Adults bereaved by suicide: raised health risks and support that comes late

Each death by suicide reaches far more people than the immediate family: one US survey estimated that 135 people knew each person who died^[1]. A Danish national register study shows that people whose spouse died by suicide develop mental disorders at a higher rate, and have higher mortality, than other bereaved spouses^[2]. Yet in a UK study of young adults, people bereaved by suicide were less likely to receive informal support and more likely to say support came late^[3].

When someone takes their own life, the people around them are left with grief, and often with questions that have no full answer. That includes partners, parents, children, brothers and sisters, friends, colleagues, and the professionals who knew them. Some also meet silence or awkwardness from others at the time they most need contact. This study brings together evidence from many countries on how many adults are bereaved or affected by suicide, what happens to their health afterwards, how support reaches them, and what is known about the help that works. Its strongest evidence comes from Nordic national registers and large surveys in the UK, Ireland and the United States. Most of the world, including the low- and middle-income countries where most suicides occur, has far less data.

Every suicide reaches far beyond the immediate family

The World Health Organization estimates that 727,000 people take their own life each year. In 2021, 73% of these deaths were in low- and middle-income countries, and suicide was the third leading cause of death among 15–29-year-olds worldwide. WHO notes that suicide has long-lasting effects on "the people left behind"^[5]. National counts are far more detailed in some places than others. In England and Wales, for example, 6,162 suicides were registered in 2025, an age-standardised rate of 11.3 per 100,000 people: 17.5 per 100,000 among men and 5.5 among women^[6].

Counting the people affected is much harder than counting deaths, because no register records who knew whom. For years a figure of six bereaved people per suicide was widely repeated. A US survey designed to test it, titled "How many people are exposed to suicide? Not six", asked 1,736 randomly dialled adults about the people they had known who died. It estimated that 135 people knew each person who died by suicide^[1]. Knowing someone is not the same as being closely bereaved, and that study does not say how many of the 135 were deeply affected. But it shows that the circle is wide.

A meta-analysis of 18 population-based studies reached a similar picture from the other direction. Pooling them, 21.83% of people had known someone who died by suicide during their lifetime, and 4.31% in the past year^[4]. A 2024 scoping review put it as "approximately one in five people"^[7]. A 2026 Irish study opens with an estimate that about 10 million people worldwide are bereaved by suicide each year^[8]. That is an estimate, not a count, and the abstract does not give its basis.

Health risks are higher than for other bereaved people, not only the general population

Grief after any death can be intense, and the evidence does not suggest that a mental disorder is the expected outcome for people bereaved by suicide. The question for services is whether this group carries extra risk beyond grief itself, and the strongest answer comes from Denmark. Researchers followed all 6.7 million adults in the country from 1980 to 2014, identifying 4,814 men and 10,793 women whose spouse died by suicide^[2].

Within five years of the death, men in this group developed a mental disorder at 1.8 times the rate of the general population, and women at 1.7 times. The comparison that matters most is with other bereaved spouses, because it separates the effect of a suicide from the effect of being widowed. Against people whose spouse died in other ways, men bereaved by suicide had 1.7 times the rate of mental disorders and women 2.0 times. They also had higher risks of suicidal behaviour and death, and used more municipal support^[2].

The effects were not only on mental health. Spouses bereaved by suicide also had raised risks of physical conditions "such as cirrhosis and sleep disorders", and drew more on sick leave benefits and disability pensions^[2]. That points to consequences for work and income as well as health, though the abstract gives neither sizes nor the comparison group for these outcomes. The authors concluded that the excess risks "highlight a need for more support directed toward spouses bereaved by suicide"^[2].

A register study shows association, not cause. Couples in which one partner dies by suicide may already differ from other couples, for example in shared stresses or in mental health before the death, and a register cannot capture everything. The Danish findings are strong because of their size and the comparison with other bereaved spouses, but they come from one country with a universal health system and detailed records.

Suicide risk is raised in close family, which is why support matters

A systematic review of 57 studies, published in 2014, found evidence of an increased risk of suicide in partners bereaved by suicide, and in mothers whose adult child died by suicide. It also found an increased risk of depression in sons and daughters bereaved by a parent's suicide, and of admission to psychiatric care for parents whose child died this way^[9].

Brothers and sisters are affected too. A Swedish whole-population study followed 1,748,069 people aged 25–64 between 1981 and 2002. After a sibling's suicide, the risk of suicide was 3.19 times that of people who had not been bereaved among women, and 2.44 times among men, allowing for the way death risks cluster within families^[10]. These estimates are imprecise: the range of plausible values for women ran from 1.23 to 8.25 times.

The raised risk is not explained simply by the suddenness of the death. A UK survey of 3,432 adults aged 18–40, all of whom had had a friend or relative die suddenly, compared 614 people bereaved by suicide with 2,106 bereaved by sudden natural causes. After adjustment, people bereaved by suicide had 1.65 times the odds of a suicide attempt compared with those bereaved by sudden natural causes^[11].

These are relative risks within whole populations. They do not mean that suicide is an expected result of bereavement, and no single cause explains any one death. Most people bereaved by suicide do not take their own life. The same evidence points to what can help: in an Irish survey of 2,413 adults bereaved or affected by suicide, high levels of perceived social support were associated with lower risk of poor mental health and suicide-related outcomes, among both men and women^[8]. Help is available, and the helplines listed near the top of this page are free and confidential.

Support often arrives late, and stigma stands in the way

The same UK study of 3,432 young bereaved adults looked at the support people received. Overall, 21% of the whole sample said they had received no formal or informal bereavement support, with no difference between the groups^[3]. But the kind and timing of support differed. Compared with people bereaved by sudden natural causes, people bereaved by suicide had lower odds of receiving informal support (an adjusted odds ratio of 0.79) and of receiving support immediately (0.73), and higher odds of saying support was delayed (1.33). They did not differ on formal support^[3].

Stigma appears to be part of the reason. The differences "became non-significant when adjusting for stigma", suggesting that perceived stigma accounts for much of the gap^[3]. The 2014 review likewise found some evidence of more rejection and shame among people bereaved by suicide^[9]. This places the problem where it belongs: in how communities and services respond, not in bereaved people.

A UK national online survey of 7,158 people bereaved or affected by suicide, published in 2022, gives a fuller picture of need, though as a self-selected sample it cannot show how common these experiences are among everyone bereaved. Suicide had a major impact on 77% of respondents, and half reported mental or physical health problems linked to the death. Over a third reported suicidal thoughts, and 8% said they had attempted suicide as a direct result of the death. Most had not accessed support services, and the majority saw local suicide bereavement support as inadequate^[12]. The authors called for "proactive outreach", and for the death of a friend by suicide to be recognised as "a significant loss"^[12].

Men may need particular attention. In the Irish survey, men had 1.57 times the rate of current suicidal thoughts reported by women, after adjustment^[8], and a 2024 systematic review of 35 studies, published between 1995 and 2023, set out the impact of suicide bereavement on men specifically^[13]. The Irish researchers call for "tailored postvention supports for men and women"^[8].

The evidence on what helps is still thin

Support offered after a suicide is often called postvention. It includes peer and group support, outreach to families soon after a death, counselling, and online support. The need for it is well established; the evidence on which forms work best is much weaker. This is a gap in research funding and evaluation, not a sign that support does not matter.

A 2019 systematic review found only 11 controlled studies of interventions for people bereaved by suicide, conducted between 1984 and 2018. Their quality was weak. There was "some evidence of the effectiveness of interventions for uncomplicated grief", but evidence for interventions aimed at complicated grief was lacking, and the authors called for "additional methodologically sound studies"^[14]. A 2025 review of 11 systematic reviews, published between 2008 and 2023, looked instead at which parts of support bereaved people themselves found helpful, across peer, group, community and online formats. It found that the quality of the reviews "varied considerably" and that the evidence on effectiveness "is not straightforward"^[15].

Evaluation of real-world services is also patchy. A 2024 systematic review identified 36 studies evaluating postvention services or models, and called for further evaluation of community-based services in the UK^[16]. A 2024 scoping review of how suicide bereavement support is put into practice found 16 studies, and called for consistent terminology and better use of implementation frameworks^[7].

What the evidence asks of us

The figures point in the same direction across countries and study types. Several implications follow for the organisations, health systems and governments that respond to suicide.

• Plan for the whole circle, not only next of kin. With around one in five people knowing someone who died by suicide in their lifetime^[4], and friends often deeply affected^[12], support offers can reach friends, colleagues and communities as well as family.
• Reach out early. In the UK, people bereaved by suicide were less likely to get immediate support and more likely to report delays^[3]. Survey authors call for "proactive outreach"^[12], so that support does not depend on bereaved people finding it themselves.
• Treat bereaved spouses and families as a group at raised risk. Danish registers show higher rates of mental disorders and suicidal behaviour than among other bereaved spouses, and more use of sick leave benefits and disability pensions^[2]. Primary care, mental health and employment services all have a part to play.
• Address stigma directly. Differences in informal and timely support were no longer significant once stigma was taken into account^[3]. Public messages and workplace guidance can help communities stay in contact rather than step back.
• Fund health and social care, not only the voluntary sector. The 2014 review found that policy recommendations rely heavily on the voluntary sector, and urged policymakers to strengthen health and social care resources^[9].
• Evaluate what is offered, everywhere. Controlled evidence is scarce and weak^[14], and it needs to extend to low- and middle-income countries, where 73% of suicides occur^[5]. Funders can build evaluation into new services from the start.

Related studies in this series look at parents whose child has died and widowed parents with young children, and our library covers mental health after a parent dies in childhood.

Language: this piece uses plain words such as “died” rather than euphemisms, because they are clearer. Where it discusses suicide, it follows the Samaritans’ media guidelines.

Why we're publishing this

People bereaved by suicide are numerous, they carry measurable extra risks to their health, and the support they receive often comes late or not at all. The organisations that support them have long made this case. We have gathered the population evidence in one place, with every figure linked to its source, so that those organisations can cite it when they ask health systems, employers and funders for support that reaches people early.

How to read this data

The figures here come from different kinds of evidence, and they are not interchangeable. The global death count is a WHO estimate; the England and Wales figure is a count of registered deaths. Figures for how many people are affected are survey estimates: the "135 people" figure comes from one US telephone survey and counts everyone who knew the person, not only those closely bereaved. The "about 10 million a year" figure is an estimate whose basis is not given in the source we saw. The Danish and Swedish findings come from national registers, which cover whole populations and allow comparison with other bereaved people, but adjust only for factors the registers record. The UK study of young adults sampled staff and students at universities and colleges, and the UK and Irish surveys of people bereaved or affected by suicide are self-selected samples, so they describe the people who took part rather than everyone bereaved. Odds ratios and rate ratios are relative measures: they describe how much more common an outcome is in one group than another, not how likely it is for any individual. Most of the evidence comes from northern Europe, the UK, Ireland and the United States. None of the studies drawn on here comes from the low- and middle-income countries where most suicides occur.

Use this data

Free to cite with attribution to Understanding Bereavement. Charities, services and journalists are welcome to reuse these figures and charts. For the underlying figures as a spreadsheet, get in touch.

Important: This study summarises published research about groups of people for general information. It is not medical advice or bereavement support, and it cannot describe or predict anything about an individual person or family. If you are worried about yourself or someone else, please speak to a GP or another qualified professional, or contact one of the helplines listed above.

Sources

1. Cerel J, Brown MM, Maple M, Singleton M, van de Venne J, Moore M, Flaherty C. How many people are exposed to suicide? Not six. Suicide and Life-Threatening Behavior, 2019. europepmc.org/article/MED/29512876
2. Erlangsen A, Runeson B, Bolton JM, et al. Association between spousal suicide and mental, physical, and social health outcomes: a longitudinal and nationwide register-based study. JAMA Psychiatry, 2017. europepmc.org/article/MED/28329305
3. Pitman AL, Rantell K, Moran P, et al. Support received after bereavement by suicide and other sudden deaths: a cross-sectional UK study of 3432 young bereaved adults. BMJ Open, 2017. europepmc.org/article/MED/28554915
4. Andriessen K, Rahman B, Draper B, Dudley M, Mitchell PB. Prevalence of exposure to suicide: a meta-analysis of population-based studies. Journal of Psychiatric Research, 2017. europepmc.org/article/MED/28199930
5. World Health Organization. Suicide: fact sheet. WHO, 2026. who.int/news-room/fact-sheets/detail/suicide
6. Office for National Statistics. Suicides in England and Wales: 2025 registrations. ONS, 2026. ons.gov.uk/…/bulletins/suicidesintheunitedkingdom/latest
7. Nicholls T, Krysinska K, Reifels L, Kartal D, Andriessen K. Implementation of suicide bereavement support: a scoping review. Frontiers in Public Health, 2024. europepmc.org/article/MED/39610383
8. Griffin E, Cully G, Veronneau S, Tuomey F, O'Connell S, Andriessen K. Gendered patterns of common mental health outcomes and suicidal ideation after suicide bereavement and the role of perceived social support. Health Promotion International, 2026. europepmc.org/article/MED/42639837
9. Pitman A, Osborn D, King M, Erlangsen A. Effects of suicide bereavement on mental health and suicide risk. The Lancet Psychiatry, 2014. europepmc.org/article/MED/26360405
10. Rostila M, Saarela J, Kawachi I. Suicide following the death of a sibling: a nationwide follow-up study from Sweden. BMJ Open, 2013. europepmc.org/article/MED/23624991
11. Pitman AL, Osborn DP, Rantell K, King MB. Bereavement by suicide as a risk factor for suicide attempt: a cross-sectional national UK-wide study of 3432 young bereaved adults. BMJ Open, 2016. europepmc.org/article/MED/26813968
12. McDonnell S, Flynn S, Shaw J, Smith S, McGale B, Hunt IM. Suicide bereavement in the UK: descriptive findings from a national survey. Suicide and Life-Threatening Behavior, 2022. europepmc.org/article/MED/35611626
13. Logan N, Krysinska K, Andriessen K. Impacts of suicide bereavement on men: a systematic review. Frontiers in Public Health, 2024. europepmc.org/article/MED/38655522
14. Andriessen K, Krysinska K, Hill NTM, et al. Effectiveness of interventions for people bereaved through suicide: a systematic review of controlled studies of grief, psychosocial and suicide-related outcomes. BMC Psychiatry, 2019. europepmc.org/article/MED/30700267
15. Hofmann L, Putri AK, Pitman A, et al. Perceived effectiveness of components of interventions to support people bereaved by suicide. Crisis, 2025. europepmc.org/article/MED/39534922
16. Abbate L, Chopra J, Poole H, Saini P. Evaluating postvention services and the acceptability of models of postvention: a systematic review. Omega, 2024. europepmc.org/article/MED/35790465