Suicide - Postvention
cALL 800-273-8255 or
text "sos" to 741741
The aim is to support and debrief those affected; and reduce the possibility of copycat suicide. Interventions recognize that those bereaved by suicide may be vulnerable to suicidal behaviour themselves and may develop complicated grief reactions.
Postvention includes procedures to alleviate the distress of suicidally bereaved individuals, reduce the risk of imitative suicidal behavior, and promote the healthy recovery of the affected community. Postvention can also take many forms depending on the situation in which the suicide takes place. Schools and colleges may include postvention strategies in overall crisis plans. These strategies are designed to prevent suicide clusters and to help students cope with the emotions of loss that follow the suicide of a friend. Individual and group counseling may be offered for survivors (people affected by the suicide of an individual).
The Suicide Aftercare Association , a 501(c)(3) public charity, was formed to reduce the possibility of suicide contagion and secondary suicides by performing biohazardous cleaning of suicide attempt and completion scenes so families are relieved of this burden.
Responding to Loss (RTL) is one of the crisis response programs that has been used to deal with postvention at high schools. This program is part of the Community Action for Youth Survival (CAYS), which is a three-year adolescent suicide prevention project serving three counties in the Chicago area. The objective of RTL is to provide strategies that will help high school crisis teams develop a structured response to the suicide of any student or member of the staff. There are three components to this program. The first is Preparing for Crisis Training, the second is Peer Witness Intervention, and the third is Crisis Consultation. This program proved to be quite successful during its trial and the participants of the program were generally satisfied with the training that they received. As a result of this program, several schools have developed or revised their crisis team in response to a suicide. They have done this by following the Preparing for Crisis training aspect of the program and also through consulting with the CAYS program.
The LOSS Program includes a first-response team with the objectives of delivering immediate services to the survivors of a suicide at the time of the death. This team is made up of para-professional survivor volunteers and staff members of the Baton Rouge Crisis Intervention Center, located in Baton Rouge, Louisiana. The LOSS Program is different from other postvention programs in several ways. First, the LOSS team physically goes to the scenes of the suicides to begin helping the survivors to cope with their loss as close to the event of death as possible. Members of this team can provide access to the needed resources and can begin the grieving process at the scene of the death. Second, since the LOSS team includes survivor volunteers at the scene, an immediate and meaningful bond is established between the newly bereaved individuals and the para-professional surveyor team members. This bond allows for the start of a conversation between the bereaved and the crisis team members about grief and the potential for hope after suicide. Third, the LOSS team has a strong relationship with other first responders, such as law enforcement, emergency services, fire departments, funeral home representatives, and more. This relationship allows the newly bereaved to have a larger variety of choices in regards to coping with a suicide compared to other survivors who might not have access to this program. This model of postvention provides referrals for additional support to all survivors and individuals at the scene of the suicide  The model of the LOSS Program has changed the scene of the suicide to a more "concerned and caring environment" for all individuals and survivors.
Postvention is a term often used in the suicide prevention field. The definition below is from the U.S. national guidelines developed by the Survivors of Suicide Loss Task Force.
[Postvention is] an organized response in the aftermath of a suicide to accomplish any one or more of the following:
A Shared Vision: U.S. National Guidelines
In 2015, the Survivors of Suicide Loss Task Force of the National Action Alliance for Suicide Prevention released its report Responding to Grief, Trauma, and Distress After a Suicide: U.S. National Guidelines. In preparing this report, the task force was inspired by the following vision: a world where communities and organizations provide everyone who is exposed to a suicide access to effective services and support immediatelyand for as long as necessaryto decrease their risk of suicide, to strengthen their mental health, and to help them cope with grief.
Key principles for creating a comprehesive postvention effort include:
of a comprehensive approach to suicide prevention.
All settings should incorporate postvention as a component of a comprehensive approach to suicide prevention. All communities and organizations should be prepared to respond to a suicide death, including tribes, towns, senior living facilities, workplaces, and health care providers.
For more action steps, see the U.S. National Guidelines. Appendix B provides recommendations specific to national organizations; state and tribal governments; communities and local officials; schools, universities, businesses, and workplaces; mental health and public health agencies; professional organizations and accrediting bodies; faith communities and leaders; funeral professionals; first responders; social media and online communities; media; loss and attempt survivors; and researchers.
The resources on this page will help you respond appropriately to a suicide death and to support those touched by suicide.
Survivors of Suicide
Loss Task Force. (2015, April). Responding to grief, trauma,
and distress after a suicide: U.S. National Guidelines (p.
1). Washington, DC: National Action Alliance for Suicide
Prevention. Retrieved from www.sprc.org/resources-programs/responding-grief-trauma-and-distress-after-suicide-us-national-guidelines
Effective suicide prevention is comprehensive: it requires a combination of efforts that work together to address different aspects of the problem.
The model above shows nine strategies that form a comprehensive approach to suicide prevention and mental health promotion. Each strategy is a broad goal that can be advanced through an array of possible activities (i.e., programs, policies, practices, and services). This model of a comprehensive approach was adapted from a model developed for campuses by SPRC and the Jed Foundation, drawing on the U.S. Air Force Suicide Prevention Program.
Identify and Assist Persons at Risk
Many people in distress dont seek help or support on their own. Identifying people at risk for suicide can help you reach those in the greatest need and connect them to care and support. Examples of activities in this strategy include gatekeeper training, suicide screening, and teaching warning signs.
By teaching people to recognize when they need supportand helping them to find ityou can enable them to reduce their suicide risk. Self-help tools and outreach campaigns are examples of ways to lower an individuals barriers to obtaining help, such as not knowing what services exist or believing that help wont be effective. Other interventions might address the social and structural environment by, for example, fostering peer norms that support help-seeking or making services more convenient and culturally appropriate.
Ensure Access to Effective Mental Health and Suicide Care and Treatment
A key element of suicide prevention is ensuring that individuals with suicide risk have timely access to evidence-based treatments, suicide prevention interventions, and coordinated systems of care. Suicide prevention interventions such as safety planning and evidence-based treatments and therapies delivered by trained providers can lead to significant improvement and recovery. SPRC encourages health and behavioral health care systems to adopt the Zero Suicide framework for integrating these approaches into their systems. Reducing financial, cultural, and logistical barriers to care is another important strategy for ensuring access to effective mental health and suicide care treatment.
Support Safe Care Transitions and Create Organizational Linkages
You can reduce patients suicide risk by ensuring that they have an uninterrupted transition of care and by facilitating the exchange of information among the various individuals and organizations that contribute to their care. Individuals at risk for suicide and their support networks (e.g., families) must also be part of the communication process. Tools and practices that support continuity of care include formal referral protocols, interagency agreements, cross-training, follow-up contacts, rapid referrals, and patient and family education.
Respond Effectively to Individuals in Crisis
Individuals in your school, organization, or community who are experiencing severe emotional distress may need a range of services. A full continuum of care includes not only hotlines and helplines but also mobile crisis teams, walk-in crisis clinics, hospital-based psychiatric emergency services, and peer-support programs. Crisis services directly address suicide risk by providing evaluation, stabilization, and referrals to ongoing care.
Provide for Immediate and Long-Term Postvention
A postvention plan is a set of protocols to help your organization or community respond effectively and compassionately to a suicide death. Immediate responses focus on supporting those affected by the suicide death and reducing risk to other vulnerable individuals. Postvention efforts should also include intermediate and long-term supports for people bereaved by suicide.
Reduce Access to Means of Suicide
One important way to reduce the risk of death by suicide is to prevent individuals in suicidal crisis from obtaining and using lethal methods of self-harm. Examples of actions to reduce access to lethal means include educating the families of those in crisis about safely storing medications and firearms, distributing gun safety locks, changing medication packaging, and installing barriers on bridges.
Enhance Life Skills and Resilience
By helping people build life skills, such as critical thinking, stress management, and coping, you can prepare them to safely address challenges such as economic stress, divorce, physical illness, and aging. Resiliencethe ability to cope with adversity and adapt to changeis a protective factor against suicide risk. While it has some overlap with life skills, resilience also encompasses other attributes such as optimism, positive self-concept, and the ability to remain hopeful. Skills training, mobile apps, and self-help materials are examples of ways to increase life skills and build resilience.
Promote Social Connectedness and Support
Supportive relationships and community
connectedness can help protect individuals against suicide
despite the presence of risk
factors in their lives. You
can enhance connectedness through social programs for
specific population groups (such as older adults or LGBT
youth) and through other activities that reduce isolation,
promote a sense of belonging, and foster emotionally
Identifying persons who may be at risk for suicide is a key part of a comprehensive approach to suicide prevention. Family members, friends, teachers, coaches, coworkers, and others can play an important role in recognizing when someone is at risk or in crisis and then connecting that person with the most appropriate sources of care. But these individuals may need training on how to identify suicide risk and provide assistance.
Screening for Suicide Risk
Health care providers can help identify persons at risk by carrying out screening programs. However, when screening for suicide risk, it is important to have resources and systems in place to connect anyone identified as being at risk to appropriate follow-up care and assistance
Screening efforts should never be standalone programs. They are more effective when conducted as part of a comprehensive and strategic plan that begins with an assessment of the local context and the resources available to address the suicide problem.
When screening for suicide risk, it is important to have resources and systems in place to connect anyone identified as being at risk to appropriate follow-up care and assistance.
Programs that screen individuals for suicide risk are more effective when they:
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Seeking help for a mental health problem is not easy. Individuals who are struggling with thoughts of suicide or other mental health issues may face any number of barriers.
Barriers To Help-Seeking
Not recognizing that you need emotional support or professional help
Not knowing how to find help
Cultural traditions that value individual independence or frown on seeking help outside of the family
The mistaken belief that the problems you are facing cannot be resolved, even with assistance
Lack of access to care, either because of a lack of providers or due to financial issues
Many individuals are affected by mental health problems.
Mental health issues are not signs of weakness or character flaws.
Many individuals need help and support to feel better.
There are many ways to get help and support, including telephone and online sources of assistance, mental health services, peer supports, and other options.
There are health care professionals who are specially trained to assess suicide risk and provide effective treatment for suicidal thoughts and behaviors.
There is hope. Individuals with mental health problems can get better, and many recover completely.
Individuals with mental health problems can get better, and many recover completely.
Include people with lived experience on your suicide prevention planning team.
Identify local and national options for obtaining help, such as the National Suicide Prevention Lifeline, warmlines, online support communities, and mental health services, and promote them through outreach campaigns and other channels.
Identify and reduce structural and environmental barriers to seeking help. For example, make services more accessible, convenient, and culturally appropriate.
Educate the community about the warning signs for suicide and correct misinformation.
When training community gatekeepers to identify and assist people at risk, have course participants identify barriers to seeking help and make plans for how they personally would seek help if they needed it.
Reduce stereotypes, prejudice, and discrimination by sharing true stories of individuals who sought help and benefited from it.
Provide information on self-help tools and support options that people can access on their own.
Train peers to support help-seeking and provide information about available services and resources.
Engaging in strategic planning can help you learn about your communitys beliefs and behaviors about help-seeking as well as available resources, enabling you to focus and tailor your efforts. When promoting help-seeking, it is also essential to plan ahead to ensure that sufficient resources are available to meet an increased demand for services.
Respond to Crisis
Reduce Access to Means
Life Skills and Resilience
Best practices in
Interventions following the suicide or death of an individual should be based on four principles: Support, learn, counsel, educate.2
A whole-community approach is important in postvention strategies following a suicide, all relevant community partners need to work together.
These postvention guidelines have been adapted from The Riverside Trauma Center Postvention
Verify death and cause+
Support those most impacted by the death+
Identify those at risk and prevent contagion+
Commemorate the deceased+
Provide psychoeducation on grieving, depression, post-traumatic stress disorder (PTSD) and suicide+
Provide services should additional suicides occur+
Link to resources+
Evaluate and review lessons learned+
1.Teen Mental Health. (2010). The effectiveness and safety of suicide postvention programs. Research review and recommendations: A summary report. Retrieved from: http://teenmentalhealth.org/product/effectiveness-safety-suicide-postvention-programs/
2.Chehil, S. & Kutcher, S. (2012).
Suicide risk management: A manual for health professionals.
Oxford, UK: Wiley-Blackwell.
To access the full reference for any of the terms, please click here.
The provision of care utilizing evidence-based decision-making and continuous quality improvement regarding what is effective (Alberta Mental Health Board, 2005).
Emotional exhaustion, depersonalization and a reduced feeling of personal accomplishment that develops as a result of prolonged stress or frustration typically associated with the workplace. Burnout occurs over a fairly long period of time and is cumulative, not the result of one bad day. (National Child Traumatic Stress Network, Secondary Traumatic Stress Committee, 2011; Best Start Resource Centre, 2012)
How a community can build on its own existing strengths and abilities rather than being overwhelmed by problems or feelings of powerlessness (Austen, 2003).
Cis-normativity is the assumption, sometimes unintentional, that everyone is cisgender (i.e. that everyones biological sex at birth corresponds with their gender identity and expression). As one example, separating boys and girls in gym class is a common cisnormative practice in schools.
A group of people who share a concern, geographic area or population characteristics (Kim-Ju et al., 2008). Together to Live focuses on communities who share a concern for youth suicide.
The assets already existing within a community, including concrete resources needed to address particular issues and the wisdom, expertise and leadership to make things happen (Austen, 2003).
Individuals taking action around specific community issues (Kim-Ju et al., 2008).
A term used to describe secondary traumatic stress, which refers to the presence of post-traumatic stress disorder symptoms caused by at least one indirect exposure to traumatic material. Symptoms can include exhaustion, feeling overwhelmed, isolated and disconnected. (National Child Traumatic Stress Network, Secondary Traumatic Stress Committee, 2011; Best Start Resource Centre, 2012)
A phenomenon whereby susceptible individuals are influenced towards suicidal behaviour through the knowledge of another persons suicidal behaviour (US Department of Health and Human Services, Public Health Service, 2001).
The use of communication technology to facilitate deliberate, repeated and hostile behaviour towards an individual (Paglia-Boak, Adlaf & Mann, 2013).
Death by suicide
A purposeful self-inflicted act that is fatal and is associated with implicit or explicit intent to die (Chehil & Kutcher, 2012).
An approach to evaluation inquiry for complex environments which focuses on collecting information as a project is unfolding. The information gathered is intended to be used to guide and inform the developing project (Gamble, 2008; Patton, 2011).
To flourish is to be able to enjoy life, cope with lifes difficulties, believe in yourself and others, feel you belong somewhere in the world and believe that you have something you can give to others. (Source: http://www.handsonscotland.co.uk/flourishing_and_wellbeing_in_children_and_young_people/flourishing_topic_frameset.htm)
Acronym that stands for First Nations, Inuit and Metis.
A community member whos strategically positioned to recognize and refer someone at risk of suicide (e.g. neighbours, teachers, coaches, caseworkers, police officers; White, 2013).
Hetero-normativity is the assumption, sometimes unintentional, that everyone is heterosexual. As one example, the underrepresentation of gay and lesbian couples in the media is a widespread heteronormative practice.
Performing targeted evidence-informed interventions (including community interventions) to foster behaviour change.
When there is not enough research to justify drawing conclusions or the research points to mixed conclusions (Chehil & Kutcher, 2012).
Acronym that stands for lesbian, gay, bisexual, transgender and queer (and/or questioning).
Life promotion is a holistic and strength-based approach to suicide prevention. It is based on the belief that preventing youth suicide involves helping young people find their own path to a healthy and meaningful life.
Implies that there is some evidence for a programs effectiveness, however no research has comprehensively looked at the evidence (e.g. when there is no systematic review or meta-analysis of the literature).
A visual representation of a program or initiatives inputs (necessary resources), activities (actions, events), outputs (products), and resulting short-, mid-, and long-term outcomes.
A deliberate attempt to cause injury to ones body without the conscious intent to die (School Mental Health Assist, n.d.).
Outcome (summative) evaluations
A type of evaluation that focuses on the overall success of a program to determine whether a program should be continued (Wholey, Hatry, & Newcomer, 2010).
the protective effect that responsible media can have on individuals (e.g. increased awareness about the signs of suicide among those exposed to the media reporting).
Emotional duress that results when an individual is exposed to one or more traumatic events (National Child Traumatic Stress Network, Secondary Traumatic Stress Committee, 2011).
An intervention strategy aimed at attending to the needs of those who require assistance after a suicide.
Postvention programs aid those in the grieving process in addition to reducing the incidence of suicide contagion through bereavement counseling and education (Szumilas & Kutcher, 2010).
Systematic efforts to reduce the risk of suicidal thoughts or behaviours, and ultimately death by suicide (School Mental Health Assist, n.d.).
Similar to universal prevention where population-based strategies are used to prevent a problem from occurring altogether (Heller, Wyman & Allen, 2000).
Process (formative) evaluation
A type of evaluation that focuses on the improvement and development of an ongoing program (Wholey, Hatry, & Newcomer, 2010).
The application of systematic methods to address questions about program operations and results, including ongoing monitoring of a program, one time studies of program processes or program impact (Wholey, Hatry, & Newcomer, 2010). The approaches used are based on social science research methodologies and professional standards (Wholey, Hatry, & Newcomer, 2010).
Factors and experiences believed to promote resilience and better mental well-being that may buffer against the negative effects of risk factors and stressors (Kutcher & Chehil, 2007). Examples of protective factors for youth suicide are coping skills and social support.
Procedure that aims to weigh out risk and protective factors to determine the level of suicide risk for an individual or a community.
Factors or experiences associated with an increased probability of a particular event occurring. Examples of major risk factors for youth suicide include a previous attempt, a psychiatric diagnosis (e.g. mood disorders, substance abuse) and access to lethal means (Gutierrez et al., 2008; Doan et al., 2012).
Practices involved in recognizing and responding to a person with suicidal ideation or behavior.
A prevention strategy that aims to reduce the chances of a potential problem happening, at the earliest possible moment. It usually targets at-risk groups that have yet to show definite symptoms of the problem (e.g. reducing modifiable risk factors of youth suicide; Heller et al., 2000).
A very broad range of self-inflicted behaviours causing tissue damage or injury, which may or may not be associated with an intent to die. Also includes behaviours that dont involve tissue damage or that result in a degree of injury that is vague or unclear (Klonsky, 2011).
Stigma can be broken down into three components: (1) people or groups of people are marked (e.g., people marked mental illness), (2) negative labels are associated with people who are marked, and (3) people who recognize the mark buy into the label.
Strategic action planning
An approach that can help you understand the issue of suicide in your community, set realistic goals, identify activities that will help you reach your goals, and implement evaluate and improve these activities over time.
Thoughts, images, or fantasies of harming or killing oneself (Chehil & Kutcher, 2012).
Any purposeful self-inflicted acts, including suicide attempts, self-harm and self-injury, that may lead to death regardless of the intent of those behaviours and actions (Chehil & Kutcher, 2012).
Intentional, self-inflicted death (White, 2013).
A purposeful self-inflicted act with implicit or explicit intent to die, which does not result in death (Chehil & Kutcher, 2012).
The conscious decision to take ones life (Chehil & Kutcher, 2012).
A visual tool that will map out your project.
Efforts that target a group we know for whatever reason is at higher risk (e.g., targeting those with a previous attempt, those with mental illness for early identification and intervention; School Mental Health ASSIST, n.d; Chehil & Kutcher, 2012).
A prevention strategy that resembles a treatment strategy, where the goal is to reduce any further negative effects of an established problem (e.g. relapse prevention; Heller et al., 2000).
Prevention efforts that target everyone regardless of their level of risk (e.g. whole school approaches; School Mental Health ASSIST, n.d; Chehil & Kutcher, 2012).
A permanent cognitive change in the service provider that typically develops over time as a result of empathic engagement with another persons trauma that can lead to pervasive disturbances in all areas of the professionals life (National Child Traumatic Stress Network, Secondary Traumatic Stress Committee, 2011; Best Start Resource Centre, 2012).
negative effects that irresponsible
media reporting can have on individuals (i.e. a spike in
deaths by suicide after a widely publicized suicide)