An examination of mental disorders associated with spousal suicide bereavement: a longitudinal population-based study
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Date
2012
Authors
Spiwak, Rae
Journal Title
Journal ISSN
Volume Title
Publisher
Canadian Journal of Public Health
Abstract
Suicide bereavement is a significant public health problem, with an estimated 48 to 500 million individuals bereaved by suicide every year. Accurate measurements of suicide bereavement related health is an essential component to understanding this public health problem and organizing appropriate resources for prevention and intervention. Spousal suicide bereavement is thought to be associated with poor health outcomes due to its substantial impact on the surviving partner. There are limited theoretical frameworks to better understand the relationship between suicide bereavement and associated health, therefore to address these limitations we proposed an integrative risk framework that is testable using administrative data. The overall goal of this research was to determine if spouses bereaved by suicide have greater rates of mental disorders as compared to spouses bereaved by other sudden deaths. To achieve this goal, 7 manuscripts were written in the areas of theory, methodology, policy, and four related studies using longitudinal population-based administrative data to examine rates of mental disorders among spouses bereaved by suicide, sudden natural death, and unintentional injury. These cohorts were examined both individually as compared to matched non-bereaved spousal samples and then comparatively where suicide bereaved spouses were compared to spouses bereaved by sudden natural death and unintentional injury death using advanced statistical modeling. The overall findings of this research demonstrate that while spousal bereavement seems to be a time of poor mental health, when comparing bereavement cohorts, suicide bereaved spouses appear to be doing more poorly overall. The findings from this body of research support the need for future studies in numerous areas. First, research is needed to examine the impact of the deceased’s pre-death health on the surviving spouse to determine if caregiver stress helps explain the elevated pre-bereavement rates of mental disorders found. Second, the role of guilt and stigma in suicide bereavement and its impact on help seeking is an additional area for future work to determine if reported rates are potential underestimates due to these factors. All of these factors will ultimately inform targeted interventions for spouses bereaved by suicide.
Description
Keywords
Mental health, Suicide, Epidemiology, Bereavement
Citation
Spiwak R, Elias B, Bolton JM, Martens PJ, Sareen J. Suicide policy in Canada: lessons from history. Can J Public Health. 2012;103(5):e338-341.