Dr. Sharon McDonnell presented on the experiences and perceived needs of parents bereaved by suicide. Her research found that parents had negative experiences with professionals breaking the news of their child's death and a lack of follow up care. However, some parents reported positive interactions with doctors who were compassionate and supportive. McDonnell is developing a training program to help professionals better support those bereaved by suicide, as understanding in this area has improved but specialists services are still needed.

1. The Experiences and Perceived
Needs of Parents Bereaved by
Suicide
Dr. Sharon McDonnell
Centre for Mental Health and Risk, University of Manchester
Sharon.j.mcdonnell@manchester.ac.uk

2. Centre for Mental Health
and Risk
Suicide Prevention
• Suicide
• Self harm
• Suicide bereavement

3. Aim of the Presentation
• Describe the experiences and perceived
needs of parents bereaved by suicide
• Highlight the progress that has been
made to try and support those bereaved
by suicide.

4. Suicide Prevention
Research has three
aspects:
• Prevention
• Intervention
• Postvention (care of
those bereaved by
suicide)

5. Suicide Bereavement
• Suicide bereavement is a risk factor for suicide.
• Little is known about the experiences of those bereaved
by suicide.
• No specialist services within the NHS.
• Health professionals uncertain how to respond..
• Those bereaved feel isolated and helpless.

6. Suicide
Tip of the iceberg:
The small perceptible part
of a much larger problem
that remains hidden.
What lies beneath?

7. Statistics
• 5,000 die by suicide in England each year.
• Estimated 7-10 people are profoundly affected by
each suicide. (Lukas and Seiden, 1987)
• Translates to 35,000 to 50,000 bereaved by suicide
in England and Wales annually.
• Suicide rates are between 80% - 300% higher than
the general population. (Lukas and Seiden,1987)

8. Researchers Experience of
Suicide Bereavement

9. Parents Bereaved by Suicide
• High suicide rate amongst young men under the
age of 35 years.
• Some parents can feel suicidal and find it
difficult caring for surviving children who are
also finding it difficult to cope.

10. Aim of the Study
• Investigate the experiences of parents
bereaved by suicide
o Experiences of contact with
professionals.
o Perceived needs
o Responses to the death

11. Professionals are often uncertain how
to respond to those bereaved by
suicide.
o Psychiatrists (Brownstein,1992)
o GPs (Halligan, 2000)
o Intensive care staff (O’Dell, 1997)

12. Disillusionment with Services
• Often began whilst caring for their
suicidal child.
• Intensified with subsequent
contact both prior and after their
child’s death.

13. Findings: Parents’ perceptions
• Being informed of their child’s death.
• Professionals avoiding contact.
• Inappropriate responses to the suicide.
• Failure to refer suicidal parents to
specialist services.

14. Breaking bad news
• All parents were able to recollect
graphically their experiences of being
informed of their child’s death.
o Traumatised
o Angry
o Lasting distress (2 years post loss)

15. Breaking Bad News: Transport Police
Father found son’s suicide note and phoned the
police.
“They said “Well where do you think he‟s gone?
And I said, “I think he‟s gone on the railway, put
himself under the train (distressed). And they
said, Well that‟s exactly what he‟s done.”
(crying)

16. Avoiding contact: GPs
• None of the participants were visited by their
GP after the death.
• Every participant in the study would have
liked their GP to have visited them.

17. Avoiding contact: GPs
R: “Have you ever felt a professional has
treated your loss in an insensitive
way?”
“Well….to say nothing at all [GPs] is the
most insensitive of all.”

18. Avoiding contact: GPs
GPs at place of death
“He pronounced him dead and went. And I
never heard another word from him, not „How
are you?‟, not, „Are you suffering? Do you want
any help?‟…..nothing.”

19. GPs inappropriate responses to
the suicide
• Father
„He (GP) just said it‟s (suicide) on the
increase in the North west.‟
• Mother
His first words, (GP) „Well you know
schizophrenics tend to do that.‟

20. GPs failure to refer suicidal
parents to specialist services
Mother bereaved 20 months
R : “You said before that you‟ve felt like you wanted to
end your life?”
“Yeah, I told him [GP] that and I said, „I really need
somebody to talk to.‟ He said, „Well have you got a
friend?‟ I said, „I haven‟t [..]‟ So he said, „So there‟s
nobody you can talk to?‟ So I said, „No not really.‟ I
haven‟t had no help. I wanted somebody to talk to.
He said he‟d get in touch with them, erm a
bereavement counsellor.”

21. Disengagement with Services
Husband referring to his ‘suicidal’ wife:
“Mary went to see doctors (asking for
counselling) and they said there‟s a 3
month waiting list, so what‟s the point? I
think she‟s just give it up…..nobody
seems to be bothering.”

22. Consequences
Multiple assaults to parents assumptive world by
health professionals
• Perceive them to be insensitive and uncaring.
• Reject the NHS as a source of support.
Intensifying the parents sense of:
• Helplessness
• Hopelessness
• Isolation

23. Positive Experiences
Parents were able to recognise +ve
experiences with professionals
o Funeral directors and coroners officers
Few reported +ve experiences with
health professionals and police
o But those that did found it valuable source
of support

24. Positive Accounts of Health
professionals
P. “My ex GP he‟s known me from being 6 years of
age and he knew Rick (son). He‟s my mum‟s doctor,
he knew what had gone on and he was very upset.
He kept sending messages to me. Please tell her to
come and see me. I had to go to see him because
he‟d asked so many times.”
R. “Were you glad he was bothering though?”
P. ”Yeah, but this particular day.”

25. Continued
P. “ I was really upset and I didn‟t want to go and I didn‟t
think anybody could help me you see, and then when I
walked in, I just walked in the door and he just put his
arms around me […] He just held me really tight and he
said. “I‟m so sorry. I‟m so sad” and he was holding my
hand and I was crying you know, I was devastated.”
R. “ Did it make you feel better?
P. “Of course it did. I thought thank God… Thank God for
him.”

26. Implications
Implications for clinical practice
• Training for health professionals on how to respond to the
bereaved.
• Aim of interventions: Ensure parents remain engaged with
health professionals after the child’s death.
Negative
experiences
Findings give a vivid insight into parents’
perceptions of contact with professionals.
Reduced
contact with
Health Services
Increased
health risk?

27. NHS/Health Professionals:
To Summarise
• Our understanding of how to respond and care
for those bereaved by suicide is far behind our
understanding of other ‘at risk’ populations.
• No specialist services within the NHS.
• Currently, no specialist training in suicide
bereavement for health professionals.

28. Development of a Parental Suicide
Bereavement Training Pack
• Funded by the National Institute for Health Research
(Research for Patient Benefit)
• 3 year project (July 2011 – June 2014)
Aim
• To develop a training pack to provide health
professionals with knowledge, skills and a frame-
work in which to guide them on how to respond and
care for parents bereaved by suicide.

29. Method
Stage 2
Bereaved
parents
perspective
Stage 4
Community
mental health
teams
perspective
Stage 3
GPs
perspective
Stage 5
A&E staff
perspective
Synthesis of four stages
Development of parental suicide
bereavement training pack for
health professionals (DVD)
Stage 1
Identify
deceased and
parents

30. Recruitment
Parents
• Children aged between 16-34 years
• Subsequent suicides
• Self recruitment poster
GPs
• Would welcome guidance on how to
respond to parents

31. Timing of Current Study
• Launch of Suicide Prevention Strategy
Sept 2012
• Interest at National level (House of
Commons)

32. Suicide Bereavement: Progress Made

33. Progress Made
• 1999 DH funded the parental suicide bereavement study.
• 2002 Suicide prevention strategy identified those bereaved
by suicide as a vulnerable population.
• 2006 DH resource pack for those bereaved by suicide.
• 2008 Release of health talk on line (suicide bereavement).
• 2011 DH funding the development of a parental suicide
bereavement training pack for health professionals.
• 2012 Suicide prevention strategy: emphasis on the needs of
those bereaved or affected by suicide.

34. Resource Book for
People Bereaved
by Suicide
Provides practical guidance
for those bereaved by
suicide including health
professionals.
Suggestions that this
document could be used as
training material for health
professionals.
(DH, 2010)

35. Web based Information:
Suicide Bereavement
Healthtalkonline.org
Perceptions of
• Why the suicide took place;
• Suicide notes;
• Being informed;
• Seeing the body or not being able
to do so; and
• Suicide in prison.

36. Identifying the Needs of
Those Bereaved by Suicide

37. Going in the Right Direction
‘One way to keep
momentum going is to
have constantly
greater goals.’
Michael Korda (novelist)

38. Centre for Mental Health and Risk
• Annual suicide bereavement conference
• Develop a suicide bereavement research unit
1. Children
2. Adults
3. The offender pathway
4. Those responsible for their care
Email: sharon.j.mcdonnell@manchester.ac.uk

39. Suicide Bereavement Conference
Suicide Bereavement is Everyone’s
Business: Policy Research and Practice
Manchester conference centre
18th September 2013
Contact: sharon.j.mcdonnell@manchester.ac.uk