Best practices in postvention

Note: Research examining the effectiveness of postvention programs is limited and results of studies to-date are mixed. There is some evidence that some postvention strategies, including school-wide programs can be harmful.1 We need to continue to grow the evidence around postvention interventions by evaluating our work and sharing the lessons we’ve learned.

Interventions following the suicide or death of an individual should be based on four principles:  Support, learn, counsel, educate.2

A whole-community approach is important in postvention strategies – following a suicide, all relevant community partners need to work together.

These postvention guidelines have been adapted from The Riverside Trauma Center Postvention Guidelines

  • No information should be released until circumstances of the death are confirmed by the appropriate authorities.
  • Families may want to keep the cause of death private. They may need support exploring the pros and cons of sharing the cause of death.
  • Mobilize a crisis response team comprised of local resource partners and people who are close to and familiar with the youth. The crisis response team should try to gather for an initial meeting within hours of the death.
  • Some organizations (e.g. schools or workplaces) may be inclined to handle the crisis on their own, but outside partners can assist by providing consultation to those unaware of how to support individuals experiencing loss. Outside resources can also ensure that those who are directly responding to the crisis are themselves supported.

Tips:

  • Develop a strategy within your community to provide clarity about what to do, when to do it and who will do what. Ensure your strategy is supported by evidence so that you can learn from other people’s experiences. For information on developing a postvention strategy, check out the Policies and protocols section of this toolkit.
  • Be sure to evaluate what you’re doing so that you can build on what you know. For more information, check out the Evaluation section of this toolkit.
  • Work together. It shows solidarity as a community and can reduce frustration for those who are trying to help. For more information, check out the Come together section of this toolkit.
  • The most effective way to provide details is in a written statement that can be distributed.
  • The statement should include factual information about the death (including acknowledgement that it was a suicide), condolences to the family, plans to provide support, information about funeral plans and any changes in work or school schedules over the coming days.

Tips:

  • Don’t read an announcement over a public address system. Rather, have a conversation in smaller groups (e.g. homeroom, team meetings, etc.). This will give you a better chance to gauge reactions.
  • Provide everyone with the same information to prevent rumours. 
  • There are many people who may be impacted by the death, including family, close friends, fellow team/club members, colleagues, neighbours, a romantic partner, school staff and staff from agencies who may have been in close contact with the individual. Those impacted should be supported.
  • Friends and family of the deceased will experience the most acute loss and will require ongoing support. They should be at the centre of your postvention efforts.
  • The emphasis should be on mourning the loss. This extends beyond support provided immediately following the death. Plan to care for vulnerable individuals at potentially sensitive milestones (e.g. birthdays or anniversaries). 

Tips:

  • Many people will struggle to make sense of the why. This is an opportunity to remind people that suicide is never the result of a single factor, but rather is a convergence of many factors.
  • Those affected should be encouraged to get support from community mental health services or support groups.
  • Individuals deemed at risk need someone who knows them well to check on them and their family.
  • After a death by suicide, it’s important to identify whether close friends or others are at risk of suicide or other risky behaviours. Those at risk could include individuals who:
    • have a history of suicidal behaviour
    • experience depression
    • have a history of tragic loss or suicide in their family
    • identify with the deceased (regardless of whether they had a close relationship)
    • may have felt responsible for contributing to or who felt they could have prevented the suicide

Tip:

  • Those at risk may not need an immediate referral or evaluation, but they should be encouraged to ask for support and should be made aware of those who can be of most help to them.
  • Commemoration activities should be the same for any death, regardless of the cause. Focus on the personal attributes that will be remembered, rather than the cause of death. Whole-community events during the school or work day with required participation are not ideal. Voluntary commemoration activities and funerals that are held after school or work hours are preferred.
  • Focus on facilitating healthy grieving as a necessary form of prevention (e.g. memorialize those lost to suicide by encouraging and supporting suicide prevention activities of local or national organizations, raising scholarship money through activities or becoming involved in helping other suicide survivors).
  • Help individuals understand the grieving process and educate them about the signs and symptoms of depression, PTSD and suicide.
  • It’s important to use an evidence-informed curriculum.

Tip:

  • For younger people who haven’t experienced a loss, it may be comforting to understand that their reactions are normal.
  • Don’t panic.
  • If necessary, seek assistance from experts.
  • Work together as a community in a coordinated fashion to establish or carry out prevention plans and to ensure protocols are in place for responding to future suicidal behaviours.

Tips:

  • The community should consider forming a community coordinating committee. This committee should:
    • include membership from schools, public safety, community leaders, local mental health agencies, local media, clergy and the regional coalition for suicide prevention.
    • work together with the community on suicide prevention at the community level by developing plans and protocols to respond to any future deaths or suicidal behaviour and to begin a plan for prevention in the community (if applicable).
  • Link individuals and groups to resources for continued support as required.
  • Be sure to include contact information for emergency services.

Tip:

  • Think beyond traditional resources. Consider resources for basic needs, addictions, sexual health and crisis resources.
  • Obtain ongoing feedback from everyone involved in postvention services, including youth.
  • Be sure to evaluate everything you do! This can help you enhance your strategies should postvention be required again in the future.