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In addition to giving family members support at a crucial moment, working with them is vitally important because they may be at heightened risk for suicide themselves, says Phil Kleespies, PhD, who coordinates psychological emergency room services at the Boston Veterans Administration.

"Given the example set by one family member, others may perceive suicide as a way to solve emotional problems," he says. "Informing them about available resources for suicide survivors may increase their options and reduce the possibility of another tragedy in the family."

Clinicians are conducting simple but powerful interventions to help families cope. They include:

* Onsite interventions. A program run by the Baton Rouge Crisis Intervention Center in Baton Rouge, La., provides family members with support as close to the time of death as possible. Called LOSS, or Local Outreach to Suicide Survivors, the program works with the local coroner, police and other relevant officials to offer help to suicide survivors as part of the first-response team. With empathy and understanding, LOSS members help survivors deal with their immediate reactions to the death as well as to practical issues such as organ donation, funeral arrangements and viewing the body. "We've stayed on the scene as many as nine hours after the event," says Frank Campbell, a social worker who heads the Baton Rouge Crisis Intervention Center.

* Reconstructing the events. Another strong tool is to help families reconstruct the events of the suicide together. Family members often live with divergent views of what happened that day and may not have discussed it since. Helping them share their perceptions and create a more accurate picture can facilitate healing and closure. Campbell has worked successfully with families in this regard as many as 20 years after the fact, he says.

* Attending the funeral. This can help both the family and the clinician. In one instance, the family of a young man who had completed suicide invited Campbell to the memorial service. Besides bringing a measure of peace and closure to the family, the event "gave me the chance to have my own feelings of grief and bereavement validated," he says. The memorial service also is a time to tell families you're available if they wish to talk, Kleespies adds.

* Offering reassurance and fostering the grieving process. A typical reaction by families is to feel scrutinized by others after a suicide. This in turn can interfere with their ability to grieve, says Edward Dunne, PhD, director of Pride at Ackerman, a clinic for gay and lesbian families in New York. A basic intervention, therefore, is simply to let the family know they're being watched less than they think, and that everyone grieves differently, Dunne says.

--T. DeANGELIS