Loss Experience of Family Survivors of Suicide in South Korea: The Pain of Muganjiok

Background: Suicide is a serious public health concern worldwide. This issue is particularly grave in South Korea, which has reported the highest suicide rate among OECD countries. It is known that the suicide of one individual influences family, friends, and other relationships. Family survivors of suicide are at an increased risk of suicide themselves, as they are likely to experience worsened mental health. This may include grief and loss, along with complex emotional responses such as anger, despair, and self-blame; therefore, attention at the societal level is required. This study aims to explore the loss experiences of family survivors of suicide and discuss the implications for mental health policies and practices.

Method: The participants were family survivors of suicide who had been in the bereavement period for at least three months or more. They were purposefully selected participants with the assistance of case managers from mental health welfare centers. Starting in April 2023, seven individual in-depth interviews lasting approximately 60 to 90 minutes with the children, parents, spouse, and siblings of the deceased were conducted. The authors utilized semi-structured questionnaires, asking questions such as, “How has your and your family’s life changed after the suicide?” The collected data was analyzed using Stake's (1995) case study method, which focuses on the similarities and differences between cases. We performed continued comparative analyses to identify and categorize meaningful codes. To ensure rigor in our study, we adhered to Lincoln and Guba’s (1985) principles of truth values, applicability, consistency, and neutrality.

Results: The participants were five women and two men ranging in age from the teens to the 60s and consisting of a variety of occupations. The collected data was examined under the overarching theme “The life of family survivors of suicide left behind: A hell of constant suffering.” This was further divided into two categories – “Can’t understand or say suicide” and “Complex emotions are intertwined and mixed up” – supporting 12 sub-categories (“Dead full of doubts,” “Suicide: secrets that can’t be told to anyone,” “ Shocked by unbelievable reality,” “Emptiness and loneliness,” “Struggling with longing,” “The death of the deceased seems to be my responsibility,” “Sorry for everything and regret it,” and “Having a hard time and hitting the wall,” etc.) and 55 concepts.

Implications: This study highlights the need for active support and the provision of psychosocial services in mental health welfare centers for family survivors of suicide. It is necessary to diversify the programs such as self-help groups for bereaved families and group programs considering the entire life cycle. Mental health welfare centers should collaborate with administrative welfare centers, hospitals, and public health centers to facilitate easier access to their services for family survivors of suicide. Government-level approaches should consider improving social awareness and enhancing the accessibility of services for family survivors of suicide who are reluctant to seek help due to social prejudice and stigma in South Korea.

Note: Muganjiok is one of the hells described in Buddhism, referring to a hell where suffering is continuous without any interstice.