Their needs may require special attention

For every suicide it is claimed that on average six people suffer intense grief.1 With around 5000 suicides per year in England and Wales and at least 800 000 worldwide, the burden of suicide is immense. Those affected include parents, partners, children, siblings, friends, colleagues at work, and clinicians. The need for provision of care for this population is emphasised in the National Suicide Prevention Strategy for England.2 This issue has also been highlighted by the recent publication of the European Directory of Suicide Survivor Services by the International Association for Suicide Prevention, which lists support services for people bereaved by suicide.3 Here we review the specific issues faced by people who have lost someone through suicide, the nature of available help, and future needs in this area.

Does bereavement by suicide differ from the impact of other sudden death? Initial uncontrolled studies implied a particularly difficult grief process. More recent studies controlling for effects of loss in general have shown that bereavement after suicide is not necessarily more severe than other types of bereavement but that certain features or themes may be more prominent.4^–7 These factors may make coping with the …