Mental health impact of losing a sibling to suicide: Does sex-composition matter? Evidence from Norwegian register data on healthcare consultations

Objective

This study examines the impact of suicide versus accident bereavement on sibling's mental health – proxied for by mental healthcare use – and investigates whether this impact varies among different sex-compositions of the sibling dyad. Both forms of bereavement are sudden, but suicides are expected to have greater impact on mental health, e.g., due to guilt and stigma. We furthermore investigate whether the impact of sibling suicide bereavement depends on prior mental healthcare use of the deceased sibling.

Methods

We draw on Norwegian full population administrative data to examine changes in the probability of siblings’ mental healthcare use following sibling bereavement. We estimate stratified individual fixed-effects linear probability models to account for characteristics that set suicide and accident bereaved siblings apart.

Results

Overall, suicide bereavement has a stronger impact on surviving sibling's mental health than accident bereavement. This difference is driven by men and women losing a brother. Suicide bereavement has a particularly strong impact for men losing a brother if the latter had not been using mental healthcare prior to committing suicide.

Conclusions

These findings are in line with the notion that knowledge about the sibling's mental health problems could mitigate the mental health impact of sibling suicide loss. Plausibly, the presence of sisters – either the surviving or the bereaved sibling – may foster emotional disclosure, which may enable anticipation even in the case of an otherwise sudden event. In the absence of sisters, care use of the deceased sibling may offer some anticipation.