Supporting children and young people bereaved by suicide
This information sheet offers guidance when someone may have died by suicide. It covers ideas for what to tell children and young people, how they might feel and respond, and what might help to support them.It may not be clear that the person has died by suicide, or the official cause may be given as something else, such as an accident or an open verdict. In this sheet, we use the term ‘bereavement by suicide’ as many of the same issues and feelings may apply when the cause of death is not clear but it may have been suicide.There is no right way to grieve or to respond when someone may have died by suicide.This information is based on what we learn from bereaved families and professionals. Everyone’s situation and response is different, and you can use whatever information here is helpful or relevant.
Families tell us that good information and support was essential in helping them at the time of the death, and afterwards. As well as support from family or friends, you can ask for guidance and information from some of the professionals who become involved, such as the police or hospital staff.
Telling children about a sudden, shocking or unexplained death of someone significant to them is not likely to be a one-off event, but a process that may need to happen in stages over the days, months and even years after the death. By telling a child the truth in small steps, their understanding gradually grows in a way that you can all more easily handle together. Telling children that the person has died. The important first step is to tell them that the person has died. Try to do this as soon as possible, as children can overhear the news from other sources. It is best that they hear it from someone they are close to and who they trust. •Find a time and space where you can be with the child and remove distractions.•Say that you have something very sad to tell them, and then say for example:‘Dad died last night’. For young children(under six years), explain what ‘died’ means, for example by saying something like “This means that his body doesn’t work anymore, and he doesn’t feel anything or need anything. It also means that he won’t be coming back, which is very sad and hard to face”. •Be guided by their response. Answer any questions honestly but don’t give more information than you need to. It is OK to say ‘I don’t know the answer to that,but I will tell you if I find out’.•Some children may not understand the permanence of death.You may need to repeat the same information over and over again, and it helps children to hear the same consistent information from you and other adults.
Giving simple details. A next step can be giving simple, factual details which the child or young person can picture. This can help them shape the details into a story that they can understand and tell other people:“She died at her house.”“He died in his car.”“Aunty found Dad this morning. The ambulance came and paramedics tried to help Dad but he had already died.
What and when you decide to tell children about the death will depend on the situation, and it may only be appropriate to tell them when the facts become clearer, or when they are old enough to understand. However, if any details, including the word ‘suicide’, are likely to appear in the media, social media or in your community, it is important that children hear this from you or someone else they trust first:“Dad died because he took too many tablets....“Mum died because she put something tight round her neck and she couldn’t breathe...“Joe was on the railway line and he was hit by a train.... Sometimes, the full facts around a death may never be made clear. However, children and young people may find it harder to grieve, and trust the adults around them later on, if they do not hear at least some basic truths about how the person died. You can help build trust between you by giving children truthful information and answering their questions as honestly as you can.If a child is told different versions of a story, then:•What they are told doesn’t add up into a story that they can understand and process.•Their imagination of what happened is often worse than reality.•They may find out the truth in an unhelpful way, or hear it at a time where there is no support.•Different family members will not know what the child knows,and what they can be told.•A child may think that because they are not being told everything, the death was in some way their fault, or that the person did not love them.•As time passes, it becomes more difficult to change the story.
How you explain ‘suicide’ will depend on who you are talking to, their age and understanding and what you feel able to say. Here are some suggested phrases to explain what suicide means. You may want to use just part of this, or find another words that feel right for you and the child you are supporting:“We think she/he did this on purpose.When someone does something dangerous to themselves and they die, it is called suicide.Sometimes it is called ‘ending your own life’ or ‘taking your life’.”Explaining why the person ended their life. This may be very difficult or impossible to explain if you do not know how the person who died felt. It may also be very painful to do, but you may consider adapting some of the following words:“It might be that Dad has been very sad and confused for a long time. He might have thought it would be better if he died. This is not true, but he may have felt too sad and confused to be able to think clearly. There is nothing that you did or said that made Dad do this –he loved you very much.” “Ram had problems for a long time, and the problems built up on top of each other, like a tall tower. The higher the tower got, the more Ram thought he couldn’t solve any of the problems because there were too many.”“Sometimes a person can feel so sad, ill or confused that they decide that the only way to stop feeling so bad is to stop living. They might think that their friends or family will be better off without them. Neither of these things are true but the illness has made them think this...”
No meaning or no warning.
Any death can be hard to understand, but after a possible suicide, it can be more difficult or impossible to understand why the person made that decision. Also the sudden nature of the death means that there is no opportunity to say goodbye, which can lead to shock and greater disbelief for longer. Stigma or lack of trust in support. The stigma often attached to suicide can mean that children are not offered sources of support offered to other bereaved children. People sometimes feel that they do not know what to do or say. Some bereaved families may feel that they have been failed by their family doctor and the mental health services who in their view ‘allowed’ the person to die. They may therefore be reluctant to access any similar help for a bereaved young person.
Due to involvement of many strangers such as police officers, coroners and the media,a family’s private grief may suddenly become a very public affair. Young people may be surrounded by complete strangers,rather than people that they want to be close to.If the suicide took place at home, it may become a potential “crime scene” and stop feeling comfortable and safe. Possessions can be removed by the police, including any suicide note. Such procedures may lead to a delay in the release of the body, delaying the rituals that can be really important in helping people with their grief, such as a funeral or other occasions where they can say goodbye.Difficult or shocking memories. We commonly make sense of experiences, including bereavements, by thinking about the experience and talking about it. However a suicide can be violent or shocking, especially if someone directly saw the event or its aftermath. This can “trip up” the usual grieving process because each time you think of the person,the graphic vivid image of the death takes over from any other softer,more pleasant memories. Bereaved children and adults may dread thinking about the person who has died and avoid it wherever possible. This makes grieving very difficult.How children and young people might feel and respond. Like adults, children will experience the feelings of grief that they might have in any close bereavement, and also different feelings because it may have been the person’s decision to die. One girl of 5 years old summed it up like this: “Mummy, I know Papa loved us, but it doesn’t feel like it, when he did what he did”.Children may feel vulnerable, angry or frightened. At the same time they also have the ability to play and love and have fun. Older children may find it difficult to talk about their feelings. Children and young people of all ages will respond in different ways, from emotional or angry responses to refusing to engage or being withdrawn. Or they may focus on helping or protecting their adults or siblings. They might be overwhelmed by complex and conflicting feelings, which they cannot fully understand. Sensitive, truthful and loving responses that are appropriate for the age and level of understanding of each child will allow them to grieve in their own way. This is the ideal, but when parents are grieving themselves, it is not always easy. Making use of support available to you will, in turn, help you to support your child.
Be aware that children are around and that they can overhear what adults are saying.•Reassure them repeatedly that they are in no way responsible for what happened and that they could not have prevented it. Guilt or shame is a very common feeling after a possible suicide.•Stress that the person loved them, if this was the case. Be aware that some children (and adults) may feel that because the person chose to end their life, they were also rejecting their family in some way.•Keep routines as normal as possible and explain any changes. Explain who will be with them and at what time. Ensure that planned activities happen, as this will help children to feel secure.•Include in familiar activities children and young people who withdraw, while acknowledging any need they have for space alone.
Find time and space for comfort, reassurance and communicating with children and young people to help them feel they are included and important.•Involve children and young people in arrangements and in making simple decisions that affect them, such as about attending the funeral. It is important for even very young children to feel included in decisions, as they will remember this feeling later on, even if they do not remember much about the event or the person who died.•Involve other adults who see your child regularly, including telling them what the child has been told about the death. Such adults include teachers at school and parents of your child’s friends.This can help support you, and can keep messages from adults consistent.•Acknowledge the feelings they might have now and in future, and explain that it is OK to have lots of different feelings, and that they can talk to you about how they feel.
Being able to make sense of the death can be very difficult, especially if there is no answer to the question ‘why?’However, if a child is able to build their own story around the death, this can help them to fit what happened into their own understanding of the world (their ‘world view’). This can also help them talk about it to other people. Understanding that they are not to blame is important for this. •Having opportunities to talk and ask questions is also useful in making sense of the death.It can be very hard for adults and children to talk about suicide, because of possible stigma, not knowing what to say and not wanting our own view of the world to be challenged. Telling the story is not a one-off event; it goes on for a long time and children need to regularly update their knowledge to fit in with their growing and changing understanding of the world.•Expressing thoughts and feelings including drawing, writing or playing.Some children may want to draw or write their own story of what happened, which can also be very helpful for you in that you can see what they understand.•Continuing and creating rituals can provide concrete ways of expressing complex and intense feelings, while they are still learning about how to express them. Being part of a ritual with other people also helps them to feel a sense of belonging and support. A simple family ritual can be a special meal together, lighting a candle or saying out loud a short poem or memory.•Building memories of the person, by collecting items such as photos, music on a CD, or by writing or drawing memories of their own. A memory box or workbook can become their own special place for this.•Keeping normal boundaries around behavior which will help children feel secure. You can acknowledge that it is OK to feel angry or very upset,but help them find ways to express this in a way that is safe for them and others.
Grieving children of all ages need the support listed above. In addition, adolescents and young people will have a greater understanding than young children of the loss they are facing. They may also know more about the person who died, and any problems they had. Young people may want to spend more time out of the house or with friends, and this can help them to escape from any tension or difficult memories they have at home. This is all normal, and can be helpful for young people, as long as they also know that their family or other support is available. Young people may also be at an age where their emotions are strong, even frightening and difficult to manage. Not knowing how to deal with such emotions can result in outbursts or behavior that is challenging for them or for you.Some young people (and adults) may start taking risks, such as driving recklessly, drinking or taking drugs, as a way to shut out painful feelings or to feel more in control. This may help the person to stay numb for longer, so others around them can assume that they don’t need support,when actually the opposite may be the case.
Children or young people, and their families,can worry that the child might also be at risk of suicide, particularly if they are of the same gender as a family member who died, or when they get to the same age.Research around this is mixed, and there are many possible factors which bring one person to consider suicide. There is some evidence of a higher risk of suicide for someone who has been bereaved by suicide. On the other hand, there is also evidence that the experience of being bereaved by suicide, along with good support, can help someone reject this as a potential option for themselves in future.The key thing is access to support that helps them to grieve, understand their emotions and increase the child’s resilience and ways to learn coping strategies. Such support can also help to reduce their chance of mental health problems in future.Signs that someone might be at risk of suicide can include depressed mood, recent changes in behaviour, giving away possessions, a history of self-harm or mental health problems, talking about self-harm or suicide, substance abuse, being unusually impulsive, or showing hostility.It is important to remember, however, that any one of these factors does not necessarily mean that the person is at risk of suicide. If you are worried about a child or young person in this way, you can ask them if they have had thoughts about ending their own life. This may seem blunt, but many people who have thoughts of suicide feel they can’t tell anyone. Asking them directly reduces the stigma around talking about suicide, it gives the young person an opportunity to tell you what they are thinking, and it can open the way to find support.
If a child or young person does tell you they have been thinking about suicide, you can encourage them to tell you more, and reassure them that you will listen and that they are not alone. You can also look for support options together.
Bereavement support or counseling
Although the environment around children and young people may give them all the support they need, in some cases bereavement support or counseling may also be useful. It can offer the person a way to express any thoughts or ideas that could be unbearable even for the most supportive of families. Professional practitioners are able to handle and contain the young person’s distress in a way that family or friends may not be able to, due to their own grief or worry. Professional support can also help young people to develop their own coping strategies and prevent further harm. It aims to offer a judgment-free environment in which someone can express all their complex feelings, including any they do not want to face, such as relief, shame or anger.
Group support
Group support can be particularly helpful for children and young people who are bereaved by suicide. Just the process of hearing other people’s stories immediately makes the young person realize that they are not alone. Other young people who had similar experiences sometimes provide more powerful support than professionals who may be perceived by the young person as being out of touch. In conclusion, some of the feelings involved in bereavement after a suicide may be different to other bereavements, and the effects may be much stronger and longer-lasting. There are particular challenges around such a death that may make the normal processes of grief much harder. Children and young people may need similar kinds of support as for other bereavements, but with a greater awareness of the extra challenges, more time and greater understanding from those people around them
