|Preventing Suicide: How to Start a Survivors Group (WHO, 2000, 50 p.)|
What are self-help support groups?
Self-help support groups are groups made up of people who are directly and personally affected by a particular issue, condition or concern. They are run by their members, which means that those directly affected by the issue are the ones who control the activities and the priorities of their group. While many self-help groups obtain resources and assistance from outside the group, e.g. from professionals or other groups, the members are the decision-makers.
Evidence strongly suggests that self-help support groups are a powerful and constructive means for people to help themselves and each other. It has been shown that the groups can make a significant contribution to positive outcomes for those who participate. There appears to be an increasing tendency for individuals to get together and form such groups.
The drive for the establishment of groups has come from two directions:
· from individuals in response to unmet needs;
· from formal services in an effort to provide additional support and care.
The establishment of self-help support groups became popular after the Second World War. Groups to support bereaved widows in both North America and the United Kingdom were established in the 1960s. Groups specifically for suicide bereavement started in the 1970s in North America and have since been established in various centres throughout the world. In a number of countries established bereavement groups branched out and formed suicide bereavement groups. These include The Compassionate Friends, which was originally established in Coventry, England, and now operates extensively in Canada, Malta, New Zealand, the United Kingdom and the USA. Other such groups are CRUSE in England, SPES in Sweden and Verwaiste Eltern in Germany. The majority of groups are in English-speaking countries.
Survivor (survivor refers to those who are left behind) support groups are gaining recognition as a means of providing for the need of survivors, supported partially in some countries by government funds, but also by religious groups, donations and the participants themselves. The International Association for Suicide Prevention (IASP) has noted a marked increase in interest in this area over the past decade. The driving force behind the formation of many of the groups comes from survivors themselves.
Importance of self-help support groups for those bereaved by suicide
Research has demonstrated that the mode of death differentially affects grief reactions and supports the proposition that survivors of suicide grieve differently. Usual grief reactions are intensified by a suicide. Suicide survivors have been shown to exhibit elements of grieving that are less likely to be present in other bereaved people. Suicide survivors report more frequent feelings of responsibility for the death, rejection and abandonment than those who have lost someone from natural causes. Feelings of stigmatization, shame and embarrassment set them apart from those who grieve a non-suicidal death. The survivor is more likely to spend a greater proportion of time pondering on the motives of the person who committed suicide, the question why being continually present. The universal assumption that parents are responsible for their children's actions can also place parents who have lost a child by suicide in a situation of moral and social dilemma. There are more taboos attached to the discussion of suicide than to any other form of death. Those bereaved by suicide often find it very difficult to admit that the death of their loved one was by suicide, and people often feel uncomfortable talking about the suicide with them. Those bereaved by suicide therefore have less opportunity to talk about their grief than other bereaved people. A support group can assist greatly, as a lack of communication can delay the healing process.
The coming together of those bereaved by suicide can provide the opportunity to be with other people who can really understand, because they have been through the same experience; to gain strength and understanding from the individuals within the group, but also to provide the same to others.
The group can provide:
· a sense of community and support;
· an empathetic environment and give a sense of belonging when the bereaved person feels disassociated from the rest of the world;
· the hope that normality can be reached eventually;
· experience in dealing with difficult anniversaries or special occasions;
· opportunities to learn new ways of approaching problems;
· a sounding board to discuss fears and concerns;
· a setting where free expression of grief is acceptable, confidentiality is observed, and compassion and nonjudgemental attitudes prevail.
The group may also take on an educational role, providing information on the grief process, on facts relating to suicide, and on the roles of various health professionals. Another major function is that of empowerment - of providing a positive focus enabling the individuals to regain some control over their lives. One of the most devastating aspects of a suicidal or accidental death is that there is invariably much unfinished business and many unanswered questions, and yet the individual can see no way of resolving the situation. The support of a group can often gradually dissolve the feelings of hopelessness and provide the means whereby control can be regained.