Ripples of Despair -  Shining a light on the impact of lives lost to alcohol, drugs, and suicide (2024)

Families 

When someone dies by suicide, drugs or alcohol, the impact on their family is profound. Beyond the devastating loss, families often face stigma, shame and isolation, making their grief even harder to bear. They may feel judged by others or experience self-blame, guilt and confusion.

This stigma often leads to reluctance in talking about the loss, and some families may even conceal the cause of death (170). This silence can intensify feelings of isolation and grief, highlighting the importance of access to support services and groups (171). Grieving these types of deaths is often described as 'traumatic grief' - a prolonged and intense form of loss marked by emotions such as guilt, anger and unanswered questions (172,173).

Studies have shown that people bereaved by suicide are twice as likely to be diagnosed with depression or anxiety themselves and are at greater risk of post-traumatic stress disorder, suicidal thoughts and prolonged grief (174-176). It is widely reported that bereavement from suicide can make a person more vulnerable to suicide themselves, but it can also have a protective effect in that experiencing the loss and pain of suicide makes them feel that suicide is not something they could ever do (177-179).

For all deaths due to drugs, alcohol or suicide, the whole family is impacted, and a continuing cycle of trauma is possible if the needs of people grieving go unmet. The impact can continue to be felt in the generations that follow.  

 Children in families affected by addiction or bereavement face additional risks. They are more likely to experience mental health issues like anxiety and depression, struggle in school, or develop their own substance problems. Addressing these challenges through postvention support is critical to breaking cycles of trauma and reducing long-term harm (180-182).

Communities 

The ripple effects of suicide, drug and alcohol-related deaths extend far beyond immediate family and friends, often impacting entire communities. these deaths are far more reaching than originally thought, extending beyond family, friends, and contacts to include people with a perceived closeness or someone who identifies with them (176).

It had been reported for decades that six people are affected by one suicide, based on the average size of immediate family (183). More recent research takes into account those wider ripples felt through the community and estimates up to as many as 135 people are affected, including acquaintances, colleagues, and even those who had limited interactions with the person, such as a familiar face in the local coffee shop or a member of the emergency services responding to the incident (184).

Using this figure, we can estimate that over the past 20 years almost 41,500 people may have been affected by suicide in Gateshead, whilst in 2023 alone around 2,160 people were potentially impacted.  

People who have a close relationship with the person who died, including family members, close friends and associates, are described as 'suicide-bereaved'.

The difference between 'short-term' and 'long-term' bereaved is the prolonged and debilitating impact of the death felt by the long-term bereaved (185).

This highlights just how indiscriminate suicide is, it can affect us all in many ways.  

Society

Suicide contagion 

The notion that one person's suicide can influence another's suicidal behaviour is based on the Social Learning Theory; that people learn behaviours by seeing them in others.  Where they identify with the person displaying the behaviours and see it as having a desirable outcome, their likelihood of carrying out the same behaviour is increased (186).

This is known as 'suicide contagion', "whereby one or more than one person's suicide influences another person to engage in suicidal behaviour or increases their risk of suicide ideation and attempts" (187).

Contagion can happen when a person is 'exposed' to a suicide either through direct exposure, such as suicide by a peer or witnessing the tragedy, or indirect exposure, such as a suicide reported in the media or identifying with the person who died. Both are reported to increase suicidal behaviour in people who are already vulnerable to suicide, especially in adolescents and young adults (132).

The impact on staff and services 

Frontline workers, including those in health, social care and emergency services, often face secondary trauma from exposure to these deaths (188). Staff may experience feelings of sadness, guilt or anger, leading to burnout, compassion fatigue, or even PTSD. The practice of trauma informed care has been used to increase knowledge and understanding of trauma-based behaviours and appropriate interventions to support those using services. It is also vital that trauma related responses in the workforce are also identified and appropriate support given to the staff (188).

Gateshead Recovery Partnership offers initiatives to support staff who experience the loss of someone they've worked with, including "loss of life" forums and access to counselling through the Employee Assistance Programme. These measures provide safe spaces for reflection and support. 

Emergency responders also face significant challenges, with 1 in 4 reporting thoughts of suicide linked to work-related stress or poor mental health (189). Resources like Mind's Blue Light Together platform provide crucial mental health support for those in high-stress roles  (190).

The economic impact 

The cost of alcohol harm in Gateshead 2021/2022, can be broken down across four areas, economy, social, health and crime, with an overall cost of £106.3 million (191).

If we consider the cost of harm relating to alcohol from a healthcare and NHS perspective, alcohol related hospital admissions, outpatient visits, alcohol related A&E visits, alcohol related ambulance call outs, alcohol-related healthcare appointments and other alcohol related healthcare costs total £21.2 million (191).  

Gateshead and the North East have high rates of alcohol mortality, which results in significant levels of working life lost. In addition, the ripple effect of alcohol harms more broadly, impacts the wider economy of Gateshead, at a cost of £17.6 million related to lost productivity at work, absence from work, and unemployment (191).  

For drugs, Dame Carol Black's independent review exposed the scale of the national challenge. The financial cost from the harms of drug use to society is estimated to be  £19.3 billion per year, 86% of which is attributable to health and crime related costs (192). Problematic drug use is highly correlated with poverty and impacting our most deprived communities (193).

The review identified the big business of illicit drugs, estimating its worth at £9.4 billion a year. As drug related deaths have risen, the illicit drugs market has become much more violent.  

For suicide, the economic impacts range from financial losses due to years of life lost in employment, impact on employment and productivity for those bereaved, costs felt by the healthcare system, emergency services, coroners and families. The average cost of a suicide in the UK in 2022 was estimated at £1.46 million by the Samaritans, with overall suicides costing £9.58 billion (194).

However, when looking at Gateshead from 2018 to 2022, the total cost is estimated at £122 million, with the average cost per suicide slightly higher than the UK rate, at £1.5 million  (194). This suggests that the economic impact of suicide in Gateshead may be greater than the national average.

These figures show that suicide prevention is a crucial area for public investment due to the significant emotional and financial cost caused by suicide each year.