Parents who have lost a son or daughter to suicide

Parents who have lost a son or daughter to suicide risk developing psychological ill-health that can become long-lasting and, in the worst case, life-threatening. Despite this risk, there is a lack of knowledge about the parents’ needs for professional help after a child’s suicide. We currently know very little about which interventions are helpful after a child’s suicide; the help that is offered depends on who one is lucky or unlucky enough to meet and at what time of day the death occurs. Meeting a parent who has lost their child to suicide can be difficult and both bereaved persons and clinicians are calling for recommendations that can be used for support. One reason for the lack of research in this area is that studies that include traumatised persons are often hindered by the fear that they will suffer as a result of the contact; another reason is methodological difficulties. This project started, therefore, by developing a method to be able to carry out a population-based study in an ethical and methodological way with a focus on the psychological ill-health of parents who have lost a child to suicide and their need for professional support.

The overall aim of our research is to acquire knowledge that can be used to improve the professional care of parents who have lost a child to suicide.

Method

We created hypotheses, questionnaires and an ethical protocol for contact and research participation in a qualitative feasibility study that included 46 suicide-bereaved parents. We then identified all parents who had lost a child (aged 15-30 years) to suicide during the years 2004 to 2007 and a matched (1:2) control group of non-bereaved parents from population registers. Contact was established with 1410 of 1423 parents, and 666 (73%) suicide-bereaved and 377 (74%) non-bereaved parents participated in the study by answering the respective questionnaires.

Hypothesis tests are ongoing. To date, eight articles have been published, six from the parent study and two from the sibling study. For detailed results, please see the articles on DIVA.

Results

Our interpreted results, that build on the parent study together with results from previous studies, suggest that parents who have lost a son or daughter to suicide:

• Can be included in studies if the research is methodologically and ethically designed
• Are capable of deciding for themselves whether they want to participate or not in this type of study
• Want to be contacted by the healthcare services to be offered help and support
• Can be helped by interventions that reduce psychiatric problems, such as depression, especially among those who have an increased vulnerability due to previous psychological ill-health
• Those who suffer from previous psychological ill-health are at high risk of developing depression
• Can choose whether they want to see their child's body or not, given that they have received adequate information/support, and that their decision to see or not to see can be supported by the relevant professionals
• Those who seek advice about whether to see their child’s body or not can be informed that previous research suggests that most parents who choose to see their children do not regret their decision and that almost all of those who saw their child thought that this was valuable
• Those who seek advice and who are hesitant to see the child’s body can also be informed that seeing the body does not seem to improve long-term psychological health
• Those who had found the child’s body do not have a higher incidence of long-term psychological ill-heath compared to those who did not find the body.
• The great trauma of losing a child to suicide is associated with long-term psychological ill-health. The incidence does not seem to be affected so much by the experiences in connection with seeing the child’s body.

Furthermore, our research results and previous research suggest that:

• Our ethical protocol can be used to reduce feelings of unease in connection with contact and research participation.
• Our ethical protocol can be useful for researchers and members of ethics committees prior to planning and approving research with individuals who may be particularly vulnerable.
• The high incidence of psychological ill-health among bereaved parents emphasises the need to develop interventions and recommendations that can counteract long-term psychological ill-health among parents who have lost a child to suicide.
• The knowledge that the majority of bereaved parents do not suffer from previous psychological ill-health contradicts the misconception (leading to guilt, shame and stigma) that suicide only occurs in families affected by psychological ill-health.