Postvention in Blekinge - Read in English below 

Postvention i Blekinge Drabbade familjer får en tidig och aktiv stödinsats, direkt efter att en närstående tagit sitt liv. Postvention går ut på att lindra effekterna för de efterlevande. Vi i SPES Blekinge vill ge HOPP. Det går att överleva den här chocken och det bästa är att kunna ta sig igenom sorgearbetet tillsammans med andra närstående och familj. 

Hör av dig/er till Maiellen Stensmark SPES Blekinge: Ring eller messa: 070-2900824, eller e-posta: maiellenstensmark@hotmail.com PÅ GRUND AV CORONA RESTRIKTIONER UPPMANAS DU SOM SÖKER STÖD ATT TA EN FÖRSTA KONTAKT FÖR ATT BESTÄMMA OM NÄR OCH OM DU VILL FÅ EN LÄNK TILL ETT MÖTE VIA ZOOM

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Oftast träffas vi i det hem där den avlidna bott, eller där de närmast sörjande vistas. Också platsen är betydelsefull i sammanhanget och platsen väljer alltid de sörjande. Det går även att träffas på lämplig neutral plats.

VI i SPES är själva efterlevande. SPES Blekinge har utvecklat en metod då familjen i vidare bemärkelse, de närstående, de som är viktiga för familjen, träffas. Vi vill hjälpa er att gemensamt hantera er förlust för att ni ska få en så tidig och hälsosam återhämtning som möjligt i den chock och i det kaos som råder.

Att inleda samtalen i direkt anslutning till att den närstående tagit sitt liv är mycket viktigt. Det minskar spekulationer, självkritik och skuld, som normalt är mycket jobbigt att hantera för de närstående efter att någon tagit sitt liv. Sådana tankar bearbetas när familjen lägger pussel tillsammans om hur ett liv kunde sluta så här. De närstående får kraft att finnas för varandra genom olika faser i sorgen med hjälp av den utomstående samtalsledaren, som själv har erfarenhet av att en närstående tagit sitt liv, .

Relationerna mellan alla i gruppen efterlevande hålls ihop. I samtalen hjälper man varandra att se det som hänt ur flera perspektiv. Att se sin uppgift för någon annan kan underlätta den egna sorgeprocessen. 

Under de senaste 5-6 åren har Maiellen på ideell bas träffat de familjer i Blekinge som hittat till oss. Gruppen närstående och Maiellen har träffats ofta, fram tills efter begravningen och en kortare eller längre tid därefter. Det har upplevts som ett mycket värdefullt stöd för samtliga som deltagit att ingå i gruppen och få möjlighet att bearbeta sin stora sorg tillsammans.

När stödet kommer in direkt efter att den närstående tagit sitt liv, redan i den första chockfasen så känner man stort stöd av att ingå i en familjegrupp som leds av en utomstående, även de som bor på olika orter. Det går senare bra att ha deltagare på länk. 

Familjer har uttryckt att POSTVENTION lett till ökat stöd och sammanhållning, minskat lidande för dem med störst stödbehov. Alla som deltagit kan rekommendera andra efterlevande att ta kontakt med SPES Blekinge. "Det är skönt att få sitta i grupp, att få öppna upp, inte känna sig skyldig, få vägledning, se det utifrån andras perspektiv och få vet hur resten av familjen mår. Det har varit mycket bra och har gett bekräftelse i sorgen." 

Postvention behöver finnas för alla familjer som förlorat en närstående i självmord och erbjudas av varje REGION i landet, i samverkan med kommunens krisgrupp, polisen och utföras av någon med egen erfarenhet av att en närstående tagit sitt liv. Det kan liknas vid debriefing som man har på arbetsplatser och i samhället efter stora katastrofer som omfattar många människor. Postvention minskar framför allt de närståendes lidande, som utan rätt stöd och hjälp tidigt i sorgarbetet får svårare väg tillbaka till psykisk hälsa, återgång till normaliserat vardagligt liv, med sammanhängande vilsam sömn, motion, normaliserade sociala kontakter, återgång till arbete och kraft över för samhällsengagemang. Samhällets kostnader minskar också både på lång och på kort sikt genom den här metoden som skulle erbjudas alla runt omkring i Sverige, som drabbats av att en närstående tagit sitt liv. 

Sorgeprocessen blir i fokus med hjälp av den utomstående efterlevande som leder samtalen, som informerar och samspelet mellan de närstående lindrar mycket sorg och smärta. Tankar om skuld och känslor av skam undergräver en hälsosam process för läkande- och sorg-bearbetning. Personens utveckling hindras och utan rätt stöd från början kan sorgen utveckla behov av långvarig terapi för posttraumatiska tillstånd, vilket innebär både ett utökat lidande för den efterlevande och ökade kostnader för samhället.

Postvention är i sig självmordsförebyggade. En efterlevande utan stöd kan själv befinna sig i riskzon för att ta sitt liv. I samtalen kommer det fram vad som gick fel, vilka faktorer det var som tillsammans bidrog till att en människa tagit till liv? Vad kunde ha gjorts, eller funnits, som hade förhindrat? Vilka samhälleliga förebyggande och uppföljande insatser kunde ha räddat liv? 

Vi hjälper dig utan kostnad med krishantering och svarar på dina frågor!

Idag görs mycket i Sverige för att förebygga självmord, men det är så mycket mer som behövs för att kunna rädda fler liv. Särskilt nu när flera blir drabbade av olika förluster i pandemitider. Har du drabbats av att en familjemedlem tagit sitt liv är det i sig en riskfaktor som gör att du behöver vara extra observant på dig själv och dem i din omgivning. TA EMOT STÖD OCH HJÄLP!  Vid Akut självmordskris ring 112. 

Ring eller messa: Maiellen Stensmark SPES Blekinge 070-2900824, eller e-posta: maiellenstensmark@hotmail.com  PÅ GRUND AV CORONA RESTRIKTIONER UPPMANAS DU SOM SÖKER STÖD ATT TA EN FÖRSTA KONTAKT FÖR ATT BESTÄMMA OM NÄR OCH OM DU VILL FÅ EN LÄNK TILL ETT MÖTE VIA ZOOM

Blekinge Family Postvention - early home support & peer-group support for families bereaved by suicide loss

Blekinge Family Postvention is a model based on the grief facilitator-home-visiting postvention giving the early support to the families after they lost their member in suicide. Blekinge Family Postvention model was created and first used in 2015 by a Swedish teacher, Maiellen Stensmark. She lost her daughter in suicide. Maiellen helps other families, so they could avoid the disastrous negativity that often comes with a suicide loss. It is often associated with the disturbance in communicating after the suicide loss. Maiellen noticed that her method of giving early support to suicide loss survivors is helping families to overcome pain, anger and suffering. Suicide loss survivors families find Maiellen through the association SPES Blekinge online. She is saying: "I am their doula". There is no research about Blekinge Family Postvention, but there is research showing that being in contact with others has a protective effect in crisis. Gruber et al., 2013 found out that "doula-assisted mothers were four times less likely to have a low birth weight baby and two times less likely to experience a birth complication". They suggested that "communication with and encouragement from a doula throughout the pregnancy may have increased the mother's self-efficacy regarding her ability to impact her pregnancy outcomes". Hans et al., 2018 noticed that "home-visiting programs have shown health impacts in the postpartum months after birth, incorporating doula services may confer additional health benefits to families". Similarly, during a period after a suicide loss, support of the "grief facilitator" may increase the self-efficacy of the family in dealing with their trauma.

A person who provides such early support for the family in trauma should have experience of coping with the suicide loss and applying strategies for that. Frequent conversations need to be given to the family members, during the first 3-5 weeks or longer, after the suicide loss. To talk and listen to each other, provide the family members strength-the intensity of pain and suffering decreases.

When a suicide has taken place, the grief facilitator goes home to the family in crises, to give support and create a safe space for grief and suffering. They are crying and helping each other. They need to deal with the chaos that continuously will occupy their senses, day and night, without a break, in the form of mental chatter, emotions of deep anxiety, panic and guilt. It is a crippling state of unreality and severe pain. They calm down their feelings by telling what is hurting, in what way their inner pictures, their thoughts, are challenging to bear. They share their memories and experiences from the last time they met the recently deceased. They talk about their grief, their thoughts and feelings. They tell if they can sleep and eat. We speak about the importance to breathe through the pain and the state of anxiety. We are sitting in the living room, listening to their experience, their feelings and thoughts. We speak about how one can handle themselves, let in light, again do things they liked to do before the suicide and slowly come back to the normal. It helps them carry each other, listen to each other, put together a puzzle and begin to understand and take in what happened. A grief facilitator goes home to the family, every second or third day, as many times as they ask for, to the place they chose. One and a half hour each time, depending on how many people they are. It takes time to recover from grief after suicide loss.

The support to the family after suicide loss should be a governmental matter. But today all the work done, is voluntary. The close relatives need debriefing right after the district doctor has stated the death, or the police have issued a death certificate. The military, the police, rescue services and healthcare professionals gets debriefing when a rescue operation has failed. Survivor support needs to be provided, to reduce suffering and diminish risks for the post-traumatic stress disorder and depression, and in this way, to decrease a need for medicines. Medicine is not a cure for grief. To gather the whole family, all the closest mourners allow them to mourn altogether, under the guidance of the facilitator. It gives hope!

References:

Gruber, K. J., Cupito, S. H., & Dobson, C. F. (2013). Impact of doulas on healthy birth outcomes. The Journal of perinatal education, 22(1), 49-58. https://doi.org/10.1891/1058-1243.22.1.49

Hans, S. L., Edwards, R. C., & Zhang, Y. (2018). Randomized controlled trial of doula-home-visiting services: impact on maternal and infant health. Maternal and Child Health Journal, 22(1), 105-113.


Participation of ELLIPSE in European Psychiatric Association in Florens - at zoom - 10-13/4 2021

I am Maiellen Stensmark. I am voluntarily working in an association to prevent suicide and support those who have got a suicidal loss. In our region, we voluntarily invite people with a suicidal loss to our group ones a month, by the organisation SPES Blekinge. But people hardly find us. Many have doubts about going there themselves, taking this step to meet others with grief. I saw the suffering, deep pain, and questions nobody answered. Like in my case, when I lost my daughter. She committed suicide in 2004, at 21 years old. There wasn't any help at all to receive. Neither today, 2021, and it is very hard for me to face when we have resources to prevent suicide in Sweden.

I have developed a family support model by meetings with the bereaved group directly after the suicide, giving families, a close friend and sometime neighbours in loss a supportive environment. Every case is different concerning the group of mourners. I started with this work in 2015. This method of mine is based on the experience I have achieved as a facilitator. I have met approximately twenty families, with an average of 5-7 persons each.

It is important to involve people with lived experience after a suicide loss in educational programs for students in higher education to teach young people to give proper help and support to all those who lost someone in suicide.

"Approximately one in 20 people (4.3%) experienced suicide in one year, and one in five (21.8%) have done so during their lifetime".

Andriessen K, Rahman B, Draper B, Dudley M, Mitchel PB. Prevalence of exposure to suicide: a meta-analysis of population-based studies. J Psychiatr Res. 2017;88:113-20

A suicide researcher, Karl Andriessen, tells also that:

"People bereaved by suicide may experience more shock or trauma related to the unexpected or violent nature of death compared to other forms of bereaving, more feelings of abandonment, rejection, shame, struggle with meaning-making and 'why'-questions, and less social support".

Postvention in Blekinge is, similarly to Karl Andriessen description, the promising supportive and educational intervention, that involve the bereaved social environment, and comprise of sessions led by trained facilitator.

We usually meet at least six times during 5-6 weeks. After these weeks, some of the mourners want to maintain our contact. The benefit of this is sharing within the group to lower the stress. I encourage them by listening and confirming their grief, emphasising the importance of sleeping, eating and drinking. I ask, more or less, the same question to all of them about these issues. I tell them how important it is for them to explain how they feel to each other. And by our talk, this stress reduces. All this is about to handle the chock, lower panic, and instead help them bear each other.

I explain that stress after this loss is better not to overanalyse mentally to avoid a more chaotic mental situation. It is good to talk about it when they are together, or with help from a facilitator or therapist.

I explain to them that in my experience, the best way to let free of emotions is by crying, laughing, but also to scream loud out when others do not hear. It is the only sound way of letting free emotions. One can also write down his/her feelings and put the note in a box until he/she is strong enough to read it through and one more time meet the experienced feelings and mental situation.

I can understand what they have been through between the lines, what happened before death and how they found the deceased. When they are ready, we can talk about it, but I never push them. They can get a more comprehensive picture of what happened, why, about how life could end in this way, by talking to a facilitator, everyone together, at the same time, in the same room. They describe it by showing their emotions, explaining what they have experienced. Il is also a way of reducing shame and guilt and help them to calm down emotionally. As a result, mental stress reduces.

I educate them to replace grief, feelings and thoughts and to occupy themselves, their brains, doing other things. That brings them emotions of good feelings and satisfaction even if they are in grief.

We meet in this way during 3-5 weeks and much longer with those how wish that.

I have met some persons on a more or less regular basis during years after their loss. Some want to come to the monthly meetings to handle their grief with others also suffering from suicidal loss. In the Ellipse program, we have interviewed the participants with and without participating in a Family Postvention group. Those who suffer a heavy loss, like after a suicide, thought that participation in the Family Postvention could helped them to recover.

Based on my experiences, I would like to suggest that every region in Europe develops emergency care after suicide. Facilitators have an exceptional opportunity to support bereaved families by understanding suicidal loss and after education about their role. That is why it is important to involve people with bereaved experience in developing the educational program in suicide prevention.

It is also a winning concept for us with deep grief after suicide. We transform our loss to be helpful for others. We can save lives, reduce victims for suicide, reduce suffering, reduce the need for medication, and reduce the period of deep grief after suicide.

Suicide loss is not an illness but may become lifelong grief. Therefore facilitators support must be initiated very soon after the loss. If not, in some month time, the need for medicinal treatment is evident. Also, persons coming to healthcare right after the loss are given medication as treatments that do not reduce their grief because medicins can't lift this emotional condition. The bereaved people can also live their lives in love and good health when they learn how to cope with their grief. That is why, it is so important to learn how to help them.