What are the most effective interventions to support children and young people bereaved by suicide in the family: a rapid review

Abstract: Bereavement by suicide is different from other forms of bereavement and needs specialised support. Children and young people who lost loved ones to suicide are more likely to suffer a complicated bereavement process and have poorer mental health. This review aims to assess the evidence for the effectiveness of interventions to support children and young people (up to the age of 24 years) bereaved by suicide. The review included evidence available up until 29 March 2023. Three studies were identified and all reported on group therapy interventions lasting between 10 and 14 weeks. Key findings and certainty of the evidence: Reductions in anxiety and depressive symptoms were found in children who received the group interventions. However, due to the types of study designs used and limitations of the included studies, it is unclear if this is attributable to the interventions, so caution should be applied when generalising the results. The strongest evidence came from a non-randomised controlled study, in which children in the intervention group had significantly greater reduction of anxiety and depressive symptoms compared with children in the control group. However, this study was limited due to numbers of participants lost to follow-up. Research Implications and Evidence Gaps: Further research is needed to develop interventions to support children and young people bereaved through death by suicide of a family member. Additional research is needed to evaluate the effectiveness and cost-effectiveness of planned interventions. Policy and Practice Implications: It is difficult to draw firm conclusions due to the limited evidence and low quality of included studies. However, there are indications that group interventions may help to reduce anxiety and depressive symptoms in children bereaved by suicide. It will be important to develop guidance and standards of practice for these services based on best available evidence. All such services must use validated outcome measures as part of an integral evaluation process set up from service initiation. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The Specialist Unit for Review Evidence was funded for this work by the Health and Care Research Wales Evidence Centre, itself funded by Health and Care Research Wales on behalf of Welsh Government ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors