Significant others are often crucial for suicidal persons or suicide attempters’ access to care, yet little is known about their efforts to seek help. This article presents the findings of a qualitative pilot study carried out in Switzerland on the help-seeking process of 18 significant others, their perception of the care received by their loved one, and the interactions and collaboration they experienced with professionals. Most significant others repeatedly sought out support for their loved one and themselves. The help-seeking process seemed mostly difficult, was seldom successful on the first attempt, and was filled with multiple difficulties, such as availability and continuity of care and cooperation issues with professionals. Two-thirds of participants were not satisfied with the care provided to their loved ones and half of them faced challenges in their cooperation with professionals, i.e., poor sharing of information or not being acknowledged as partners or supported by professionals. Based on their experience, providing education about suicidal crises and care programs to significant others might lighten their burden and improve their cooperation with professionals, who in turn may benefit from training in communication issues and specific methods of cooperation with significant others in suicidal situations.

The reactions of professionals after a patient suicide are still a subject of controversy in academic literature. This article reports on retrospective data about the aftermath experienced by mental health professionals working in institutional settings in Switzerland. Findings indicate that both self-rated emotional responses and traumatic impact were low for the majority of the 258 professionals surveyed. Variables that mediated the impact included the support received and the characteristics of the professional-patient relationship. No significant differences were found with regard to gender and profession.

Introduction: Spirituality and religion have only been marginally investigated in the experiences of the bereaved by suicide (or survivors of suicide). Aim: This article directly addresses two questions: In what way was spirituality or religion an issue for survivors of suicide? How were they helpful (or not) during their reconstruction process? Method: Research involved qualitative studies, carried out in Switzerland with 50 survivors of suicide using in depth-interviews. Data were analyzed according to grounded theory principles. Results: Suicide triggered questioning mainly about the afterlife of the deceased and of how transcendency relates to agency and responsibility in the suicidal act. Spiritual or religious issues play an important role in the process of reconstruction for survivors, notably in meaning-making and responsibility-clarifying processes, in forging a continuing bond with the deceased and in honoring their life and memory. Nevertheless, this role is complex and can either support or make the recovery difficult (or both). Conclusion: Mental health and social care professionals may support survivors' resilience and their reconstruction process by valuing the constructive aspects of their spiritual and religious experiences and by taking into account the spiritual and religious struggles they face to offer effective support to survivors of suicide during recovery.

Objectives: Prevalence rates of death by euthanasia (EUT) and physician-assisted suicide (PAS) have considerably increased in older adults, and public debates on these practices are still taking place. In this context, it seemed important to conduct a systematic review of the predictors (demographic, physical, psychological, social, quality of life, religious or existential) associated with attitudes toward, wishes and requests for, as well as death by EUT/PAS among individuals aged 60 years and over. Method: The search for quantitative studies in PsycINFO and MEDLINE databases was conducted three times until April 2018. Articles of probable relevance (n = 327) were assessed for eligibility. Studies that only presented descriptive data (n = 306) were excluded. Results: The review identified 21 studies with predictive analyses, but in only 4 did older adults face actual end-of-life decision making. Most studies (17) investigated attitudes toward EUT/PAS (9 through various hypothetical scenarios). Younger age, lower religiosity, higher education and socioeconomic status, were the most consistent predictors of endorsement of EUT/PAS. Findings were heterogeneous with regard to physical, psychological and social factors. Findings were difficult to compare across studies because of the large variety of outcomes measures and sample characteristics. Conclusion: Future studies should adopt common and explicit definitions of these concepts, as well as mixed longitudinal research designs that would allow for better consideration of various personal and social factors, and their interplays, on the decisionmaking process with regard to EUT/PAS.

Abstract. Background: Several countries have regulated euthanasia and physician-assisted suicide (PAS). Research has looked at the experiences of patients, family, and professionals. However, little is known of the effects on bereaved individuals. Aims: We aimed to assess (a) what is known about the grief and mental health of people bereaved by euthanasia or PAS and (b) the quality of the research. Method: Systematic review according to PRISMA guidelines with searches in Cinahl, Embase, PsycINFO, Pubmed, and Scopus. Results: The searches identified 10 articles (eight studies), and the study quality was fair. People bereaved by euthanasia/PAS generally had similar or lower scores on measures of disordered grief, mental health, and posttraumatic stress compared with those who died naturally. Lack of social support and secrecy may compound their grief. Being involved in the decision-making process and having the feeling of honoring the deceased's will may facilitate their grief. Limitations: Studies used self-reports from non-random self-selected participants, were retrospective, and were conducted in only three countries. Conclusion: There is little evidence of increased risk of adverse grief or mental health outcomes in people bereaved by euthanasia/PAS. As more countries legalize assisted dying, high-quality studies of the factors that may hinder or facilitate the grief process are needed.