title: Lack of Trust in the Health-Care System After Losing a Child to Suicide.
abstract: BACKGROUND
  Lack of trust in the health-care system after losing a child to suicide may prevent bereaved parents from seeking professional treatment when needed, thus diminishing their chances of recovery.
  
  
  OBJECTIVE
  This is the first large study to aim at evaluating the incidence of lack of trust in the health-care system and associated variables in suicide-bereaved parents.
  
  
  METHODS
  This nationwide population-based survey included 569 parents who lost a child to suicide 2-5 years earlier and a matched comparison group of 326 nonbereaved parents. Using a study-specific questionnaire, we asked bereaved and nonbereaved parents if they trusted the health-care system and measured psychological and background variables.
  
  
  RESULTS
  Prevalence of lack of trust in the health-care system differed between the bereaved (46.5%) and the nonbereaved parents (18.3%), giving a relative risk of 2.5 (95% CI = 2.0-3.3). After multivariable modeling, high scores of depression, living in big cities, and being single were identified as variables associated with lack of trust in suicide-bereaved parents.
  
  
  CONCLUSIONS
  Suicide-bereaved parents show lack of trust in the health-care system. We present possible effect modifiers that may be considered in professional interventions aiming at influencing suicide-bereaved parents' level of trust.
authors.affiliation: 1 Stockholm Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
authors.forename: Rossana
authors.initials: R
authors.lastname: Pettersen
authors.forename: Pernilla
authors.initials: P
authors.lastname: Omerov
authors.forename: Gunnar
authors.initials: G
authors.lastname: Steineck
authors.forename: David
authors.initials: D
authors.lastname: Titelman
authors.forename: Atle
authors.initials: A
authors.lastname: Dyregrov
authors.forename: Tommy
authors.initials: T
authors.lastname: Nyberg
authors.forename: Ullakarin
authors.initials: U
authors.lastname: Nyberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001601:Bereavement; D003695:Delivery of Health Care; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010290:Parents / Q000523:psychology*; D012306:Risk; D013405:Suicide; D011795:Surveys and Questionnaires; D013548:Sweden; D035502:Trust; D014505:Urban Population
keywords: bereavement; distrust; health care; suicide survivor; trust