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Words to say it: When a parent dies by suicide

Serving Families with Children Following a Parent's Suicide

We were recently asked to assist a funeral director with providing information for a family to use following the death of a parent by suicide. Thank you to Nancy Rappaport, MD for providing us with the following advice. She is an Assistant Professor of Psychiatry at Harvard Medical School and an attending child and adolescent psychiatrist at the Cambridge Health Alliance, a Harvard teaching affiliate, where she is also Director of School-Based programs with a focus on servicing youths, families and staff in public schools. She is the author of "In Her Wake: A Child Psychiatrist Explores the Mystery of Her Mother's Suicide."

Words to say it: When a parent dies by suicide

By Nancy Rappaport, MD

Finding the "right" words to tell a child that they have lost their parent is always a challenge, particularly when a parent dies by suicide. The guidelines below offer a developmentally informed approach for guardians or surviving parents who may be stunned or upset in the immediate aftermath of losing someone to suicide.

TIP: If possible, find a quiet place where you can be alone with the bereaved child. Invite one other trusted adult if you need additional support or if your child may be comforted by their presence.

Start the conversation by asking the child what he or she has noticed or heard about the recent death. Most children will see from your expression and hear in your voice that something upsetting has happened and many will have observed or overheard upsetting comments about the death. It is important to learn what your child may have come to understand, so that you know where to begin and so you can correct any mistaken ideas. Different ages require different approaches. These are some of the things you may want to explain to your child/teenager.

Older Children and Teenagers (8-16 years old): "I have really sad news to tell you. Your parent died."

"We have some information and it seems like he died by suicide [where it happened, who found the parent, brief facts]. I am really upset and I expect that each of us will have lots of different feelings over the next days, weeks, and months as we try to understand how something like this could have happened."

"I want you to know that you are not alone and I will be here for you. I don't want you to suffer alone, so I hope you will share your thoughts and feelings with me and guide me in the ways I can be most helpful to you."

"You may choose to talk with me now or later about what you are feeling, and if you want to ask more questions, I will be available to you. It may be hard to figure out what you need right now, but we will figure this out together."

"Sometimes when a parent dies by suicide, people think that they may have done something to cause it. I can tell you that you are not responsible and that your parent loved you."

"Some people we know may focus on how your parent died, because suicide is especially upsetting to others, but I hope we will be able to focus less on this last piece of [Mom/Dad's] life and more on how he/she lived and all the things we shared together.

"We never know what goes through someone's head in the last minutes of their life. If someone feels so bad that they want to kill themselves, not only can it make us feel sad, but we may feel angry at times as well."

"This is a lot to take in. I am going to be quiet now. I am just going to sit here for a bit in case you want to talk, or you can just sit with me." (Sit for 20 minutes, let child go whenever he or she wants to ... but let him or her know that you will check in with them again in a couple of hours.)

TIP: Older children and teenagers sometimes process momentous information in a disjointed manner compared to the ways adults process traumatic events. As a result, kids can sometimes seem unfazed by the news of suicide, or they may want to go on as if nothing dramatic has happened. This "denial" may simply mean that they need time to process an unimaginable loss. It is important for you to invite their questions, which may arise at seemingly random times. It may be helpful for you to make a point of "checking in" with the child/teenager at various times and to be sure to make time alone with them in the hectic aftermath of a death.

Younger children (4 to 8 years old): "Daddy/Mommy died. We are all so sad and surprised. Am I the first one to tell you this or did you already hear this?"

"What did you hear?"

"Daddy/Mommy died. We think Daddy had a brain illness which made him very confused and he didn't know how to get help."

"Do you know what it means to be dead? Sadly, when someone is dead like [Grandma's cat, Uncle Albert, etc.] they are dead forever. Dead means the person can't eat, or hear, or talk because when a person dies his/her body stops working forever and it can't be fixed."

"We can remember them from pictures and talk about them, but we cannot see them anymore. It is really sad, confusing, and hard to believe. Does this make sense?"

"What are you wondering about?"

"I hope you'll ask me any questions you have or let me know if you have any worries."

"Nothing any of us thought or did caused [Daddy/Mommy] to die and that is important to remember."

(Talk about who will be there for the child on the day you speak with them, and who will be there from that point on, reassuring them what will be the same in the routine and what may be different. Reassure your young child that you are still a family and he/she is still loved by many people who you can name for them.)

TIP: Children will do better when you are honest with them and they get accurate, concrete information about what has happened to their parent, explained in a way that is appropriate for their age. As the conversation unfolds, a child will let an adult know what he/she may need to know. This is more appropriate than providing all sorts of information right away as this can be overwhelming to a young person. Children will teach us what they need to know, and being honest with them allows them to stay trusting of you during a time they may feel vulnerable.

In addition, children of any age need explicit reassurance that they are not to blame for the suicide of their parent.

Infants to 3 Year Olds: Write a letter telling the story that will be read to the child later in life. Ask others to write down memories of the parent and to collect photos of the parent so that the child can use these to help understand this time when he or she is older.
Although they may not be able to talk or grasp the situation at hand, hold, rock or cuddle your young child. [Refer to Younger Children (4-8 years old) section when child matures.]

TIP: Bereaved spouses and close family members are often preoccupied, distraught, and quite busy in the days following a death. It may be helpful to designate one or two people to be responsible for attending to the young child during that time.

Whatever the child's age, suicide is an enormous life event that will be revisited many times over the ensuing weeks and months and as the child enters new developmental phases. This is not a one-time conversation to have with your child, but the beginning of an ongoing dialogue throughout the child's life.