Suicide - Coping with loss

Losing someone you care about to suicide is devastating. There is not right or wrong way to feel. You will deal with the loss in your own way. This section looks at what support is available when someone has taken their own life. It also provides information about investigations that may happen.

Overview

  • Losing someone to suicide can cause overwhelming shock and grief. You may struggle to deal with what has happened. You can get support from people who understand what you are going through.
  • Remember that it is not your fault. It was their decision to end their life. No matter what happened.
  • When someone dies, they may leave behind practical things you will need to help sort out. Such as money matters. You may be able to speak to a money adviser who can talk through any financial issues resulting from a death, including debt.
  • When someone has taken their own life, there will be an inquest which looks at where, when and how the person died.
  • You might feel that mental health services did not provide enough support to your friend or relative before they died. You could make a complaint or there may be a case for clinical negligence.
  • Supporting someone who has lost someone to suicide is an important role. Making yourself available for chats or practical support can be helpful.

Coping with grief

How do I cope with grief?

Losing someone you care about is always difficult. But losing someone to suicide can come with extra emotional problems.

How may I be thinking?

This will be personal to you. There is no such thing as ‘normal’ thoughts.

You may think 1 or more of the following thoughts:

  • I didn’t do enough to support them.
  • I made the situation worse.
  • I could’ve stopped them.
  • I shouldn’t have left them alone.
  • I didn’t realise how bad they were feeling.
  • How dare they leave me.
  • I don’t understand why they did it.
  • Why didn’t they talk to me?
  • There is still a stigma around suicide.

These thoughts are common. But whatever you are thinking, it’s important to remember that when someone has taken their own life, it was their decision. It was out of your control. It wasn’t your fault.

How may I be feeling?

There is no such thing as a normal feeling. Grief is a personal experience. Whatever you feel, is a normal feeling. Common feelings are:

  • shock and numbness,
  • overwhelming sadness,
  • tiredness or exhaustion,
  • anger. This maybe towards the person who has died, God, or their illness, and
  • guilt. You may feel guilty about how you feel, or something that you did or didn’t do.

These feelings are likely to pass or become easier to deal with in time. Allow yourself time to deal with what has happened. Emotional support may help you to deal with your emotions quicker.

How long will I feel this way?

There is no set length of time for dealing with a bereavement. But if you feel as though your symptoms have lasted too long, or they are having a big impact on your life you should get support.

A big impact on your life may be:

  • not able to move on,
  • not able to get out of bed,
  • self-neglect, such as not bathing or eating, or
  • damaging existing relationships.

Emotional support

Where can I go for emotional support?

There are always people who can help with how you are feeling. Taking the first step to talk to someone about how you are feeling can be very difficult. Talking about how you are feeling is an important step of the grieving process for many people. Take this step when you feel ready.

You can get emotional support from:

  • friends and relatives,
  • a religious leader,
  • charities, through their emotional support lines and support groups, or
  • a counsellor.

There is a list of charities at the bottom of this page in the useful contacts section.

Emotional support lines are not the same as counselling services. Often emotional support lines are called ‘listening services.’ They are there to provide a listening ear.

They can be a support if you want a confidential and non-judgemental safe space to talk. Especially if you are finding it difficult to talk to others who are struggling with the loss too. Or if you are experiencing feelings which you think other people may not agree with.

Counselling

You may be able to get counselling through:

  • NHS,
  • charities,
  • organisations that train counsellors,
  • employee assistance programme through your employer, or
  • private therapy.

NHS
The NHS may be able to offer you bereavement counselling. Or they may refer you to a local bereavement service.

Talk to your GP to find out what bereavement services you are able to access in your area.

In October 2019 the government announced plans to roll out NHS bereavement services for people who are affected by suicide. This will include one to one sessions with volunteers, group support and referrals to mental health services. At the moment this is only available in 10 areas across England. Click the link below for more information:
www.gov.uk/government/news/suicide-bereavement-support-to-be-made-available-across-england

Charities or organisations that train counsellors
Charities or organisations that train counsellors sometimes offer free or low-cost counselling services. You will need to look online to see if there are any charities offering counselling in your area.

Employee assistance programme
Your employer may provide an employee assistance programme (EAP). An EAP will often offer legal advice or counselling service which is free to use. It is a confidential service. Your employer won’t be told if you use it.

Private therapy
You can choose to pay to see a therapist privately. The benefits of private therapy are:

  • you have more choice,
  • there may be shorter waiting times, and
  • you can be more flexible about who you see.

But the main drawback is the cost. Some therapists offer reduced fees for people on low incomes. You can ask the therapist if they offer this. Some therapists may also have cheaper initial assessment appointments. This allows you and the therapist to see if you will get on together.

If you don’t feel you would work well with the therapist, you do not have to see them again.

It is important to understand the terms and conditions of seeing the therapist and payments before you agree to anything.

You can find more information about ‘Talking therapies’ by clicking here.

Practical support

Where can I go for practical support?

You may have practical issues to deal with following someone’s death. You may have to:

  • tell other family and friends what has happened,
  • register the death,
  • arrange the funeral,
  • check if they have a life insurance policy,
  • check if they have a will,
  • deal with their estate,
  • check if you can get any bereavement benefits, and
  • tell organisations about their death such as: 
    • their banks,
    • Driver and Vehicle Licensing Agency (DVLA),
    • utility companies,
    • credit card companies, and
    • the Department for Work and Pensions (DWP).

The government website has a step by step guide for you to follow called ‘What to do when someone dies.’ This gives information about what to do after a death. You can find this at www.gov.uk/when-someone-dies.

Where do I go if I have debt?

If someone’s death has caused you financial hardship you can get support from debt organisations. You can find these in the useful contact details below on this page.

Investigations

Will there be an investigation into their death?

When someone takes their own life there will be 1 or more investigation into the death. This process can be very hard when dealing with grief at the same time.

These investigations can help you to get answers to questions you may have about someone who has taken their own life.

The investigations are:

  • inquest,
  • case note review, and
  • safety incident investigation.

What is an inquest?

An inquest will be held if it appears that someone has taken their own life. An inquest is a court hearing where a coroner, who is usually a doctor or solicitor, investigates someone’s death. An inquest looks at:

  • who died,
  • where they died,
  • when they died, and
  • how they died.

An inquest can’t blame a particular person or organisation for someone’s death.

The inquest will say how they think that someone has died based on the evidence. These include the following.

  • Suicide
  • Natural causes
  • Accident
  • Alcohol or drug related
  • Open. This is when there is not enough evidence to say how someone died.

The coroner has to tell certain people the following information about the inquest hearing:

  • date of hearing,
  • time of hearing, and
  • where hearing will be held.

The coroner has to tell the following people of the deceased:

  • the next of kin,
  • personal representative, and
  • anyone else interested in the person who has died, who has made themselves known to the court. This is called an ‘interested person.’

The inquest hearing will be public. This means that you can go along to the hearing.

The coroner will decide who will give evidence. You can suggest witnesses who you think may be helpful. You can tell the coroner directly or do it through your solicitor if you have one. Your coroner may release a witness list of who they are planning to include. A coroner will:

  • call a witness to give evidence at the hearing, or
  • will arrange for their statement to be read at the inquest without the need for the witness to attend.

Will an investigation happen if my loved one ended their life in prison or was detained under the Mental Health Act?

An Article 2 inquest must be held if someone took their own life when they were in state detention. This includes:

  • detained in hospital under the Mental Health Act,
  • police custody,
  • prison, or
  • immigration centre.

An article 2 inquest will still look at:

  • who died,
  • where they died,
  • when they died, and
  • how they died.

But it will also look at the broad circumstances of the death. This will include events that led up to the death.

The wider investigation has to happen to make sure that they meet their legal duty to comply with Article 2 of the European Convention of Human Rights. Article 2 is a right to life.

The investigation will be carried out by someone who was not involved with what happened to your relative.

The organisation INQUEST may be able to give you more information about an Article 2 inquest. Their contact details are in the useful contact section further below on this page.

Should I get a solicitor?

Inquests can be a complicated legal area. You may want to get support and advice from a solicitor.

Can I get legal aid?
You may be able to get legal aid. You can check by:

  • using a legal aid calculator. Click this link to use www.gov.uk/check-legal-aid, or
  • contacting Civil Legal Advice. Their contact details are at the bottom of this section.

Will there be an NHS investigation into mental health care and treatment?

Since September 2017, NHS trusts should publish details of how they respond to, and learn from, the deaths of patients in their care. You can usually find this on their website. Or you can call them and ask for details.

A case note review will be carried out when a ‘significant concern’ is raised about the care provided to a patient.

Significant concern means:

  • any concerns raised by family that can’t be answered at the time, or
  • anything that is not answered to the family’s satisfaction.

This may happen if the death is accidental, sudden or unexpected.

A case note review means that a clinician will look at the case notes of the person who has died. The clinician will usually work for the NHS, but they will not have been involved with the person’s care.

They will look at how well care was provided to the person who has died. If the review finds any issues with the care they received, you will be contacted to discuss this.

Will there be an independent investigation into healthcare?
External investigators may be asked to investigate if the death is because of a ‘safety incident.’ But sometimes these investigations are carried out by the NHS.

A safety incident is an incident, which could have led, or did lead to, harm for patients receiving the healthcare. The incident will be unintended or unexpected.

A safety investigation should happen if there is concern that a safety incident may have contributed to a patient’s death. The aim of the investigation is to learn from mistakes and reduce future risk for patients.

You should be told if an investigation is going to happen. The investigation process will be explained to you. And you should be asked when and if you would like to be involved.

Can I get more information about the investigation process?
The local mental health trust should have a policy on how they investigate deaths of patients in their care. You can ask for a copy of this policy. You may need to make a Freedom of Information request.

The policy should look at communication with family and carers and how you will be involved.

Follow this link for more information about ‘Freedom of information requests.’

www.england.nhs.uk/contact-us/foi/

Your local Patient Advice & Liaison Service (PALS) may be able to help you get a copy of this policy. You can find details of your local PALS office through the website link below.

www.nhs.uk/service-search/patient-advice-and-liaison-services-(pals)/locationsearch/363

What can I do if I think that someone’s death was caused by their treatment and care?

You can ask for an investigation if you have concerns that your loved one’s care or treatment lead to their death. Talk to Patient Advisory and Liaison Service (PALS).

PALS are part of the NHS. They offer confidential support, information and advice to patients and their family.

Follow the below website link to find your local PALS:

www.nhs.uk/Service-Search/Patient-advice-and-liaison-services-(PALS)/LocationSearch/363

What can I do if I think that compensation should be awarded?
A case review and investigation will not deal with compensation. If you think that someone’s care was negligent you can contact AvMA for advice. Their contact details are in the Useful Contacts section at the bottom of this page.

Can I make a complaint?

You can make a complaint if you are not happy. For example:

  • you may feel that the case note review or safety incident investigation doesn’t answer all your concerns about their care or treatment, or
  • you may feel that the case note review or safety incident process has not been followed correctly.

You may want to wait until an inquest has been held before you make a complaint. This may help you find out about other problems that you want to complain about.

There is a 12-month time limit for making an NHS complaint.

Can I get support to make a complaint?
An NHS complaints advocate can help you if you need support to make a complaint. An NHS complaints advocate is free to use and not part of the NHS.

You can usually find an NHS complaint advocate by using an internet search engine such as Google. You can type in phrases such as, ‘NHS advocate in Birmingham.’ Or wherever you live.

You can find out more about:

  • Inquests by clicking here.
  • Advocacy clicking here.
  • Legal Advice clicking here.
  • Clinical Negligence clicking here.
  • Complaints - NHS and social care clicking here.

Helping someone else

How can I help someone who has lost a friend or relative to suicide?

You should treat them the same way as you would treat anyone who is grieving. You may worry about saying the wrong thing. But remember that you know this person, trust your instincts.

It may help to:

  • let them know that you care about them and that they are not alone,
  • encourage them to talk,
  • empathise with them. You could say something like, ‘I can’t imagine how painful this is for you, but I would like to try to understand,’
    listen,
  • be non-judgemental,
  • repeat their words back to them in your own words. This shows that you are listening. Repeating information can also make sure that you have understood them properly,
  • offer to help them with the practical tasks following death such as sorting finances, or
  • offer to keep in contact.

It may not help if you:

  • try and find an easy solution for them,
  • change the subject,
  • talk about yourself,
  • judge them, or the person who has died,
  • tell them that they shouldn’t feel like that,
  • tell them that are being silly, or
  • don’t follow through with your commitments.

Remember that you don’t need to find an answer, or even understand why they feel the way they do. Listening to what they have to say will at least let them know you care.

Further Reading

Survivors of Bereavement by Suicide (SOBS) have information for friends and family– which provides advice on how to support someone who has been bereaved. www.uksobs.org/about/suicide-bereavement/supporting-the-bereaved/supporting-friends-and-family/

The Department of Health has a booklet for people who have been bereaved by suicide called ‘Help is at hand’. It provides advice on both the emotional and practical aspects of grief and you can download it at www.supportaftersuicide.org.uk/support-guides/ . Or order a hard copy by ringing 0300 123 1002.

National Debtline have a factsheet called ‘Dealing with the debt of someone who has died.’

www.nationaldebtline.org/EW/factsheets/Pages/dealing-with-debt-when-someone-dies/bereavement-and-debt.aspx

Useful Contacts

Survivors of Bereavement by Suicide (SOBS)
SOBS is an organisation set up for people over the age of 18 who have lost someone to suicide. They have a national helpline offering support. They also have group meetings and information factsheets.

Telephone: 0300 111 5065 (9am-9pm, Monday - Friday)
Address: The Flamsteed Centre, Albert Street, Ilkeston, Derbyshire DE7 5GU
Email: email.support@uksobs.org
Website: www.uksobs.org

Support After Suicide Partnership
A special interest group of the National Suicide Prevention Alliance who focuses on supporting those bereaved or affected by suicide.

Email: online contact form at: www.supportaftersuicide.org.uk/contact/
Website: www.supportaftersuicide.org.uk

Cruse Bereavement Care
Cruse offer free, confidential help to bereaved people. Some of their local branches also have support groups for people who have been bereaved
by suicide.

Telephone: 0808 808 1677 (9.30am-5pm, Monday-Friday – excludes bank holidays, with extended hours until 8pm Tuesdays, Wednesdays and Thursdays)
Address: PO Box 800, Richmond, Surrey, TW9 1RG
Search for local branches: www.cruse.org.uk/get-help/local-services
Website: www.cruse.org.uk

INQUEST
Provides information about inquests including the rights of the family to be involved. It has also produced ‘The inquest handbook’. INQUEST gives a free copy to bereaved families or you can read it on their website. It also runs an advice telephone and email service.

Telephone: 020 7263 1111 (press option 1 – Monday, Wednesday and Thursday 10am – 5pm)
Address: 3rd Floor, 89-93 Fonthill Road, London, N4 3JH
Email: online form at www.inquest.org.uk/forms/help-and-advice-form
Website: www.inquest.org.uk

The Bereavement Advice Centre
This is a national service providing free practical advice about what to do after a death. Such as dealing with their debt. They have guides available for you to follow on their website.

Telephone: 0800 634 9494. Open 9am-5pm, Monday to Friday
Address: Bereavement Advice Centre, Heron House, Timothy's Bridge Road, Stratford Upon Avon, CV37 9BX
Website: www.bereavementadvice.org

The Compassionate Friends
This service supports bereaved parents and their families for the loss of a child.

Telephone: 0345 123 2304 (9:30am - 4:30pm)
Email: info@tcf.org.uk
Website: www.tcf.org.uk

National Debtline
Provides free, independent, confidential advice on a self-help basis. You can contact them over the telephone, by e-mail or letter.

Telephone: 0808 808 4000. Monday to Friday 9am-8pm and Saturday 9.30am-1pm
Address: National Debtline, Tricorn House, 51-53 Hagley Road, Edgbaston, Birmingham, B16 8TP
Webchat: visit website to use webchat
Website: www.nationaldebtline.org

Action Against Medical Accidents (AvMA)
(AvMA) is a UK charity which gives free and confidential advice and support to people affected by medical accidents.

Telephone: 0845 123 2352 (Monday to Friday 10am until 3.30pm)
Address: Freedman House, Christopher Wren Yard, 117 High Street, Croydon, CR0 1QG
E-mail: visit website to use client form
Website: www.avma.org.uk

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