MedicalResearch.com Interview with:
Dr. Alexandra Pitman BA MSc(Econ) MBBS MRCPsych FHEA PhD
Honorary Research Associate & Consultant Psychiatrist, Division of Psychiatry
University College London
London
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Pitman: We conducted this study to settle a long-standing debate over whether bereavement by suicide is more stigmatising than bereavement due to other causes of sudden death. This is important because the more we understand about the stigma of suicide bereavement, the better equipped we are to design services to support this group. Providing support for people bereaved by suicide is one of five key messages in WHO suicide prevention strategy, and features prominently in the suicide prevention strategies of high income countries such as England, Wales, Northern Ireland, the US, and Australia. The evidence to date suggests that we lack effective interventions to address their known risk of suicide and mental health problems, constituting a failure to tackle an important public health problem.
Although suicide is commonly believed to be highly stigmatising for bereaved relatives and friends, qualitative work suggests that people bereaved by other causes of death also feel stigmatised by their loss. For example, a
British study of people bereaved by suicide and other unnatural causes of death found that interviewees in both groups described societal pressure to contain their grief and even to hide it. Our earlier systematic review in the Lancet Psychiatry had identified studies comparing health and mortality outcomes in people bereaved by suicide and other causes of death, among which 7 studies had compared perceived stigma scores using a validated measure. In all cases the measure was the stigmatization subscale of the
Grief Experience Questionnaire. Taken together these studies were inconclusive as to whether people bereaved by suicide and other unnatural mortality causes differed in relation to stigma scores. Partly the problem seemed to be one of sample size in having insufficient statistical power to demonstrate score differences, should they exist. We decided to conduct a large-scale British study to compare grief outcomes such as stigma, shame, responsibility and guilt, as well as clinical outcomes such as suicide attempt. Previously published findings from this study, reported in
BMJ Open, show an increased risk of suicide attempt in people bereaved by suicide, whether related to the deceased or not.
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