"Families arrive exhausted, scared, and with very scattered information."

"The association was founded in 2012 because of the feeling of loneliness that survivors experience, not only after the death of our family members by suicide, but throughout the entire process leading up to it, from understanding our role after an attempt and how we could support the person in that situation, to the lack of support we received afterward. And in that moment of loneliness, several people connected and decided to create the association to help others going through a similar experience and give them tools to better intervene within their families."

"The word 'survivor' is associated with the grief of someone who has lost a loved one to suicide, which can become pathological. It is probably one of the most complicated forms of grief, due to the stigma, the frequent lack of understanding from family members themselves, and the impact it has on them, who often feel responsible and guilty. The word 'survivor' attempts to capture the fact that we are people who also need very specific support to navigate this grieving process through acceptance and prevent it from becoming pathological. We are a vulnerable group in this painful and emotional process that can end in suicidal behavior."

"We are the only organization that offers these support spaces in the period leading up to suicide. We focus heavily on prevention, and we are usually contacted by the close circle of people experiencing intense emotional pain who are expressing suicidal thoughts or who have already attempted suicide. But we also assist anyone concerned about someone who expresses a desire to die . What do they find in our space? First, highly individualized attention ; that is, we dedicate a significant amount of time to listening to each family's story and their current circumstances. And from there, we offer group sessions with other family members going through the same situation, where we try to overcome the fear of talking about suicide. We discuss suicidal behavior, the likelihood of suicide, and the risk and protective factors."

In the association we support and provide tools to people who live with someone at risk of suicide, so that they can offer better intervention from the family setting.

We also provide them with comprehensive information about the healthcare system , so they understand its complexity, are familiar with all the available protocols and resources, and can connect with them. In another session, we discuss how to approach sensitive conversations , what role we should play as family members when the person verbalizes or expresses this distress—in other words, what is expected of me as a mother, sibling, or friend—and we delve into active listening techniques. We also can't forget how the people who have come to us feel, because seeing someone you love no longer want to live is incredibly difficult. That's why we talk to them about how this situation affects them , the emotions it generates, and how to manage them. We also have a mutual support group made up exclusively of family members, which organizes monthly meetings.

The role of the family and the environment of people at risk of suicide

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"When a family comes to us, they are in a state of considerable exhaustion , experiencing sustained tension caused by the fear that their loved one might attempt suicide or harm themselves and they are not present, arrive late, or are unable to recognize the danger. Generally, they arrive very tired , a type of exhaustion very characteristic of suicidal behavior. Many explain, for example, that they don't sleep because they are constantly checking on their loved one to make sure they haven't attempted suicide, or that they experience moments of strained communication."

And then there's another element common to all the families, which is that they come with very scattered, very unstructured information . We try to organize all the information, all the fears, and all the situations they've experienced, so they can understand that everything they tell us in this disorganized way has a logic, a structure, and that everything has been studied. We try to ensure they leave, at the very least, with the feeling that what they're doing is on the right track, and from there, we can outline the steps they need to follow to support the person during the most critical moments.

"Suicide is preventable, but not predictable. We cannot anticipate how our loved one will behave, but we can add elements that are fundamental to prevention, among which is the bond. One of the most important risk factors for suicide is isolation, so the connection of the person suffering with people who understand them , who empathize with them, and who help them talk about their feelings and develop coping skills is essential. Therefore, the family has an absolutely necessary and critical role in suicide prevention, alongside professional help, of course. But often family members feel they are not doing enough, that they don't have the necessary tools to provide this support."

We need to break with some old practices so that healthcare professionals can work side-by-side with the family and the person being cared for and involve them in individualized safety plans.

The paradigm shift in suicide prevention involves engaging and empowering the person at risk and their family in individualized safety plans. We need to break with certain practices so that healthcare professionals work side-by-side with the family and the person receiving care. And in this regard, we ask ourselves: How can it be that healthcare providers still find it so difficult to refer people to support organizations? Fifteen years ago, my mother made two very difficult and complicated suicide attempts, and no one ever contacted us to ask about them, to involve us, to share our experiences, or to participate in her recovery process. Without this involvement of the support network, there can be no success in suicide prevention.

Suicide can be prevented and, as many studies support, with very active mental health prevention policies and support for people at risk of suicide, zero suicide can be achieved .

“We assist many family members of people who haven't been through the healthcare system (20% according to our estimates) and who, therefore, aren't registered. Current policies are still largely focused on survivors, that is, on suicide postvention. It's true that here in Catalonia there are several initiatives, and it's a pioneer in establishing suicide prevention protocols and plans, but we still have many people, especially those who attempt suicide or those at low or medium risk, for whom the necessary tools and resources are still lacking. For us, an attempt, a verbalization, or a crisis is an opportunity to connect the person and their support network to specific recovery plans and reduce this risk in the short or medium term; to direct them to specialized services for these cases and not, as often happens, to general mental health care. But the truth is, this is a group that still receives little support.”

Judit Pons Baños

Mental Health Nurse. Leader of Suicidal Behaviour Care and Prevention Programs

Consorci Hospitalari de Vic

"Suicide cannot be addressed solely from a health perspective"

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"Yes, but we must do it appropriately, because we also can't deny that there are certain imitative tendencies in suicidal behavior. What we mean is that when a person feels distressed and has suicidal thoughts, not talking about it won't make them stop thinking about it. However, if we create a space for the person to open up and share what they feel, we create a tremendous opportunity to convince them to seek help and to see other alternatives to this suffering or pain that we all may experience at some point. Talking opens an opportunity, an alternative to the person's distress. But there is still a lot of fear among educational and social professionals, and even among families, about 'what if I say something that could trigger or be a trigger?' But the family is always a protector who genuinely tries to support, and that is invaluable."