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Matthews LR, Quinlan MG, Bohle P. Posttraumatic Stress Disorder, Depression, and Prolonged Grief Disorder in Families Bereaved by a Traumatic Workplace Death: The Need for Satisfactory Information and Support. Front Psychiatry 2019; 10:609. [PMID: 31543835 PMCID: PMC6728923 DOI: 10.3389/fpsyt.2019.00609] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/31/2019] [Indexed: 12/18/2022] Open
Abstract
The impact of traumatic workplace death on bereaved families, including their mental health and well-being, has rarely been systematically examined. This study aimed to document the rates and key correlates of probable posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and prolonged grief disorder (PGD) in family members following a workplace injury fatality. The hidden nature of the target population necessitated outreach recruitment techniques, including the use of social media, newspaper articles, radio interviews, and contact with major family support organizations. Data were collected using a cross-sectional design and international online survey. The PCL-C (PTSD), the PHQ-8 (MDD), and PG-13 (PGD) were used to measure mental health disorders. All are well-established self-report measures with strong psychometric qualities. Participants were from Australia (62%), Canada (17%), the USA (16%), and the UK (5%). The majority were females (89.9%), reflecting the gender distribution of traumatic workplace deaths (over 90% of fatalities are male). Most were partners/spouses (38.5%) or parents (35%) and over half (64%) were next of kin to the deceased worker. Most deaths occurred in the industries that regularly account for more than 70 percent of all industrial deaths-construction, manufacturing, transport, and agriculture forestry and fishing. At a mean of 6.40 years (SD = 5.78) post-death, 61 percent of participants had probable PTSD, 44 percent had probable MDD, and 43 percent had probable PGD. Logistic regressions indicated that a longer time since the death reduced the risk of having each disorder. Being next of kin and having a self-reported mental health history increased the risk of having MDD. Of the related information and support variables, having satisfactory support from family, support from a person to help navigate the post-death formalities, and satisfactory information about the death were associated with a decreased risk of probable PTSD, MDD, and PGD, respectively. The findings highlight the potential magnitude of the problem and the need for satisfactory information and support for bereaved families.
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Affiliation(s)
- Lynda R Matthews
- Work and Health Research Team, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Michael G Quinlan
- School of Management, UNSW Business School, University of New South Wales, Sydney, NSW, Australia
| | - Philip Bohle
- Work and Health Research Team, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
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Spillane A, Matvienko-Sikar K, Larkin C, Corcoran P, Arensman E. What are the physical and psychological health effects of suicide bereavement on family members? An observational and interview mixed-methods study in Ireland. BMJ Open 2018; 8:e019472. [PMID: 29331974 PMCID: PMC5781012 DOI: 10.1136/bmjopen-2017-019472] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
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.
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Affiliation(s)
- Ailbhe Spillane
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | | | - Celine Larkin
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Paul Corcoran
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
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Hawton K, Simkin S, Rees S. Help is at hand for people bereaved by suicide and other traumatic death. PSYCHIATRIC BULLETIN 2018. [DOI: 10.1192/pb.bp.107.018242] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Bereavement following suicide is traumatic. Guilt, shame, stigma and feelings of rejection and isolation set it apart from the sadness following other kinds of death and may make it difficult for the bereaved person to obtain help (Harwood et al, 2002; Hawton & Simkin, 2003; Beautrais, 2004). the necessary official processes surrounding death by suicide, like the police and coroner's investigations, can add to the trauma (Biddle, 2003). This may be compounded by inaccurate or insensitive media reporting. Bereaved individuals are at risk of increased morbidity from abnormal grief reactions (Mitchell et al, 2005) and suicide (Qin et al, 2002), and they often need considerable support (de Groot et al, 2006; 2007).
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Kearns M, Muldoon OT, Msetfi RM, Surgenor PWG. Darkness into light? Identification with the crowd at a suicide prevention fundraiser promotes well-being amongst participants. EUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY 2017. [DOI: 10.1002/ejsp.2304] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Michelle Kearns
- Centre for Social Issues Research, Department of Psychology; University of Limerick; Limerick Ireland
| | - Orla T. Muldoon
- Centre for Social Issues Research, Department of Psychology; University of Limerick; Limerick Ireland
- Health Research Institute; University of Limerick; Limerick Ireland
| | - Rachel M. Msetfi
- Centre for Social Issues Research, Department of Psychology; University of Limerick; Limerick Ireland
- Health Research Institute; University of Limerick; Limerick Ireland
| | - Paul W. G. Surgenor
- Pieta House; Centre for the Prevention of Suicide and Self-Harm; Dublin Ireland
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Shields C, Russo K, Kavanagh M. Angels of Courage: The Experiences of Mothers Who Have Been Bereaved by Suicide. OMEGA-JOURNAL OF DEATH AND DYING 2017; 80:175-201. [PMID: 28882098 DOI: 10.1177/0030222817725180] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Despite the increasing number of people being bereaved by suicide, little is understood concerning the experiences of those bereaved by suicide as they struggle to make sense of a loved one's death. The current study explored the experiences of four mothers who had been bereaved by suicide and the role of support groups in the meaning-making process following bereavement by suicide. Participants were interviewed and transcribed interviews were then analysed from an interpretative phenomenological perspective. Four main themes were identified: Continuing role of the mother; A never-ending quest; Finding sanctuary; and Rising up from the ashes. These themes relate to a range of emotions following bereavement by suicide, the meaning-making process, the social context and the role of the support group. Clinical implications are discussed in relation to these findings.
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Affiliation(s)
- Chris Shields
- 1 Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Kate Russo
- 1 Queen's University Belfast, Belfast, Northern Ireland, UK
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Finlayson M, Simmonds J. Workplace Responses and Psychologists' Needs Following Client Suicide. OMEGA-JOURNAL OF DEATH AND DYING 2017; 79:18-33. [PMID: 28530495 DOI: 10.1177/0030222817709693] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This research aimed to explore the role of workplace responses in psychologists' adaptation to client suicides. Participants were 178 psychologists who completed an online self-report questionnaire which included both open and closed questions yielding qualitative and quantitative data. Fifty-six (31.5%) participants reported one or more client suicides. Mixed results were found in terms of perceived support from the workplace following a client suicide. Psychologists reported a need for more open communication in the workplace, peer supports, space to grieve, as well as opportunities to engage in a learning process. The findings have important implications for research and for understanding the role of the workplace postvention. It also raises the need for external support to be accessible for psychologists working in private practice.
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Bottomley JS, Burke LA, Neimeyer RA. Domains of Social Support That Predict Bereavement Distress Following Homicide Loss. OMEGA-JOURNAL OF DEATH AND DYING 2015; 75:3-25. [PMID: 28395645 DOI: 10.1177/0030222815612282] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Psychological adaptation following homicide loss can prove more challenging for grievers than other types of losses. Although social support can be beneficial in bereavement, research is mixed in terms of identifying whether it serves as a buffer to distress following traumatic loss. In particular, studies have not parsed out specific domains of social support that best predict positive bereavement outcomes. Recruiting a sample of 47 African Americans bereaved by homicide, we examined six types of social support along with the griever's perceived need for or satisfaction with each and analyzed them in relation to depression, anxiety, complicated grief, and posttraumatic stress disorder outcomes. Results of multivariate analyses revealed that the griever's level of satisfaction with physical assistance at the initial assessment best predicted lower levels of depression, anxiety, and posttraumatic stress disorder levels 6 months later, while less need for physical assistance predicted lower complicated grief at follow-up. Clinical implications and suggestions for future research are discussed.
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Abstract
A questionnaire was administered to a national sample of 293 people receiving the American Association of Suicidology’s Surviving Suicide to learn (a) who self-identifies as bereaved by suicide (survivors), (b) their coping strategies, and (c) what they prefer to be called. Findings suggest that (a) there are many different relationships in which people are bereaved, (b) survivors use many coping strategies, and (c) they use numerous terms to describe themselves. Implications include outreach to survivors should go beyond the immediate family, the suicide support group should not be the sole suggestion for services, and many prefer the term suicide survivor.
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Omerov P, Steineck G, Runeson B, Christensson A, Kreicbergs U, Pettersén R, Rubenson B, Skoogh J, Rådestad I, Nyberg U. Preparatory studies to a population-based survey of suicide-bereaved parents in Sweden. CRISIS 2014; 34:200-10. [PMID: 23261907 DOI: 10.1027/0227-5910/a000175] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND There is a need for evidence-based guidelines on how professionals should act following a suicide. In an effort to provide empiric knowledge, we designed a nationwide population-based study including suicide-bereaved parents. AIM To describe the process from creating hypotheses through interviews to the development of a population-based questionnaire. METHOD We used interviews, qualitative analysis and various means of validation to create a study-specific questionnaire to be used in a nonselected nationwide population of suicide-bereaved parents and a control population of nonbereaved (N = 2:1). The Swedish Register of Causes of Death and the Multigeneration Register were used to identify eligible individuals. All presumptive participants received a letter of invitation followed by a personal contact. RESULTS We developed a questionnaire covering the participants' perception of participation, their daily living, psychological morbidity, professional actions, and other experiences in immediate connection to the time before and after the suicide. Almost three out of four parents (bereaved = 666, nonbereaved = 377) responded to the questionnaire. CONCLUSIONS By involving parents early in the research process we were able to create a questionnaire that generated a high participation rate in a nationwide population-based study that might help us to answer our hypotheses about bereavement after suicide.
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Affiliation(s)
- Pernilla Omerov
- Stockholm Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institute, Sweden.
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Andriessen K, Krysinska K. Essential questions on suicide bereavement and postvention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2011; 9:24-32. [PMID: 22470275 PMCID: PMC3315078 DOI: 10.3390/ijerph9010024] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 12/12/2011] [Accepted: 12/21/2011] [Indexed: 11/16/2022]
Abstract
During the past decades public and research interest in postvention, i.e., support for families and communities after a suicide, has increased. However, the postvention field is still facing a number of important challenges and questions. This article aims to discuss a series of essential issues on suicide bereavement and postvention, regarding the current state of the art and future developments. Who is a suicide survivor and how many suicide survivors are there? Is suicide bereavement different from other types of bereavement? What are the needs of suicide survivors and what is postvention from a clinical perspective and from a public health perspective? Can postvention be prevention? With this last question, the article concludes with a series of recommendations in order to strengthen the potential of postvention as prevention.
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Affiliation(s)
- Karl Andriessen
- Suicide Prevention Program of the Flemish Community Mental Health Centres, 9000 Gent, Belgium
- Author to whom correspondence should be addressed; ; Tel.: +32-9-233-5099
| | - Karolina Krysinska
- Unit for Clinical Psychology Research, Faculty of Psychology and Educational Sciences, Catholic University Leuven, 3000 Leuven, Belgium;
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Dyregrov K. What Do We Know About Needs for Help After Suicide in Different Parts of the World? CRISIS 2011; 32:310-8. [DOI: 10.1027/0227-5910/a000098] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: “A person’s death is not only an ending: it is also a beginning – for the survivors. Indeed, in the case of suicide, the largest public health problem is neither the prevention of suicide (...), nor the management of attempts (...), but the alleviation of the effects of stress in the survivor-victims of suicidal deaths, whose lives are forever changed and who, over a period of years, numbers in the millions ...” (Edwin S. Shneidman, 1973 ). Aims: As there is no doubt that suicide postvention should be given a more prominent position on the agenda than is presently the case, this paper explores what we now know about perceived needs for help on the part of suicide bereaved in different parts of the world. Methods: A search of related literature in the field was undertaken using the PubMed/PsychInfo databases. In addition, professionals throughout the world working in the field of suicide postvention were invited to submit reports about suicide postvention measures or literature. Results: Very little research was found that reflected the perceived needs for help on the part of the bereaved – and all the studies stemmed from countries in the Western world. However, the bereaved in these studies agreed about a common need for peer and social support, and that professional help must be adapted to and offered with respect for individual needs. Thus, it seems that in societies in which the stigma about suicide has diminished, the bereaved experience very similar needs for help, whereas in other societies it is difficult to talk about their need for help because of the sanctions and taboos connected to suicide. Conclusions: We need far more culturally sensitive research in order to explore and clarify how each community understands suicide and reacts to families who have lost someone by suicide.
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Affiliation(s)
- Kari Dyregrov
- Norwegian Institute of Public Health, Oslo, Norway, and Center for Crisis Psychology, Bergen, Norway
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Schneider B, Grebner K, Schnabel A, Georgi K. Is the Emotional Response of Survivors Dependent on the Consequences of the Suicide and the Support Received? CRISIS 2011; 32:186-93. [DOI: 10.1027/0227-5910/a000081] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Despite numerous studies that have assessed emotional reactions of people bereaved by suicide, many questions in this field are not yet clarified. Aims: The purpose of the present study was to explore how emotional reactions of those bereaved by suicide depend on their gender, the relationship to the deceased, the consequences (“only negative,” “negative and positive,” “predominantly positive”) of the death for the bereaved and the professional support received. Methods: The relationship between emotional reactions and characteristics was assessed in 163 suicide bereaved. Most bereaved, including all the parents of the suicide victims, had experienced emotions that occurred so often and so strongly that they had disturbed everyday life. The most frequently reported emotions were guilt and depressed mood. Female gender and being parents or spouses were associated with increased risk for lack of energy. Furthermore, the emotions of the bereaved depended on the consequences of the suicide and the professional support received. Conclusions: Professional support might be particularly important for suicide bereaved.
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Affiliation(s)
- Barbara Schneider
- Center for Psychiatry, Department of Psychiatry, Psychosomatics, and Psychotherapy, Goethe University, Frankfurt, Germany
| | - Kristin Grebner
- Center for Psychiatry, Department of Psychiatry, Psychosomatics, and Psychotherapy, Goethe University, Frankfurt, Germany
| | - Axel Schnabel
- Center for Legal Medicine, Goethe University, Frankfurt, Germany
| | - Klaus Georgi
- Center for Psychiatry, Department of Psychiatry, Psychosomatics, and Psychotherapy, Goethe University, Frankfurt, Germany
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Burke LA, Neimeyer RA, McDevitt-Murphy ME. African American Homicide Bereavement: Aspects of Social Support That Predict Complicated Grief, PTSD, and Depression. OMEGA-JOURNAL OF DEATH AND DYING 2010; 61:1-24. [DOI: 10.2190/om.61.1.a] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Psychological adaptation following homicide loss is challenged not only by the violent nature of the death itself but also by the bereaved's relationships with would-be supporters. Recruiting a sample of 54 African-American homicidally bereaved individuals, we examined perceived and actual support, the size of the support network, family- versus non-family support, and number of negative relationships to gauge the role of social support in bereavement outcomes such as complicated grief, PTSD, and depression. Results of quantitative assessments revealed that size of available network, quantity of negative relationships, and levels of grief-specific support were correlated with bereavement outcome. Clinical implications and suggestions for future research on the role of social support in adaptation of African Americans to traumatic loss are discussed.
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Abstract
The suicide death of a coworker is considered a psychiatric emergency for nurse managers and coworkers left to process the feelings associated with this type of grief. The occupational health nurse can assist nurse managers and coworkers in the grieving process. It is critical for the occupational health nurse to understand the psychological, social, and emotional implications for coworkers (suicide survivors) left to grieve the loss. Appropriate support and guidance immediately following the suicide death of a coworker will assist individuals through the normal grieving process and avoid suppressed emotions that may lead to personal and departmental dysfunction.
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Affiliation(s)
- Cynthia W Lynn
- School of Nursing and Behavioral Health, Carson Newman College, Jefferson City, TN, USA
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Abstract
Background. There has been recent interest in postvention activities which involve provision of support to family members and others affected by a suicide death. Aims. To review the current status of postvention support, including definitions used and the objectives and effectiveness of support activities for people bereaved by suicide. Methods. Selected controlled studies of support activities and programs are reviewed with narrative comment. Results. Not applicable. Conclusions. Effective postvention support can be viewed as contributing toward suicide prevention among those people who are bereaved by suicide. Further development of support programs is needed.
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Affiliation(s)
- Karl Andriessen
- Suicide Prevention Project of the Flemish Mental Health Centers, Gent, Belgium
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Lynn CW. When a coworker completes suicide. AAOHN JOURNAL : OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION OF OCCUPATIONAL HEALTH NURSES 2008; 56:459-469. [PMID: 19051570 DOI: 10.1177/216507990805601104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The suicide death of a coworker is considered a psychiatric emergency for nurse managers and coworkers left to process the feelings associated with this type of grief. The occupational health nurse can assist nurse managers and coworkers in the grieving process. It is critical for the occupational health nurse to understand the psychological, social, and emotional implications for coworkers (suicide survivors) left to grieve the loss. Appropriate support and guidance immediately following the suicide death of a coworker will assist individuals through the normal grieving process and avoid suppressed emotions that may lead to personal and departmental dysfunction.
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Affiliation(s)
- Cynthia W Lynn
- School of Nursing and Behavioral Health, Carson Newman College, Jefferson City, TN, USA
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Abstract
In Italy, postvention models specifically designed for people surviving the suicide of a loved one are very scarce. The SOPRoxi project was developed to respond to this particular lack. By involving different professional and nonprofessional figures (GPs, mental health professionals, social workers, volunteers, etc), the SOPRoxi project aims to remove the stigma associated with this condition and to offer adequate, multifaceted help to survivors.
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Affiliation(s)
- P Scocco
- Department of Mental Health, Padua, Italy.
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