Life After Death: Suicide, Care, and Responsibility

<p>This thesis focuses on suicide bereavement, particularly of those parents who have lost children to suicide while in care of the state. I argue that, for these parents, action taken following the suicide of their children is an extension of the care that was given throughout their child’s lives. For parents of those suffering with mental health issues, care is fraught with confusion and tension. This is no more apparent than when they and their children are seeking professional care. Care is inextricably linked with responsibility, which as I will show, is a very important concept in understanding suicide prevention. Governance of regimes of care shapes bereavement through biopolitical responsibilisation. The conflict found within understandings of care lays the foundation for the conflated tensions that arise in suicide bereaved parents’ search for recognition and accountability of and for their child’s suicide. In this thesis I explore these actions to understand the motives and desires of these parents. In exploring these, meaning becomes a useful analytical lens, for meaning, care, and the projects that my participants undertake in search of answers were all intimately linked. Through understanding the actions of bereaved parents as an extension of the care for their children we can understand how these actions are shaped by the governance and regimes of care within New Zealand.</p>

Life After Death: Suicide, Care, and Responsibility

<p>This thesis focuses on suicide bereavement, particularly of those parents who have lost children to suicide while in care of the state. I argue that, for these parents, action taken following the suicide of their children is an extension of the care that was given throughout their child’s lives. For parents of those suffering with mental health issues, care is fraught with confusion and tension. This is no more apparent than when they and their children are seeking professional care. Care is inextricably linked with responsibility, which as I will show, is a very important concept in understanding suicide prevention. Governance of regimes of care shapes bereavement through biopolitical responsibilisation. The conflict found within understandings of care lays the foundation for the conflated tensions that arise in suicide bereaved parents’ search for recognition and accountability of and for their child’s suicide. In this thesis I explore these actions to understand the motives and desires of these parents. In exploring these, meaning becomes a useful analytical lens, for meaning, care, and the projects that my participants undertake in search of answers were all intimately linked. Through understanding the actions of bereaved parents as an extension of the care for their children we can understand how these actions are shaped by the governance and regimes of care within New Zealand.</p>

Lived Lives at Fort Dunree: a rural Irish community perspective

Background: Elevated suicide rates have alarmed policy makers and communities. In these circumstances, the value of understanding more about communities and their potential role in suicide intervention is becoming more apparent. This study involved evaluating feedback from individuals with and without previous suicidal thinking who participated in an arts-science rural community-based intervention project around suicide in County Donegal, Ireland (Lived Lives at Fort Dunree). Methods: A combined quantitative and qualitative questionnaire was used to evaluate individual and community responses to the Lived Lives project. Results: Participants (n = 83), with and without a mental health history and previous suicidal ideation, reported they believed Lived Lives could have potential to help suicide-bereaved families, people with mental illness and people with suicidal thinking. Qualitative results suggested its’ suitability for specific groups affected by suicide. Discussion: The evaluation of the Lived Lives project indicated that supervised, “safe-space” community intervention projects around suicide have inherent value with positive impacts for bereaved individuals and communities, including those who have experienced suicidal feelings. Future research should explore the transferability of these findings to other communities, and at-risk groups.

Forgotten but not gone: A heuristic literature review of sibling suicide bereavement

INTRODUCTION: It is often said that Aotearoa New Zealand suffers from a “culture of silence” around suicide. The sibling experience, it seems, forms a silence within that silence. Suicide- bereaved siblings face what has been termed a “double loss.” Their sibling is gone, and sois their family as they knew it. Typically, they mourn both losses in isolation, the “forgotten bereaved.” Although Aotearoa New Zealand’s suicide rates are amongst the highest inthe developed world, there are currently no academic papers dedicated exclusively to the sibling experience of suicide loss. This has serious implications, as suicide-bereaved siblings experience significantly higher rates of mental illness compared to control groups even when pre-existing psychopathology, health problems, and social disadvantages are taken into consideration. In addition, their own risk of suicide has been found to double.METHOD: This heuristic literature review aims to clarify and summarise what research focused on the sibling experience of suicide bereavement has highlighted so far, drawing on the author’s lived experience to examine key themes of guilt, “unacceptable” anger, social stigmatisation, self-judgement, isolation, and the shattering of relational trust.FINDINGS AND IMPLICATIONS: Siblings cannot be expected to “seek” help, it needs to be offered—strongly and repeatedly. With this in mind, potential implications for mental health practice with suicide-bereaved siblings will be discussed, as well as broader social initiatives and areas in need of future research.

Using Multiple Regression Analyses to Uncover Patterns of Correlates of Grief Problems, Depression and Suicidal Ideation Among Suicide Bereaved Individuals

This analysis of a convenience sample survey of 195 suicide bereaved adults focuses on predictors of three important highly interrelated experiences among the suicide bereaved: grief problems, depression and suicidal thinking. Although each of these three experiences can be explained by a unique set of predictors, they share many commonalities. Several predictors stood out especially in either aggravating or alleviating these experiences: personal (or post-traumatic) growth, perceived social support, feelings of blameworthiness, perceived suicide stigma, years since loss and a respondent’s mental health difficulties experienced prior to their suicide loss. We also review the clinical implications of these results.

Pulling Together – The Protective Role of Belongingness for Depression, Suicidal Ideation and Behavior Among Suicide-Bereaved Individuals

Background: While belongingness has frequently been investigated in the general population as an antidote to experiencing depression, suicidal thoughts, and suicidal behavior, it has rarely been evaluated as a protective factor among individuals bereaved by suicide. Aims: We examined whether perceived belongingness could moderate the differences between suicide-bereaved, suicide-exposed, and nonexposed respondents regarding depression, suicide ideation, and suicide attempts. Method: We conducted an online survey of the adult Israeli population ( N = 806), with 203 suicide-bereaved, 266 suicide-exposed, and 377 nonexposed respondents. Participants completed several questionnaires tapping depression and suicidality as well as perceived belongingness levels. Results: Individuals bereaved by suicide reported the highest levels of depression, suicide ideation, and suicide attempts in comparison with suicide-exposed and nonexposed individuals. However, belongingness was found to moderate these distinctions concerning suicide ideation and suicide attempts. Limitations: Belongingness was assessed by only a single question, and the online survey suffered from a relatively high nonresponse rate. Conclusion: Our results suggest that belongingness may act as a potent antidote to the adverse mental health consequences among individuals bereaved by suicide. Clinicians should accord adequate attention to fostering social connectedness among their clients bereaved by suicide.

Being pro-active in meeting the needs of suicide-bereaved survivors: results from a systematic audit in Montréal

Background Suicide is a major public health concern. In 2017, the suicide rate in Canada was 11 per 100,000 inhabitants. According to literature, 1 in 5 people have experienced a death by suicide during their lifetime. The aim of this study was to describe the met and unmet needs of suicide-bereaved survivors and to provide postvention recommendations. Methods Further to an exploratory mixed-method audit of 39 suicides that occurred in Montreal (Canada) in 2016, suicide-bereaved survivors (n = 29) participated in semi-structured interviews and completed instruments to discuss and assess potential pathological grief, depression (PHQ-9), and anxiety (GAD-7), as well as health and social services utilization. A panel then reviewed each case and provided recommendations. The mean age of participants was 57.7 years and 23 were women. Results Although help was offered initially, in most cases by a health professional or service provider (16/29), 22 survivors would have liked to be contacted by telephone in the first 2 months post suicide. Four categories of individual unmet needs (medical/pharmacological, information, support, and outreach) and one collective unmet need (suicide pre/postvention training and delivery) emerged. Conclusions Although Quebec provincial services have been developed and offered to suicide-bereaved survivors in the past decade, many dwindled over time and none has been applied systematically. Recommendations for different stakeholders (Ministry of Health and Social Services, coroners, NGOs, and representatives of suicide-bereaved survivors) outlined in this study could be an interesting first step to help develop a suicide pre/postvention strategy.