Health and Life Suicide Suicide bereavement | Help, advice, support “Supporting a friend or someone you care about who is experiencing suicidal thoughts can be intimidating, but we often forget about those that have lost loved ones to suicide.” Find a support group What is bereavement and grief? | How will suicide bereavement impact me? | How will suicide bereavement affect others? | How can I help someone who may be suicidal after a bereavement? | Seeking emergency help What is bereavement and grief? Bereavement is a term used when a loved one, or someone you are close to or important to you, has died and you experience a period of grief. Grief is a usually an emotional and physical response to this loss; the loss of love, friendship, intimacy, and affection. Grief is not only emotional or physical but can be behavioural, social, cultural, and spiritual. Grief may include the following stages: denial anger bargaining depression acceptance. Stages of grief don’t arrive in the same order or appear the same for everyone. The early weeks and months of seeking support and maintaining self-care are crucial. It is worth remembering we all grieve in our very personal and different ways. As individuals we have a unique relationship with the person who died. Some of the added trauma of losing someone to suicide is often the not knowing or denial of what has happened. For some people bereaving, their families and friends may have struggled and were unable to accept their loved one's sexuality or gender identity or gender expression. Feelings of anger from the person bereaving may emerge because families and friends may have excluded their LGBTQ+ loved one. They may experience guilt (‘if only’ feelings of blaming oneself) and shame. It’s important for people bereaving that they have done nothing wrong and understand that some factors that uniquely affect LGBTQ+ people contribute to mental health issues in the community. Levels of depression, anxiety, self-harm, and loneliness are much higher in queer people than the general population. These, alongside other factors can contribute to suicidal thoughts in the LGBTQ+ community. Because suicidal feelings are more common for us, it is sometimes easier for people to ignore our feelings or brush them off. There is no right or wrong way to feel or heal, and if we have someone to talk to then perhaps this reduces the ripple effect of grief which can be impactful to individuals, families and communities. The greater knowledge we have around suicide and ways to cope and reach out are vital. It’s okay to talk about suicide. How will suicide bereavement impact me? It’s important to understand that suicide, unfortunately, still carries stigma (the silence and secrecy leading to shame) and therefore there is an extra layer of trauma that can lead to emotional reactions which are different for everyone. On top and inbetween this trauma, being part of the LGBTQ+ community, people are further affected because it is a member of their community that died. We will all grieve the loss of a loved one differently and remember and honour them in our own unique way. The first thing we may experience in suicide bereavement, is the shock of what we have heard, seen, or experienced with person that has ended their life. We know emotional and physical pain are inter-connected. During bereavement we may experience some of the following symptoms: Emotional feelings The shock and disbelief (due to the suddenness) The anguish, longing and searching (visual and audio experiences of your loved ones) The anger, guilt, relief, and shame from our culture or communities. Being angry with yourself or others (organisations, friends, colleagues etc) is common. Mixed or conflicting emotions are common too) The fear and anxiety (how will I cope? What does the future hold? Who do I look after now? Who needs help right now? How do I look after myself?) Despair, depression, and sadness. (The lack of sleep. Internalising shame and guilt. Feeling overwhelmed, for example managing finances, looking after the home or your job. This may be a good time to talk to someone like your GP or telephone support services.) Having intrusive and suicidal thoughts Physical feelings Breathing issues Chest tightening Lack of energy Noise sensitivity Poor sleep and concentration Stomach pain Throat issues Trauma For some people they may have been the first to be told about the suicide or discovered the person who had ended their life. This will often lead to: Nightmares Flashbacks Post-traumatic stress. Please immediately speak to the doctors if you are experiencing any of the above. Often people, for many reasons, try to deal with trauma on their own and this leads to greater risk to their mental health. How will suicide bereavement affect others? Often this depends on the relationship the person had with their loved ones who have ended their life. A life partner, a father, a mother, a sibling, a friend, and someone you were caring for. Often this can be someone that was a client, an extended member of a family, a long-lost friend, or a celebrity. Life partners and families Often people living together may be married or in civil partnership or simply just be living together. We have chosen to live our lives with our partner(s) and do not expect this sudden loss due to suicide. We can feel angry at what might see as a betrayal and feel rejected by what has happened. This judgment is a very ‘normal’ reaction because for some people, they did not expect this. Families may also blame the living partner too. It is really important time to talk to someone for support and to be listened to in a private, confidential, and non-judgemental space. Partners’ whose families are not accepting of a same sex relationship, may find that they are blamed or excluded unnecessarily. These further compounds the fear that others will judge them too and that the sexuality of the person who died or that of those around them was a contributory factor to their death. This blame culture can be commonplace for attitudes in a heteronormative world in which we live in. Sometimes it may be ex-partners that we lose. Even if your relationships did not work out prior to these feelings, missing someone may still happen. Others and you may find this grief confusing as you may have experienced pain in the previous relationship that ended. How you experience this grief is important and individual to you. Sometimes the relief of losing someone who was in pain can be very conflicting and upsetting too. As LGBTQ+ parents you may also have children to look after and support. Make sure you seek support on this through your networks. Sometimes a balancing of caring for others that are bereaving and for yourself can be difficult to manage but write down the networks that can help you. A suicide bereavement plan of sorts can help. This plan may be as much as talking this through, or actually writing some thoughts and questions down to ask others and key names and telephone numbers. Finding out who your support structures and spaces are will give you choice. In the weeks or months following the death of a life partner there will likely be impact on your social life, work life and feeling of loneliness and isolation. Often, there can be a lack of understanding or empathy from non-LGBTQ+ families; and if we are not married or have a civil partnership nor have a will this can lead to stressful financial matters too. Friends may over check in on you and suggest things you could or should be doing as they are trying to deal with their own grief and their concerns for you. Reassuring your friends that you are okay for now is perfectly fine but do try to unpack your feelings with a professional such as a bereavement counsellor or a support line such as Samaritans. In time and when you are ready to you will reconnect with people, places, and hobbies you enjoyed. Sometimes out of trauma there can be ways forward to connect and discover knowledge to reduce stigma. How we remember our life partners we lost to suicide can prove to be helpful, whether this is through something creative such as writing, artwork or preserving memories physically or through social media. How can I help someone who may be suicidal after a bereavement? The key thing to remember that the grieving and recovery process is long and complex. Try not to stop with offers of support once the funeral is over. Sometimes the odd phone call, or text, or email or a letter can go a long way to make people feel that they still matter. It’s important for people experiencing bereavement to know that they are enough and loved. If you are concerned for someone bereaving and having suicidal thoughts don’t be afraid to ask, “are you having thoughts of suicide?”. Studies show that it does not increase suicidal thoughts if you ask if they are thinking about suicide. Asking can possibly provide valuable information about how to help. The person will often feel less alone. The majority of people will say that they have made no definite plans, but this is potentially a serious situation. Remain calm in voice tone and expression when actively listening. If the conversation or communication leads you to believe that they are in immediate danger (i.e., they have suicide plan) then try your best to consider disabling this plan and making sure they are ‘safe for now’. You may not feel skilled or feel confident to do this and you may want to take immediate action. For example, is someone saying they are going to hurt themselves, or has said they plan to end their life, or has already attempted? If you think their injuries are life-threatening, you can call 999 for an ambulance. Here are some top tips we researched for people who are bereaving the loss of someone through suicide: Ask what you can do to help. This could be something practical such as help with the food shop, making food, house cleaning and making phone calls they may be avoiding, funeral arrangements etc. Do not overload with help – always ask first. Trying your Best. Try not to be too hard on yourself. You are trying your best. Sometimes just being there such as attending the funeral and any other occasion such as a memorial service is enough, for now. The person bereaving knowing that you are there beside them will make a difference. Call them. Telephone or have a conversation and ask if they would like your support and in what capacity. Sometimes during the inquest process this can be very traumatic time, something that is not only full of fear but also isolating. Help if you can. Be Dependable. Try to keep any promises that you make realistic and achievable. Show Empathy. Phone calls, text messages (keep this limited, remember the person bereaving may already be receiving text messages from others) a letter perhaps. Act Fast. Remember to act quickly if you think the person is at any health risk or immediate risk of danger to themselves. It’s okay to call 99 in an emergency. Look after yourself too. Be Generous. Remember the person bereaving will value the time you spend and the listening you do. Try not to give any advice or opinions. Simply giving someone time will help. Be Helpful. Sometimes the small thing that show you care and are there for them have the biggest impact. But try not to be over helpful which will go against your feelings of wanting to fix things, but this is not about you. Instead seek permission if you think the time is right and appropriate to help and offer to talk about services. Be inclusive. Listen and understand their needs. Are they aware of prolonged symptoms of grief or depression? Is it time to encourage them to seek help from their GP? Being joyful. Sometimes talking about the joyous and fun things about the person we have lost can offer relief and a greater understanding of their lives. Some signs to look out for when someone is bereaving: Are they feeling constantly restless and agitated? Are they complaining of feeling tired all the time? Is there a change of personality i.e., feeling angry and aggressive or very happy? Are they feeling tearful most of the day? Are they opening any post? Are they isolating themselves and not answering any communication? Are they excessively using alcohol or drugs (prescription or not) Are they telling you they are finding it hard to cope with everyday things? Are there any signs that you can tell? Are they talking about feeling hopeless, helpless, or worthless? Are they saying things like ‘what’s the point?’ or other self-defeating thoughts. Are their sleeping or eating or daily self-care changing? Are they engaging in risk-taking behaviour, like gambling or violence or chemsex? Speak from the heart If you are speaking out of love and concern, just be yourself and show that you care. Talk to them, hold them while they cry, or just spend time with them. Acknowledging what people are experiencing can help process their thoughts. Listen A suicidal person usually is carrying around some burden that they feel they can't hold onto anymore. Offer to listen as they share what they are feeling. Here are some tips to engage in active listening: Give them all of you attention—making eye contact and putting away all types of distractions Have patience—a person may not be immediately ready to open up. Creating a safe space through non-judgmental listening can help a person feel comfortable enough to open up. Use open questions—this allows for the person to think and reflect on their feelings as well as encourages them to talk. Say it back—repeating something back demonstrates that you have given someone your undivided attention. Don’t be afraid of silence or negative responses. You will be able to tell if someone is not comfortable enough to talk at that level. Avoid trying to solve the problem Try not to offer quick solutions or belittle the person’s feelings. Rational arguments do little good to persuade a person when they are in this state of mind. Instead, offer compassion for what they are feeling without making any judgments about why they feel that way. Take care of yourself Caring for someone who is struggling with suicidal thoughts can be very stressful and can take a toll on the friend providing support. Be sure to take care of yourself as well. Talk to someone you trust, a therapist, anyone who can offer you support for what you have been through and how you are feeling. Mental health is important, some ways to look after yourself is by: Allowing yourself to take a mental health break—you know when you’ll need one and you know you’ll be more productive if you give yourself time to relax and recharge. Avoid felling guilty try to not feel bad about experiencing negative emotions, they’re natural. Allow yourself to notice your feelings without judging them as good or bad. Notice the positive — taking the time to notice the positive things helps you experience a better day. Keeping active—going on walks through the park or going exploring through a different part of town can help you feel connected to the things around you. Keeping in touch with friends—connecting with people that play an important role in your life can help you feel grounded and can help you gather strength from others. Seeking emergency help If you or someone you care about is experiencing suicidal thoughts and need support, you can contact Samaritans. They run a confidential, 24/7 phone line that will listen and provide guidance. If you or someone you know are at risk of harming themselves, you should call 999 immediately and ask for an ambulance. Supporting a friend or someone you care about who is experiencing suicidal thoughts can be intimidating. It is important to do your best to provide support and get help. What Next? SOBS 0300 111 5065 - offering peer-to-peer support to all those over the age of 18, impacted by suicide loss in the UK. Switchboard 0300 330 0630 — the longest-running helpline for LGBTQ+ people that provides support through phone, email ([email protected]) and instant messaging. LGBT Foundation 0345 3 30 30 30 — LGBT Foundation is based in Manchester but offers country-wide support to LGBTQ+ people through its helpline. Mindline Trans + 0300 330 5468 — Emotional and mental health support helpline for anyone identifying as transgender, non-binary, genderfluid. They also support family members, friends, colleagues and carers.