What are the most effective interventions to support children and young people bereaved by suicide in the family: a rapid review
Background and Context
In 2021, there were 5,583 suicide deaths in England and Wales (Office for National Statistics, 2022). Many of these deaths would have been parents or siblings, leaving behind bereaved children and young people.
Bereavement by suicide is different from other forms of bereavement and needs specialised support. Children and young people who have lost loved ones to suicide are more likely to suffer a complicated bereavement process and have poorer mental health.
The review was requested to inform one of the Welsh Government’s suicide prevention strategy objectives: “to provide information and support to those bereaved or affected by suicide and self-harm”, and to build on the recent consultation on “postvention” (suicide bereavement) support with a view to developing guidance on responding to young people affected by suicide.
Aim
This review aimed to assess the evidence for the effectiveness of interventions to support children and young people (up to 24 years) bereaved by suicide. The review included evidence available up until 29 March 2023.
The findings will guide Welsh Government’s strategy and work with agencies and charities that support children and young people following the suicide of a close family member.
Strategy and Outcomes
A search for primary research studies identified 348 records, of which 3 studies met the inclusion criteria and were included in this review. The three studies all reported on group therapy interventions, lasting between 10 and 14 weeks. These included children aged 6 to 15 years.
Key Findings
Reductions in anxiety and depressive symptoms were found in children who received the group interventions. However, due to the study designs used and limitations of the included studies, it is unclear if this is attributable to the interventions, so caution should be applied.
- The strongest evidence came from a non-randomised controlled study, in which children in the intervention group had significantly greater reduction of anxiety and depressive symptoms compared with children in the control group. However, this study was limited due to numbers of participants lost to follow-up.
- Some behavioural and social outcomes, such as anger and disruptive behaviour, were measured, but the results are more inconclusive due to the small sample sizes and lack of a control group in those studies.
Summary
It is difficult to draw firm conclusions due to the limited evidence and low quality of studies available. However, there are indications that group interventions may help to reduce anxiety and depressive symptoms in children bereaved by suicide. It will be important to develop guidance and standards of practice for these services based on best available evidence. All such services must use validated outcome measures as part of an integral evaluation process set up from service initiation.
Further research is needed to develop interventions to support children and young people bereaved through death by suicide of a family member. Additional research is needed to evaluate the effectiveness and cost-effectiveness of planned interventions.
Lay Summary written by Rashmi Kumar
RR0007