People who lose a loved one to suicide, accident, or homicide should seek professional help rather than trying to cope alone

4. People who lose a loved one to suicide, accident, or homicide should seek professional help rather than trying to cope alone

Cost: Calling 12356 is free of charge. Visiting a doctor and attending a psychological clinic costs the same as any other outpatient visit. The hard part is mustering the courage to reach out.

In plain terms: Within five years after losing a spouse to suicide, men are about 80% more likely to develop a mental disorder compared to the general population, while women are about 70% more likely. Compared to those whose spouses died from other causes, this risk is still 70% to 100% higher. Such bereaved individuals also tend to feel isolated and ashamed. This is precisely why they should actively seek help rather than waiting for things to get better on their own.

Benefit: A nationwide Danish registry tracked 6.7 million adults from 1980 to 2014, totaling over 136 million person-years of observation. For bereaved individuals whose spouses died by suicide, the relative risk of being newly diagnosed with a mental disorder within five years was as follows: for men, the IRR was 1.8 (95% CI 1.6–2.0), meaning a roughly 80% higher risk; for women, the IRR was 1.7 (1.6–1.8), representing a roughly 70% higher risk. Compared to those whose spouses died from other causes, the IRR for men was 1.7 (1.5–1.9) and for women 2.0 (1.9–2.2), again indicating a 70% to 100% higher risk. This group also showed higher rates of suicidal behavior, mortality, and need for municipal social assistance. Physical health risks such as cirrhosis and sleep disorders were also elevated. An additional 57 separate studies were reviewed without pooling their results. Bereavement due to suicide is linked to four key outcomes: a higher risk of suicide among surviving partners; a higher likelihood of parents being admitted to psychiatric care after their child’s suicide; a higher suicide risk among mothers after their adult child’s death; and a higher depression risk among children after their parents’ suicide. Compared to those grieving after violent deaths from other causes, people bereaved by suicide report feeling isolated and ashamed more often.

Evidence grade: A

Sources: Erlangsen A, et al. (2017). Association Between Spousal Suicide and Mental, Physical, and Social Health Outcomes: A Longitudinal and Nationwide Register-Based Study. JAMA Psychiatry. <https://doi.org/10.1001/jamapsychiatry.2017.0226>; Pitman A, et al. (2014). Effects of suicide bereavement on mental health and suicide risk. The Lancet Psychiatry. <https://doi.org/10.1016/S2215-0366(14)70224-X>; Kristensen P et al. (2012). Bereavement and mental health after sudden and violent losses: a review. Psychiatry. <https://doi.org/10.1521/psyc.2012.75.1.76> (The summary in the notes)

Notes: Sudden, violent deaths refer to accidents, homicides, or disasters. After such events, rates of PTSD, depression, and prolonged grief are higher than after deaths from natural causes, and recovery tends to be slower. Guidance on handling suicidal thoughts is provided in Section 1, Item 25.