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What are the physical and psychological health effects of suicide bereavement on family members? An observational and interview mixed-methods study in Ireland
  1. Ailbhe Spillane1,2,
  2. Karen Matvienko-Sikar1,
  3. Celine Larkin3,
  4. Paul Corcoran1,2,
  5. Ella Arensman1,2
  1. 1 School of Public Health, University College Cork, Cork, Ireland
  2. 2 National Suicide Research Foundation, Cork, Ireland
  3. 3 Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
  1. Correspondence to Ms Ailbhe Spillane; ailbhe.spillane{at}


Objectives Research focussing on the impact of suicide bereavement on family members’ physical and psychological health is scarce. The aim of this study was to examine how family members have been physically and psychologically affected following suicide bereavement. A secondary objective of the study was to describe the needs of family members bereaved by suicide.

Design A mixed-methods study was conducted, using qualitative semistructured interviews and additional quantitative self-report measures of depression, anxiety and stress (DASS-21).

Setting Consecutive suicide cases and next-of-kin were identified by examining coroner’s records in Cork City and County, Ireland from October 2014 to May 2016.

Participants Eighteen family members bereaved by suicide took part in a qualitative interview. They were recruited from the Suicide Support and Information System: A Case-Control Study (SSIS-ACE), where family members bereaved by suicide (n=33) completed structured measures of their well-being.

Results Qualitative findings indicated three superordinate themes in relation to experiences following suicide bereavement: (1) co-occurrence of grief and health reactions; (2) disparity in supports after suicide and (3) reconstructing life after deceased’s suicide. Initial feelings of guilt, blame, shame and anger often manifested in enduring physical, psychological and psychosomatic difficulties. Support needs were diverse and were often related to the availability or absence of informal support by family or friends. Quantitative results indicated that the proportion of respondents above the DASS-21 cut-offs respectively were 24% for depression, 18% for anxiety and 27% for stress.

Conclusions Healthcare professionals’ awareness of the adverse physical and psychosomatic health difficulties experienced by family members bereaved by suicide is essential. Proactively facilitating support for this group could help to reduce the negative health sequelae. The effects of suicide bereavement are wide-ranging, including high levels of stress, depression, anxiety and physical health difficulties.

  • mixed-methods
  • suicide bereavement
  • family members
  • morbidity
  • health

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  • Contributors AS drafted the initial document. AS, CL, EA and PC contributed to the design of the study. KM-S, CL, PC and EA contributed to planned analyses. KM-S, CL, EA and PC contributed to revising drafts. All authors contributed to the final manuscript.

  • Funding This work was conducted as part of the SPHeRE Programme under Grant No. SPHeRE/2013/1. We would also like to acknowledge the funding received from the Health Research Board to conduct the original SSIS-ACE case-control study, Grant No. HRA-2013- PHR-438 and the National Office for Suicide Prevention for providing funding for the supervision of this research.

  • Competing interests None declared.

  • Ethics approval Ethical approval has been granted from the Clinical Research Ethics Committee of University College Cork, reference number: ECM 4 (o) 19/01/2016. Ethical approval was also granted from the Clinical Research Ethics Committee of University College Cork, for the SSIS-ACE study, reference number: ECM 5(5) 01/04/2014.

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

  • Data sharing statement The data recorded, transcribed and analysed are very sensitive in nature. Due to the relatively small number of participants and the specific geographic location, it would not be appropriate to consider data sharing due to the risk of people being potentially identified.

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