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Support received after bereavement by suicide and other sudden deaths: a cross-sectional UK study of 3432 young bereaved adults
  1. Alexandra L Pitman1,2,
  2. Khadija Rantell3,
  3. Paul Moran4,
  4. Lester Sireling5,
  5. Louise Marston6,
  6. Michael King1,2,
  7. David Osborn1,2
  1. 1 UCL Division of Psychiatry, University College Medical School, London, UK
  2. 2 Camden and Islington NHS Foundation Trust, St Pancras Hospital, London, UK
  3. 3 Institute of Neurology, University College London, London, UK
  4. 4 University of Bristol, Bristol, UK
  5. 5 Independent medico-legal practice, London, UK
  6. 6 Primary Care and Population Health, University College Medical School, London, UK
  1. Correspondence to Dr Alexandra L Pitman; a.pitman{at}


Objective To test the hypothesis that people bereaved by suicide are less likely to receive formal or informal support than people bereaved by other causes of sudden death.

Design National cross-sectional study.

Setting Adults working or studying at any UK higher education institution (HEI) in 2010.

Participants A total of 3432 eligible respondents aged 18–40 years bereaved by the sudden death of a close friend or relative, sampled from approximately 659 572 bereaved and non-bereaved staff and students at 37 of 164 UK HEIs invited to participate.

Exposures Bereavement by suicide (n=614; 18%), by sudden unnatural causes (n=712; 21%) and by sudden natural causes (n=2106; 61%).

Main outcome measures Receipt of formal and informal support postbereavement; timing of valued support.

Results 21% (725/3432) of our sample of bereaved adults reported receiving no formal or informal bereavement support, with no evidence for group differences. People bereaved by suicide were less likely to have received informal support than those bereaved by sudden natural causes (adjusted OR (AOR)=0.79; 95% CI 0.64 to 0.98) or unnatural causes (AOR=0.74; 95% CI 0.58 to 0.96) but did not differ from either comparison group on receipt of formal support. People bereaved by suicide were less likely to have received immediate support (AOR=0.73; 95% CI 0.59 to 0.90) and more likely to report delayed receipt of support (AOR=1.33; 95% CI 1.08 to 1.64) than people bereaved by sudden natural causes. Associations were not modified by gender, or age bereaved, but became non-significant when adjusting for stigma.

Conclusions People bereaved by suicide are less likely to receive informal support than people bereaved by other causes of sudden death and are more likely to perceive delays in accessing any support. This is concerning given their higher risk of suicide attempt and the recommendations within suicide prevention strategies regarding their need for support.

  • suicide
  • bereavement
  • suicide prevention
  • support
  • unmet needs
  • stigma

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  • Contributors ALP, DO and MK conceived and designed the study. ALP, DO, MK, PM and LS contributed to questionnaire design and recruitment strategy. ALP recruited participants, managed the survey and collected data. ALP, KR and LM cleaned data. ALP, KR, LM and DO conducted data analysis. ALP, KR, PM, LS, LM, MK and DO interpreted data, contributed to writing of the report and approved the final version before submission. ALP conducted the literature search. ALP had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. No participant is identifiable from the analysis or study report. ALP is the guarantor.

  • Ethics approval UCL Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Informed consent for collecting patient-level data was obtained on the basis that data would be anonymised, stored in accordance with the Data Protection Act 1998, only used for the purposes of the study and not transferred to an organisation outside UCL. Requests to collaborate on analysis of anonymised data with low risk of identification should be made by contacting the corresponding author.

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