Postvention and its role in suicide prevention
Commissioner Gwene Cherne
Veteran Family Advocate
The Royal Commission into Defence and Veteran Suicide has laid bare the devastating impact suicide has on our veteran community. The numbers are staggering.
According to the Australian Institute of Health and Welfare, between 1997 and 2020, 1,600 current and former members of the Australian Defence Force (ADF) lost their lives to suicide. This is a national tragedy and we need urgent action to support our ADF members and veterans. But an often forgotten consequence of suicide is the long-lasting impact it has on the people left behind.
Each suicide sends a wave of grief and trauma through the veteran community. Recent research shows that for each person who dies by suicide, 135 other people are directly impacted. Partners, children, family, friends, colleagues. A single person touches so many lives.
No matter the cause, coping with a loved one’s death is always difficult. But suicide carries extra burdens. Often the death is violent and sudden. Families can be left with questions about why their loved one took their life. They may blame themselves; they may wish they had noticed something sooner, or tried harder to get help. This can cause trauma.
Feelings of grief are inevitable. After all, grief is an expression of love. But trauma is also present too. While trauma and grief may go hand in hand, they are different, and the treatment to recover from each is also different.
This is why it’s time to have a conversation about postvention, and the steps we can, and should take, to better support families struggling after suicide.
So, what is postvention? Postventions are supports provided to families after a suicide has occurred. Postvention recognises that suicide has a profound impact that differs from other deaths. People who have lost someone to suicide are at an increased risk of dying by suicide themselves. They are also likely to experience symptoms of posttraumatic stress. They may become socially isolated, struggle with feelings of guilt and shame or succumb to substance abuse.
But with targeted support, risks can be managed and families given the best chance to rebuild their lives after suicide.
Immediately following a death, people should receive access to services that can assess and provide support for posttraumatic stress. After a death, many people report feeling alone and are reluctant to seek help. How could anyone understand what they’re going through? If you haven’t experienced it, you couldn’t know. But there is a community who have been there. People who have lived through the trauma and recovered. So we need to get better at connecting those who are left behind. Talking to someone who knows what they’re going through is the best way to validate their feelings, share their grief, and receive advice on how to seek specialist support.
Something postvention can give people is a language to talk about their pain. The shock, the grief and the trauma that comes with losing a loved one to suicide has no comparison in daily life. For the longest time I didn’t know how to speak about it, and that traps the pain inside, where it festers and grows darker day by day. Eventually it becomes a monster that you don’t want to look at, let alone speak about, and it is heavy. But through postvention you can learn a language that gives voice to those feelings and gain a community where it is safe to connect and tell your story.
Sometimes when you’re having a bad day it can be as simple as saying, ‘I feel like my feet are in concrete and I’m sinking to the bottom of the sea,’ and have someone there who understands. It also helps those suffering to connect better with those around who are not as affected by the death. Those left behind often lose people from their social networks after the suicide. Learning how to reconnect to loved ones who cannot understand the deep, heavy, unrelenting pain can be life saving.
Once a person has the support they need, they can start to move beyond the initial shock of the death. It is true that the grieving never truly stops. But with time and work it is possible to adapt to the daily rhythms of grief, and begin a new relationship with a loved one which isn’t defined by their death.
If we give families these tools to navigate their grief and trauma, they will have the best chance to build a new life. In time, they may even provide support to someone else who is suffering.
We need to get better at making the tools for recovery available. Recent research out of the Tragedy Assistance Program for Survivors (TAPS) has led to the development of best-practice postvention treatment. They have shown that for someone to have the best chance of recovery, they need to be connected to an understanding community. They need to receive early assessment of their own mental health, and easy access to appropriate trauma support. And we need to remember that support will look different for different people. That’s why we need networks of providers who specialise in a range of different treatment and delivery strategies, so people can get the right help that will work for them.
Postvention is not a silver bullet. On its own, it cannot cure the trauma. But it is an important tool. Armed with these tools families will feel supported and be better able to build a new life after loss.
Right now, I am working with Military and Emergency Services Health Australia, a number of organisations and lived experience leaders in our community to develop a framework that will align support systems for bereaved families with the Postvention Australia Guidelines. There is a wealth of expertise in our civilian suicide services. It is time for Australia to use that knowledge, listen to the lived experience of veteran families, and design a formal postvention program that focuses on educating the bereaved. We know what we need to do to help families through these devastating ordeals. It’s time to make it happen.
References:
- National suicide monitoring of serving and ex-serving Australian Defence Force personnel: 2020 update, Introduction – Australian Institute of Health and Welfare (aihw.gov.au)
- How Many People Are Exposed to Suicide? Not Six – PubMed (nih.gov)
- Responding to Grief, Trauma, and Distress After a Suicide: U.S. National Guidelines | Suicide Prevention Resource Center (sprc.org)