Restore equilibrium and functioning within the school, university, agency, community or organization.

Promote healthy grieving, and commemorate the deceased for all members of the community who have been impacted.

Provide comfort to those who are distressed because they are grieving the loss of a friend, colleague, or family member.

Minimize adverse personal outcomes (e.g., depression, PTSD, complicated grief, trauma reactions), including the risk of suicide contagion, by supporting the vulnerable members of the community who may have a history of trauma, previous loss, their own suicidality, or who might psychologically identify with the deceased.

Provide psychoeducation about suicide. Suicide engenders the“why” question, providing an opportunity to educate the community about suicide, debunk suicide myths, and lay the groundwork for the development of on-going suicide prevention work.

Increase opportunities for empowerment and mutual support. A suicide death is a potentially traumatic event, leading to feelings of helplessness and changed assumptions and worldview. Empowerment and mutual support can restore a sense of safety.

Highlight the complexity of the reasons behind a suicide death, avoiding oversimplifying the cause. Emphasize that suicide is not the result of a single factor or event in the life of the deceased (e.g., the breakup of a relationship, academic stress); rather it is a complex and complicated interplay of events.

Emphasize the connection between suicide and underlying vulnerabilities such as a history of trauma, mental illness, discrimination, and the combination of intense pain and hopelessness. Promote the messages that asking for help is a sign of strength, not a sign of weakness, that help is available, and that there are multiple pathways to getting help. Emphasize that there are alternatives to suicide when one is feeling distressed or hopeless, and make clear what resources are available for getting help. Messaging should focus on suicide as preventable, not inevitable.

Carefully consider the language used to describe a person who died by suicide. To prevent contagion, it is important to avoid romanticizing or glamorizing someone who has died by suicide. That is, do not portray the deceased as a hero or having died a noble or romantic death (as in Romeo and Juliet). Conversely, it is important to avoid portraying suicide as a selfish act, or the deceased as worthy of contempt. Instead, emphasize that almost all suicide deaths are associated with psychic pain and a sense of feeling trapped.

To protect against vicarious trauma and contagion, discourage conversations about the method of the suicide. These conversations can occur in-person or online, via texting or social media (Mirick & Berkowitz, 2023). Encourage those who have details of the method to avoid sharing this information, and instead, focus on remembering their friend/colleague’s life. The message to the community should be, “We want to remember how our friend/loved one lived, not how they died.”

Ensure postvention services are trauma informed. A suicide death can be shocking, horrifying, and traumatic for friends and loved ones (Jordan, 2017). Some loss survivors develop hypervigilance about others’ mental health, fear another suicide death, or PTSD following the death (Andreissen & Krysinka, 2011; Brent et al., 1996; Mirick et al., 2022).The role of trauma in suicide attempts and suicide loss is prominent and it is essential to understand how trauma impacts grief and can be potentially retraumatizing for those impacted by a suicide death (Jordan, 2020; Jordan & McGann, 2017; Mirick & Berkowitz, 2022). All interventions should provide physical and emotional safety; be transparent; give voice and choice to those most impacted; and be culturally, linguistically, and racially appropriate (SAMHSA, 2023; Mirick et al., 2023).

Understand that support following a suicide death needs to be ongoing. For those impacted by the loss and vulnerable to adverse effects, the impact of the death can be long term and they will need support for months and possibly years (Allie et al., 2023; Mirick & Berkowitz, 2022).

All responsible postvention efforts begin with verification of the death: who died, when, the circumstances, location, and whether or not the death was a suicide. Most officials – school superintendents, CEOs, community leaders – will be initially swamped with information and rumors from students, parents, colleagues, and the press asking if they have heard that a given person has died. In an age of smartphones and social media, responsible leaders should assume that information will be shared very quickly (Bell & Westoby, 2022; Mirick & Berkowitz, 2023). Our conversations with young people found that many learned about the suicide death of a peer via text or social media (Mirick & Berkowitz, 2023). Bell & Westoby (2022) describe a “race against the clock to tell everyone the “right way” (p. 582) due to the speed of the dispersion of the news via text and social media. Problematically, while news spreads quickly, the information is often inaccurate or speculative, not based in fact (Bell & Westoby, 2022).

Organizations can counter the rumors and speculation circulating via text and social media by carefully sharing accurate information. Therefore, no official release of information should be distributed until the circumstances of the death have been confirmed by the appropriate authority: police chief, medical examiner, or immediate family member. In some cases, a family member may request that the cause of death not be disclosed. When the family does not wish to publicly acknowledge the cause of death, we suggest gently helping the family to think through the “pros and cons” of trying to keep the cause of death a secret, and the difficulty in doing so. Additionally, we share with the family that being open about the cause will help us engage in prevention activities that could support other students or co-workers and potentially avert future tragedies. If the family still does not want to disclose this information, then the organization must uphold their wishes.

However, in circumstances where the family does not wish to acknowledge the death as a suicide, but members of the community believe the death to be a suicide, we recommend finding an approach that neither confirms nor denies the cause of death, but leaves open an avenue for discussion, such as, “the family/ organization is not saying the death was a suicide at this time, but if you believe your friend died of suicide, what would it mean to you? What would we need to know to grieve and support each other?” or similar. This type of informal conversation is essential to helping members of the community process their understanding of the death.

It is important to quickly mobilize and organize internal and external resources. In a school system, the superintendent or principal should immediately notify the  crisis response team and plan for an initial meeting within hours or early on the next day. Most crisis teams have written protocols delegating actions and responsibilities in case of sudden traumatic death. Schools with working relationships with local mental health agencies, neighboring school districts, or other local resources will often invite these partners to the crisis response meeting. Ideally this will not be the first time school personnel and community programs have met.

Although some school systems are inclined to handle a crisis on their own with staff familiar to the students, local resources can provide valuable consultation for school administrators and teachers who may be unfamiliar with how to handle a devastating loss, and who may themselves be grieving the death of the student. Nearby school systems can send additional counselors to support  students who are in acute grief and they may even be able to provide backup to teachers and school staff who might want to attend the wake or funeral. Perhaps the most important reason for utilizing outside resources is to ensure school personnel who are on the frontlines of postvention efforts are themselves being supported throughout the entire postvention effort.

When a death occurs in a business or other organization, it may be more difficult to identify and mobilize resources. A small business might have little experience with the death of a colleague, and death from suicide might complicate any response due to lack of knowledge about suicide and the stigma associated with it. The CEO or their designee should contact the Human Resource Director for guidance and to strategize how best to support staff. Mid- to large-size companies typically have contracts with Employee Assistance Programs (EAP) that are usually well trained in managing sudden death or other personnel emergencies. EAPs often are on call as a valuable resource in the aftermath of a suicide death. Local mental health agencies can also provide this assistance to a business or civic association.

A member of the clergy may be another possible resource for postvention support. Few professionals know more about grief and grief rituals than the clergy, and those who have been trained in suicide postvention and trauma are a potential resource to support schools and organizations. Unfortunately, many school systems and communities may be wary of crossing the line between church and state and do not use this potential resource. However, we have had good experience working with clergy when they have been trained in crisis response, post-traumatic stress management, or suicide postvention and others have reported similar success (Macy et al., 2004; National Alliance for Mental Illness-NH, 2010). Local funeral homes are often an excellent resource for information and are usually willing to answer questions. The funeral director can provide specific information about what will happen during the wake and funeral. For many adolescents, this may be their first funeral, so knowledge about specific details can be extremely helpful: Will the casket be open or closed? Has the family decided on cremation or burial? Who will preside over the funeral? Are there religious rituals that can be explained ahead of time?

The most effective strategy for providing known details of the death is a written statement that can be distributed to everyone in the school, agency, organization, or community. It should include factual information about the death and acknowledgement that it was suicide, condolences to family and friends, plans to provide support for those impacted, information about funeral plans if known, or acknowledgement that the information will be provided once known, and any changes in the typical  schedule during the upcoming days.

Conducting this conversation in smaller groups (e.g.; homerooms, work groups, team meetings) gives those providing the information a chance to gauge individual and group reactions and provide additional support to those who need it. Internal or external mental health professionals can provide additional support as needed. In schools, it is strongly advised that an announcement not be read over a public address system. When everyone in the community gets exactly the same information – teachers reading the statement in the classroom; emails to parents or agency employees; a press release to local media – rumors will begin to subside. As noted earlier, in the past 15-20 years, with the widespread use of cell phones and social media, news of the death spreads very quickly, but often is rife with rumors and speculation, increasing the importance of accurate, trustworthy information put out by schools, organizations, or communities (Bell & Westoby, 2022; Heffel et al., 2015; Mirick & Berkowitz, 2023; Rompalo et al., 2021).

Close friends, fellow team or club members, colleagues on the same work team, or neighbors in the community may have a particularly hard time and need extra support for a period of time. Those who need support might also include a colleague who recently argued with the deceased or a romantic partner who initiated a breakup. In schools, counselors will frequently follow the schedule of the deceased student. In agencies or workplaces, EAP personnel may want to spend the day being available to the deceased’s shift or work group. A neighbor may host a gathering for families on the same block. The high school library may be staffed by mental health professionals and open for drop-in support. In secondary and higher education settings, attention is often, understandably, focused on students’ needs for support, although it is important to remember that faculty and staff may be impacted and bereaved as well (Allie, et al., 2023). The emphasis in these activities is on mourning the loss.

Suicide exposure increases the risk of suicidal thoughts and behaviors, depression, and PTSD for youth exposed to suicide (Brent et al., 1996; Insel & Gould, 2008; Swanson & Colman, 2013;  Abrutyn & Mueller, 2014). After a suicide death some attention must be devoted to identifying individuals in the school, organization, or community who are at risk for suicide attempts or other risky behaviors. Those at greater risk include individuals having a history of suicidal behavior or depression, a history of tragic loss or suicide in their family, peers who may identify in some way with the deceased even though the connection was quite remote, and students, coworkers or staff who are likely to have felt responsible for somehow contributing to or preventing the suicide (McCommons & Rosen, 2020).  For students, viewing online behavior may also provide important information about risk. Youth who actively create social media content about the suicide death are four times more likely to have suicidal thoughts or make a suicide attempt than their peers (Swedo et al., 2021).

In a school or university someone on the crisis team should create a master list of the students and staff who are believed to be at greater risk, as those students may need extra support. Staff who already have a relationship with those individuals can check in with them or their family. Most of those identified will not need an immediate referral or evaluation but can be encouraged to ask for support and asked to identify who can be of most help to them if they are feeling scared, overwhelmed, or depressed.

Identification of those at risk is not a task for schools or colleges only. Some workplaces may have a high percentage of young employees or employees with traumatic histories. There has been little research on the potential for contagion following the suicide death of a co-worker. However, a unique study from Stockholm (Hedström et al., 2008) demonstrated a significant increase in the number of suicide deaths among men in smaller work settings following a co-worker’s suicide death. Coupled with the finding by Crosby and Sacks (2002) suggesting that about 80% of suicide exposure occurs with the death of an acquaintance, rather than a family member, these studies imply that exposure to suicide is statistically much more likely in the workplace or school setting than through the death of a family member, and support the need to attend to those who may be at risk in work settings as well as educational settings (de Leo & Heller, 2008).

Depending upon the size of the setting or community, a second suicide death in a short period of time or within the same peer group may increase the risk that a cluster is developing within the community. It is important to note that while “communities” where a cluster may be developing can be distinct organizations, such as a school, university, or a workplace, it could also be a town, a sports organization, or a broader geographic area. While it is our experience that many communities may wait until a third or fourth suicide to take action, we recommend beginning to form a “suicide cluster coordinating committee” (Ivey-Stephenseon et al., 2024) following a second death. The CDC suggests this could occur as soon as after a first death (Ivey-Stephenson et al., 2024). The role of a coordinating committee is to elevate suicide prevention to a community level, and to include a wide range of school, community, and regional or state leaders in the prevention plan. Depending on the type of community, the committee should include school officials, public safety, community leaders, local mental health agencies, local media, and clergy, and should be linked to the state or regional coalition for suicide prevention as well as the state’s strategic plan for suicide prevention (see https://sprc.org/states/ for a list of state suicide prevention plans). This coordinating committee will be organizing community-wide suicide prevention efforts. For more details on these efforts, see Task #12.

The responsibility of the committee is to develop plans for a response to any future deaths and to begin a plan for prevention in the community. Post Traumatic Stress Management ([PTSM]; Macy et al., 2004) is the model that has been employed in several communities recently in Massachusetts to assist individuals and groups reacting to subsequent suicide deaths. In these communities, a wide range of community members are trained to respond to students, family members, and others. Additionally, coordinated plans and protocols are established for responding to suicidal ideation and threats noted in schools, organizations, young people taken into police custody, mental health centers, etc. In-depth training is provided for local mental health clinicians to improve skills for assessing and managing suicide risk using a best-practice curriculum such as those listed in the SPRC Best Practices Registry, including Suicide Assessment and Intervention Training for Mental Health Professionals (SAIT) developed by Riverside Trauma Center and MindWise Innovations, Assessing and Managing Suicide Risk: Core Competencies for Mental Health Professionals, developed by the American Association of Suicidology (AAS) and the SPRC, among others (see BPR.SPRC.org). Additional clinical resources have been provided by state agencies or grants to the schools to assist with implementing prevention services and identifying, triaging, and consulting regarding community members considered to be at elevated risk.

Although the original purpose of postvention activity was to facilitate grief (Shneidman, 1972), over the years the focus of postvention activities has also shifted to reducing the possibility of contagion. This has sometimes led to misguided efforts to maintain secrecy after a suicide death, blaming or stigmatizing the deceased. Little effort has focused on facilitating healthy grieving as a necessary form of prevention. School, business, and community officials can take the lead in offering public condolences to family and friends, encouraging appropriate commemorative activities, and allowing flexibility in work or class schedules so members of the community can attend memorial services (Mirick et al. 2024).

Generally, our experience has been that in schools and workplaces, large all-community events during the school or workday, requiring the participation of students or employees, are not ideal. Commemoration activities and funerals should occur after school or work hours, so participation can be voluntary and parents/guardians are more likely to accompany their children or teenagers, a practice that should be encouraged so that adolescents have access to adult support. Supportive postvention activities in the workplace or community do not have to be highly formal events but might include a casual celebration of the person’s life or activities as simple as providing meals, transportation, and other concrete support to the grieving families and peers. For example, in one situation where a loss occurred among staff at a restaurant, staff prepared a special sit-down meal to share together.

Memorials can be virtual as well as in-person. The research on virtual memorial pages has been primarily focused on the use of Facebook, but as social media use evolves and changes, so will the structure and location of these memorials. Online memorials can be a place to maintain connection with the deceased, communicate with friends and colleagues of the deceased, and process the death (Bell et al., 2015; Mirick & Berkowitz, 2023). Some adolescents and young adults describe online memorials as a source of comfort, allowing for a continued relationship with the deceased, while for others, they are distressing, and can elicit strong negative reactions (Mirick & Berkowitz, 2023). As social media use varies by developmental stage, workplaces, schools, and universities may find different social media sites used for memorialization, different needs, and unique concerns.

The CDC recommends carefully considering how to celebrate the life of the deceased while avoiding glorifying suicide (Ivey-Stephenson et al., 2024). While opportunities to commemorate the deceased are meaningful to friends, classmates, and colleagues of the deceased and an important component of the grieving process (Mirick & Berkowitz, 2023),  exposure to memorials can unintentionally increase the risk of suicidal thoughts and behaviors for vulnerable members of the community (e.g. suicide loss survivors, those with a history of suicidal thoughts and behaviors) (Swedo et al., 2021). Although earlier CDC guidelines (CDC, 1988) recommended against permanent memorials (e.g. planting trees, placing benches in a student’s memory), the more recent guidelines do not provide recommendations about permanent memorials (Ivey-Stephenson et al., 2024). As is supported by others in the field (Kerr et al., 2003; Poland, 2003), our experience has been that it is preferable to memorialize those lost to suicide by encouraging and supporting suicide prevention activities of local or national organizations, raising scholarship money through activities or becoming involved in helping other suicide survivors. Encouraging such “mobilizing,” pro-social activities is also consistent with approaches to helping survivors deal with the potentially traumatic experience of a suicide loss by supporting a sense of agency rather than helplessness (Brymer et al., 2006). When developing policies, it is important to assure consistency of the response, regardless of the type of death. In schools, similar questions arise about how to handle memorials in a yearbook or related publication. Again, the recommendation is to make it consistent with how any other death would be recognized, and to make mention of those attributes and activities about the person that will be remembered, rather than focus on the cause of death.

The goals of this task are to provide individuals with an understanding of the grieving process, suicide bereavement, depression, and suicide. Because a suicide death can be traumatic, education on trauma and PTSD is also beneficial. Youth with no previous experience with loss may not recognize  common reactions to grief or may not understand the unique characteristics of suicide bereavement (Jordan, 2020; Mirick & Berkowitz, 2022). It can be comforting and reassuring to normalize responses to a suicide death, including intense responses from individuals without a close relationship with the deceased (Mirick & Berkowitz, 2022). Education on depression and suicidality can support community members in identifying and responding positively to symptoms in themselves and others.

For teaching youth about suicide, we recommend using a curriculum for psychoeducation that is evidence-based, if possible. There are several evidence-based psychoeducation programs for use in schools, such as the SOS Signs of Suicide Curriculum (Aseltine & DeMartino, 2004; Schilling et al., 2016); Lifelines Student Curriculum (Bartowski et al., 2024); or Youth Aware of Mental Health Programme [YAM] (Lindow et al., 2020; Trivedi et al., 2022). If evidence-based programs are not feasible, then schools should use programs that adhere to best practices (Singer et al., 2019). Several interventions have been developed for providing psychoeducation in a work setting, programs such as the United States Air Force Suicide Prevention program (Knox et al., 2003), Working Minds, ASIST and others (see the Suicide Prevention Resource Center for a list of recommended resources: Workplaces – Suicide Prevention Resource Center (sprc.org)  At the community level, there are several gatekeeper trainings that show promise in terms of outcomes including knowledge, attitudes, skills, and self-efficacy (Yonemoto et al., 2019). Promising trainings include Question, Persuade, Refer (QPR) (Cross et al., 2011; Wyman et al., 2008), ASIST (Sareen et al., 2013; Gould et al., 2013) and SafeTALK (Holmes et al., 2021). Following a suicide death(s), gatekeeper trainings can be offered to diverse populations, including those who work with groups with an elevated risk of suicide.

Our recommendation is to wait at least 6-8 weeks following a death in the community to implement a prevention program. This allows time for some of the initial distress and acute grief to settle down a bit prior to engaging young people in prevention education.

Due to the elevated risk of adverse outcomes following a suicide death, with particular attention to additional suicide attempts and deaths due to contagion, screening is an essential component of any organized postvention plan. School-based screenings have two stages. First, students complete a self-report screening tool. Second, students who screen at-risk have a secondary screening with a mental health professional to provide support, assess risk, and refer for services. Screenings identify students not already known to the schools (Mirick et al., 2018; Scott et al., 2009) and can increase service use for at-risk youth (Kaess et al., 2022).

If schools are using SOS Signs of Suicide (Aseltine & DeMartino, 2004; Schilling et al., 2016), it contains a screening tool, the Brief Screening for Adolescent Depression. Schools can choose whether to have students complete the screening anonymously or confidentially. The SOS program has good acceptability by students and staff at schools (Clark et al., 2021). In our postvention work with schools, approximately 12% of students who participated in a psychoeducational program followed by screening receive a secondary screen, with an even smaller percentage referred for further evaluation or counseling (see Mirick et al., 2018 for more information). As noted above, we recommend waiting at least 6-8 weeks before engaging in prevention education and screening. This allows time for some of the initial distress and acute grief to settle down a bit prior to engaging young people in screenings.

Screening for those at risk at a workplace is a more challenging undertaking. Due to the possible negative impact on employment of an honest response about suicidal thoughts or behaviors, workplace screenings must be conducted carefully. With the exception of the military or possibly public safety employment setting, we assume employers would agree that screenings for mental health conditions or suicidality should be voluntary. Workplaces might consider making available to employees online tools that can be posted and made available to employees with encouragement to complete them. Such tools often screen for depression and suicidal thoughts and behaviors and then offer recommendations to seek assistance dependent upon the screening results. Screening tools can be found on SPRC’s best practice registry (see www.sprc.org). Screenings in the workplace are often conducted by Employee Assistance Programs.

Another consideration in the workplace following a suicide death is to ensure managers are trained to recognize warning signs of depression and suicidality. Such action may lead supervisors to refer for help workers who appear to be struggling with depression or other mental health challenges. The company Human Resources Department should be involved in any organized training or referral efforts. Unfortunately, our experience, which coincides with that of others in the field, is that managers are often reluctant to address depression or suicide prevention in the workplace. Perhaps we need to do a better job of highlighting the potential lost productivity that may be associated with workers reacting to the suicide death of a co-worker, and share the evidence of potential for increased deaths when exposed to the suicide death of a co- worker (Hedström et al., 2008). We understand this reluctance to openly discuss mental health challenges and suicide as another manifestation of the larger cultural taboo about dealing directly with psychiatric disorders and suicidality and encourage workplaces to engage in more behavioral health literacy training for supervisors to help identify and know how to respond to behavioral health risks at work.

An important part of responding to any potentially traumatic event is linking individuals and groups to resources for continued, local support as needed. Ideally, we recommend providing individuals, family members, and the school or workplace with a list of local mental health resources, including contact information for emergency mental health assessment. It is important to include some resources that are loss survivor focused.

As noted above, when multiple suicide deaths occur in a given locale, a crucial part of the response includes ensuring that the many local community professionals are collaborating with a single vision and plan. Community coalitions should also be linked to statewide and federal organizations that focus on suicide prevention and postvention.  We recommend that mental health clinicians have specialized training in suicide specific loss as well as training on best practices in suicide assessment and management. (See, for example, Suicide Assessment Intervention Training for Mental Health Professionals (SAIT) www.riversidetraumacenter.org; Collaborative Assessment and Management of Suicidality (CAMS),  https://cams-care.com/the-cams-framework/); Assessment and Management of Suicide Risk (AMSR), https://solutions.edc.org/solutions/zero-suicide-institute/amsr/amsr-services/amsr-training.   Resources specific to postvention include Samaritans organizations in various locations and the American Foundation for Suicide Prevention (www.AFSP.org).

Ongoing feedback should be sought from all involved in the postvention process: students, workers, those involved with implementing the plan, as well as management and local officials, if appropriate. Even if the postvention is a one-time event, plans should include follow-up support and the development of ongoing organizational and community structures to respond in the event of future suicide deaths. Plans should address potentially sensitive milestones like anniversaries or graduation, and those occasions may again be used as opportunities to evaluate and review the process. If the postvention is a larger, ongoing project, involving a planning or organizing committee, the committee should build in periods for review and soliciting feedback from all constituents, and the results of the feedback be built into the ongoing plan.

Many school districts, organizations, or communities that have a suicide death will respond to the tragedy determined to do anything they can to prevent further deaths from suicide. This final component of this work is the development of an ongoing system-wide suicide prevention plan and a community-wide coalition to direct and drive this work. The coalition can include community members, community organizations, mental health organizations, school or university staff, as well as young people. The coalition will work towards universal suicide prevention strategies, including building resilience, supporting the development of coping skills, addressing stigma about mental health, and supporting access to mental health services.

Workplaces, schools, and communities can all develop policies and practices that promote strong connections with family, workgroup, and community. Schools can work to create cultures that support resilience and help-seeking, and seek to de-stigmatize psychological distress, suicidality, and help-seeking for mental health. We know that schools whose cultures support these values and cultivate strong student/teacher relationships have lower rates of suicidal thoughts and behaviors (Williams et al., 2022). Schools can include curricula that teach effective coping and problem-solving strategies, and sports and civic organizations can teach or encourage frustration tolerance. Schools, organizations, and communities can provide education about mental health and suicide, and safe ways to discuss suicide online, such as the #chatsafe program (La Sala et al., 2023). Community based efforts can support the inclusion and support of groups that are at high risk for suicide, such as members of the LGBTQ+ community. Community efforts can also raise awareness and knowledge about the importance of considering access to lethal means, screening for access, and engaging in lethal means counseling (see for example, the Counseling for Access to Lethal Means [CALM] online course, https://zerosuicidetraining.edc.org/). Lethal means counseling can be incorporated into primary care settings, including pediatric primary care (Bandealy et al., 2020) and emergency departments (Runyan et al., 2018) as an effective suicide prevention measure.