An exploration of the literature was undertaken on the question of whether or not bereavement after suicide, as opposed to other modes of death, renders individuals more susceptible to enduring and complicated grief reactions. The literature from qualitative research indicated that there appeared to be a greater prevalence of individual and contextual risk factors leading to complicated bereavement for survivors of suicide, as opposed to those bereaved through most other modes of death. Trauma-related research and survivors' anecdotal reports emphasised the potential for proximal factors and specific experiences in the immediate aftermath of a suicide that could facilitate, or complicate bereavement. Factors found to indicate that suicide bereavement is distinct include survivors more often experiencing feelings of rejection, responsibility, guilt and blame, with feelings of shame and embarrassment interacting with a sense of stigmatisation. In addition, reports indicated ambivalent, challenging and negative relationships with service providers after the suicide. The impact of such factors remains largely overlooked in the context of suicide, and we therefore argue that the immediate post-death experience, specific to suicide survivors, presents a critical primary site for risk prevention and building resilience with survivors. We reflect on training for front line workers in this context. ' (Parkes, 1985, p. 15)
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