N = 72 United Kingdom K Dyregrov [54] 2002 Assistance from local authorities versus survivors’ needs for support after suicide Parents of children who committed suicide Postal questionnaire survey with in-depth interv…”

“Among survivors of suicide, felt a need for professional mental health treatment, but only one quarter actuallycomplicated grief has been shown to be associated with a substantially greater likelihood sought out help (Dyregrov, 2002).”

“However, they also stressed that they were not seeking to become lifetime clients of a treatment system, but rather that they would like guidance toward selfhelp, which would eventually enable them to get on with their lives in the best way possible (Dyregrov, 2002; McMenamy et al., 2008; Wilson & Clark, 2005).”

“The bereaved asked for outreach and immediate assistance from trained personnel, long-term follow up, information and care for surviving children [23].”

“It is well-documented that those bereaved by suicide who experience high levels of functional and social impairments, and psychological distress, also experience barriers to helpseeking (Provini et al., 2000; Dyregrov, 2002).”

“The gradual development of research in this area has led to the improved understanding that, following unnatural deaths, bereaved individuals will need more attention and assistance than had previously been provided (Dyregrov, 2002).”

“In a Norwegian study of suicide-bereaved parents, Dyregrov (2002) found a discrepancy between what the bereaved asked for (i.e. outreach and immediate assistance, and longterm follow up) and what the services offered.”

“This percentage ranges from 15% in Norway (Dyregrov, 2002) to 76% in New York (Provini et al., 2000).”

“Our findings regarding the need for others to initiate support are similar to those from Australian [22,40] and Danish qualitative work [41] and our previously published British focus group discussion [42].”

“Postvention needs assessments in disparate regions such as Canada, Australia, Norway, and the United Kingdom (Davis & Hinger, 2005 ; Dyregrov, 2002 ; Jordan & McMenamy, 2004 ; Wilson & Clark, 2005) discuss both theoretical and instrumental issues related to peer support and recommend increased utilization of peer supp…”

“A survey conducted 14 months after suicidal deaths found that 88% of survivors felt in need of professional help but did not feel they could take the initiative because of their shock and trauma (Dyregrov, 2002).”

“, 2000) to 88% (Dyregrov, 2002) find these experiences helpful (see Jordan & McMenamy, 2004, for a review).”

“A large group stressed the importance of early and outreach support, and support over time, which also fit perfect with the ideal wishes for support as reported by the bereaved (Dyregrov, 2002, 2003-2004).”

“This project was funded by the Norwegian SIDS Society.”

“(Dyregrov, 2002) has previously been used to study people bereaved by unnatural deaths.”

“Findings from two separate studies suggest that of those who participate in postvention activities, 65–88% found supports useful; however, those who did not receive professional support showed increased amounts of guilt, grief, and lack of energy (Dyregrov, 2002; Provini, Everett, & Pfeffer, 2000).”

“Following traumatic loss situations, it is well known that people want active outreach from helpers (Dyregrov, 2002a), as has been purported as a principle within crisis and disaster intervention through many decades (Lindy, Grace, & Green, 1981).”

“Dyregrov (2002) conducted a study with bereaved survivors and found that half of the survivors felt a need for professionalmental health treatment but only a quarter sought out help.”

“…by suicide was mapped out in 1998 in the Norwegian nationwide Support and Care study, a mere one-third of the municipalities had established crisis teams, 43% had written routines for follow-up, while only 16% had such a formal system between primary and secondary services (Dyregrov, 2002).”

“There has been a profusion of articles, papers, and chapters written on suicide survivorship in an effort to understand suicide bereavement (Dyregov, 2002; McIntosh, 1993; Ness & Pfeffer, 1990).”

“Two Norwegian studies found that 70–80% of suicide-bereaved parents and adolescents reported that they needed medical or psychological care in relation to the bereavement experience [16,17].”

“Other causes of sudden death, such as suicide, have shown that 88% of bereaved relatives perceive a need for treatment, with care access rates ranging from 55% to 60% (28, 29).”

“Complications in grief and stigma may be compounded by exhaustion and a loss of energy (Dyregrov, 2002), resulting in an unwillingness to involve others in the grief process as well as reducing a survivor’s capability and likelihood that they will initiate help-seeking (McIntosh, 1993).”

“This is further exacerbated when associated with feelings of weakness, shame, guilt, selfishness and the sense of rejection often associated with the self-stigma and perceived-stigma accompanying a lived experience of suicide [29, 30].”

“This finding may be explained by research suggesting that the bereaved experience professional support as available or appropriate only in the immediate aftermath of suicide (Dyregrov, 2002), especially because over 80% of participants had become bereaved more than 1 year ago.”

“…that most suicide-bereaved individuals seek support – both formal (e.g., mental health professionals, funeral directors, clergy members) and informal, (e.g., close friends; family members; McMenamy; Jordan, & Mitchell, 2008) – others do not (Dyregrov, 2002; Provini, Everett, & Pfeffer, 2000).”

“The Assistance Questionnaire (AQ, Dyregrov, 2002) has previously been used to research people bereaved from unnatural deaths.”

“Others emphasize the strong contribution made by specific stressogenic stressors such as loss (Canetti et al., 2000), injury, availability of shelter (Dyregov, 2002) and shortage of supplies (Hoven et al., 2004).”

“Survivors often feel the need for professional help but rarely seek it (Dyregrov, 2002; Provini, Everett, & Pfeffer, 2000), finding it hard to start searching for help (McIntosh, 1993), and frequently dropping out of treatment (Dunne, McIntosh, & Dunne-Maxim, 1987).”

“K. Dyregrov (2002).”

“As in previous studies (Dyregrov, 2002), suicidebereaved siblings asked for immediate, outreaching, and repeated contact.”

“In line with this, the results showed high values for almost all perceived negative consequences at the time of the relatives’ suicide, that is, Depressed mood, Meaninglessness, Anxiety, and so forth (Table 4; cf. Dyregrov, 2002; McMenamy et al., 2008).”

“In another study that utilized a Norwegian sample of 179 parents who lost a child to a violent loss, nearly 88% expressed a need for professional intervention, but with little indication of what type of intervention or for what purpose (e.g., "moving on", symptom reduction, psychiatric medication; Dyregrov, 2002).”

“P i e t il ¨ a ( 2002 ) I n t e r v i e w s w i t h p a r e n t s a nd ( a du l t) c h il d r e n c o n c e r n i n g t h e i r e xp e r i e n c e o f a ( r e s p e c t i v e ) f a m il y m e m b e r ’ s s u i c i d e a nd t h e r e f o r e n o t g e n e r a li s a b l e t o o t h e r e xp e r i e…”

“This is in line with the needs of community personnel relating to families in grief (Dyregrov 2002).”

“If rejected because the support measure came too early, a later offer should follow if they reject the offer the first time around (Dyregrov, 2002).”

“The term psych-ologist is used synonymously with psychother-apist in Norway (Lye, 2008).”

“To some extent, the bereaved connect the lack of help and understanding to stigmatising attitudes from professional helpers (Dyregrov, 2002; Titlestad, Lindeman, et al., 2021).”

“Contrary to Provini et al. (2000), some studies (e.g., Dyregrov, 2002; Davis & Hinger, 2004) found that survivors expressed considerably greater levels of perceived and unmet needs for services and support.”

“In such cases, media is often perceived as a tool in stigma reduction or public education (Dyregrov, 2002; Queensland Department of Communities, 2008).”

“This public health approach to postvention is warranted given previous research shows that 95% of bereaved individuals believe they need help accessing support, yet <50% of bereaved people actually receive it (20, 21, 23), despite multiple points of contact (e.”

“…is directed to North American models for suicide ‘postvention’ supports for survivors (Campbell, 1997; Campbell, Cataldie, McIntosh & Millet, 2004; Dyregrov, 2002; Maples, Packman, Abey et al., 2005; Shneidman, 1972; Wilson & Clark, 2004), and initiatives under the National Suicide Prevention…”

“It is fair to note that a significant proportion of people bereaved by suicide report that they need additional support beyond that provided by family and friends (Clark & Goldney, 2000; Dyregrov, 2002; Provini et al., 2000).”

“For these survivors, the grief process may have negative consequences, with the risk of both physical and mental health ramifications being magnified (Dyregrov, 2002; Erlangsen et al., 2017; Jordan, 2001; Mcmenamy, Jordan, & Mitchell, 2008; Schneider, Grebner, Schnabel, & Georgi, 2011).”

“Studies with suicidally bereaved parents in Norway (Dyregrov, 2002) and next-of-kin in New York City (Provini et al.”

“…from self-selected (non-representative) samples suggest that as many as half of survivors of suicide may have received formal support after the loss (Pitman, Rantell, Marston, et al., 2017; Provini et al., 2000) but their needs for help are not always met (Dyregrov, 2002; Wilson & Marshall, 2010).”

“In the case of suicide bereavement, the available literature suggests a need for professional intervention (Dyregrov, 2002; Provini & Cynthi, 2000), though limited guidance is available to shape the content or goals of intervention.”

“Concerning these gaps, Dyregrov (2002) acknowledged survivors’ idealised support, disparity in perceptions of support received and provided and shortcomings in organisational services that should provide help for vulnerable persons.”

“In addition, bereaved parents require early qualified help not just for themselves but for their children in particular [23,24].”

“These arguments constitute the base for our immediate-SEIB intervention and are in line with our clinical and research experience, showing bereaved people ask for immediate assistance [22,29].”

“Trained personnel should meet and assist bereaved families with their particular needs, stressing that grief is normal, individual, may be long-lasting and affects the whole family (Dyregrov, 2002 Dyregrov & Dyregrov, 2008; Dyregrov et al., 2015; Gijzen, L’Hoir, BoereBoonekamp, & Need, 2017).”

“Bereaved adolescents and young adults may need help from several groups, including their social networks, peers with similar experiences, and healthcare services (Dyregrov, 2002, 2009; Dyregrov & Dyregrov, 2007).”

“%) indicated a need for professional help, while around half the sample indicated that they had received formal help [6, 7].”

“Earlier research has further pointed out that the bereaved report higher satisfaction with help when it is flexible and has a focus on psychological and emotional needs (Dyregrov, 2002; Dyregrov & Kris-tensen, 2021; Kalsås et al., 2023).”

“The Assistance Questionnaire (AQ) (Dyregrov, 2002) has been used in previous studies to assess individuals bereaved by unnatural deaths.”

“Past research has shown similar results when working with different populations such as parents, where support from a psychologist was the most desired, yet most frequently missing (Dyregrov, 2002; Jordan, 2001).”

“…to help this group, and although we do not know whether the intervention reduces the risk of complicated grief or other health-debilitating conditions resulting from the terror deaths, it is very much in line with what those bereaved after unnatural deaths emphasise to be helpful (Dyregrov, 2002).”