Clinical and social burden for suicide survivors: if I had dealt with it properly

A suicide victim’s milieu is called “survivors”: around 6-32 family members and friends, professionals, involuntary witnesses, fellow-students and collaborators, who have lost a “significant” or loved one, keep suffering from life challenges. Their grief can be differentiated as “normal” or complicated (traumatic, prolonged), the latter representing loss rejection disorder, i.e., complicated, delayed or suspended grief relief. The loss is aggravated by the suicide circumstances: in most cases (80%) the relatives see the death as a sudden and unexpected, brutal blow. Grief caused by loss to suicide can be featured by three factors: subject scope, the survivor’s social background (stigma), impact on the family’s structure and function. The effects of complicated grief are far-reaching (by 2-4 times greater than for common bereavement). Individual susceptibility or vulnerability often determines depression and suicide hazards. Postvention (tertiary prevention) is integrated in standard antisuicide multidisciplinary (team) and multiagency programs. The biopsychosocial approach combines psychoeducation, pharmacotherapy and psychotherapy, taking depression, feeling of guilt, stigma as therapy targets. Desirable comprehensive approaches should be based on the treatment needs, resources and availability, involving awareness support, cognitive and interpersonal technique, medication focused on antidepressive treatment.