As traumatic as homicide is, the aftermath is often worse. The violent death of one of its members leaves a family in emotional and social turmoil. Of the three causes of violent death (homicide, suicide or accident), homicide often has the most intense impact. There is abundant clinical evidence indicating that following a homicidal death family members are at risk for developing sustained and dysfunctional psychological reactions. The Federal Bureau of Investigation’s Uniform Crime Report states that 16,914 people were murdered in the United States in 1998. Further, 67 percent of the murder victims in 1998 were males. Forty-four percent of the victims fell into the 20-34 year-old age group. Since these homicides affected between 120,000 and 240,000 relatives, friends, and co-workers, the magnitude of these numbers suggests that homicidal bereavement represents a major public health problem.
Prior work done by Separation and Loss Services at Virginia Mason, in Seattle, has shown that a community-based program of assessment and support for homicide survivors offers primary and preventive intervention for those family members at high risk for non-recovery. The Support Project for Unnatural Dying that Edward Rynearson, MD, Medical Director of Separation and Loss Services at Virginia Mason, developed is an integrated approach to providing services and information to homicide co-victims.
The Support Project for Unnatural Dying has coordinated services between mental health services and the criminal justice system to provide clear and focused attention on the unique needs presented by each family member following a homicide. In adapting and extending this project to other communities, under the new name The Homicide Support Project, we have trained multi-disciplinary personnel from cities across the U.S. to provide consistent, clear assistance to families in the aftermath of a homicide.
To date, we have assessed more than 1000 families (approximately 20 percent spouses, 20 percent siblings, 10 percent children, and 50 percent parents) and treated hundreds of family members with a combination of interventions. These interventions include a 10-week education support group during the initial 6 to 12 months of bereavement (during the criminal judicial inquest of the homicide), followed by a time-limited group to deal more specifically with the issues of grief and trauma thereafter. These time-limited and focused group interventions seem sufficient for most people who seek our care. Family members who are at high risk for non-recovery (past and/or present history of major depression, post-traumatic stress disorder, panic disorder, traumatic grief or drug and/or alcohol abuse) may need alternate interventions, which may include medications. Our assessment specifically searches for presence of these risk factors, since they warrant immediate and more focused treatment.