The Forgotten Mourners: A Literature Review on Parental Suicide and Community Art Therapy with Child Survivors

The prevalence of grief has raised the question of the long-term effects and efficacy of current bereavement practices (Mitchell, Wesner, Garand, Dysart-Gale, Havill, & Brownson, 2007). There is a lack of understanding and research on bereavement support for child survivors of parental stigmatized deaths; specifically, death by suicide. Children remain to be an underserved population with specific vulnerabilities regarding their inclusion in the emotional and cognitive comprehensions of the death and the resounding grief and mourning. Consequences specific to death by suicide are characterized by feelings of guilt, blame, and shame, as well as perceived stigma and isolation (Mitchell et al., 2007; Pfeffer, Karus, Siegel, Jiang, 2000; Ratnarajah & Schofield, 2007; Schreiber, Sands, & Jordan, 2017; Wertheimer, 2001). In retrospective studies, the consequences of these struggles are often seen years later in adult childhood survivors of suicide (Luecken, 2008; Mack, 2001; McIntosh, 1993; Michell, Wesner, Brownson, Dysart-Gale, Garand, & Havell, 2006). Increased psychiatric disorders, difficulties with social relationships, as well as problems with frequent drug and alcohol use were common risks reported. From these retrospective accounts, adult childhood survivors of suicide unanimously agreed that they would have benefited from the change to talk about suicide they experienced as children while still in childhood (Michell et al., 2007). Certain approaches have been found to be beneficial with this population. For example, research suggests the opportunity to engage and relate to others who share similar experiences. Social supports and community involvement have been proven to be a predictor of positive grief outcomes and relates to the installation of hope in suicide survivors (Mohatt, Singer, Evans, Matlin, Golden, Harris, & Tebes, 2013). In the United States, psychotherapeutic support groups are a commonly practiced treatment model for adults survivors, yet children remain as an underserved population regarding the same mode of treatment (Mitchell et al., 2007). Art Therapy provides less invasive and confrontational mode of communication and processing for a difficult subject that cannot necessarily be expressed through words. This literature review examined the current research on child grief outcomes and treatment of suicide specific caregiver deaths. Themes of psychological distress, isolation, and stigmatization emerged from the body of research. Results showed that certain themes/areas of practice are important to consider in clinical applications in art therapy. For example, the sense of autonomy and safety can be restored through rituals within a therapeutic setting and the specific art mediums provided ( Mohatt et al., 2013, Neimeyer & Thompson, 2014; Hill & Lineweaver, 2016; Edgar-Bailey, & Kress, 2010; Clements, Benasutti, & Henry, 2001). The study also found gaps in the literature in specific interventions directed towards suicide specific symptoms in children and long-term outcomes post-vention. Further research in these areas is recommended