Articles Tagged ‘Family Liaison Officer - Brake the road safety charity’

Brake Family Liaison Officer Awards 2018

FLO Award logo 2018 Copy

Brake's Family Liaison Officer Awards recognise the outstanding achievements and support provided by Police Family Liaison Officers.

The awards highlight best practice in supporting families following a road death or serious injury, showcasing outstanding achievement in working alongside victims of road crashes.

The awards ceremony for the 2018 Family Liaison Officer Awards took place during Brake's Annual Reception, held at the Houses of Parliament on 6 June 2018.

Photos from the awards evening are available to view here.

The two awards available for nominations in 2018 were the:

  • 'Outstanding Officer Achievement' award

Open for peer entries from Police staff, this award recognised significant, ongoing contributions to victims’ families from a Family Liaison Officer.

  • Family Award

This prize was open for families who were supported by a Police Family Liaison Officer. 

Congratulations to all of our winners and highly commends in the inaugural Brake Family Liaison Officer Awards, 2018:

Outstanding Officer Achievement Award nominations:

• PC Samantha Allen, Thames Valley Police
• PC Jonathan Ardron, Lancashire Constabulary
• PC Christopher Bradley, Norfolk Constabulary
• PC Peter James Brandon, Lancashire Constabulary
• PC Vanessa Busby, Cumbria Police
• PC John Clarke, Suffolk Constabulary
• PC Tom Davies, Cumbria Police
• DS Jeff Edwards, Metropolitan Police
• PC Jamie Lang, Dyfed Powys
• PC Matthew Nyhan, South Wales Police
• PC Nerys Reeve, South Wales Police
• PC Joanne Roberts, North Wales Police
• PC Nicola Sarjeant, Hampshire Police
• DC Jenny Stanley, West Yorkshire Police
• PO Kelle Westwood, West Mercia Police
• PS Andy Whittaker, South Yorkshire Police
• PC Michael Woodhouse, Cleveland Police

Shortlisted:

• PC Christopher Bradley, Norfolk Constabulary
• PC Tom Davies, Cumbria Police
• PC Matthew Nyhan, South Wales Police
• PC Nerys Reeve, South Wales Police
• PC Nicola Sarjeant, Hampshire Police
• DC Jenny Stanley, West Yorkshire Police

Highly commended:

• PC Michael Woodhouse, Cleveland Police
• PC Vanessa Busby, Cumbria Police

Winner:

• PC Jonathan Ardron, Lancashire Constabulary

Family Award nominations:

• PC Allie Cotton, Suffolk Constabulary
• DC Nicola Croucher, Metropolitan Police
• PC Rick Hooley, Cheshire Police
• PC Deanna Hyde, Derbyshire Police
• PC George Laflin, Suffolk Constabulary
• PC Pete Linsley, Northumbria Police
• PC Simon Myall, Suffolk Constabulary
• PC Ian Stuart, Hampshire Police

Shortlisted:

• PC Allie Cotton, Suffolk Constabulary
• DC Nicola Croucher, Metropolitan Police
• PC Simon Myall, Suffolk Constabulary

Highly commended:

• PC Deanna Hyde, Derbyshire Police
• PC Pete Linsley, Northumbria Police

Winner:

• PC Rick Hooley, Cheshire Police

Additional details about the 2018 Family Liaison Officer Awards and winning nominees can be found in Brake's media centre. If you would like any further information about the Awards, please email floaward@brake.org.uk

Details about the 2019 Family Liaison Officer Awards will be announced soon.

These awards would not have been possible without the kind support of headline sponsors Slater and Gordon Lawyers.

SlaterGordon 2015 logo 

Brake Family Liaison Officer Awards 2019

FLO Award logo 2019

Brake Family Liaison Officer Awards

Brake is pleased to confirm that its Family Liaison Officer Awardswill return in 2019, and are now open for entry.

The awards celebrate and recognise the outstanding achievements and support provided by Police Family Liaison Officers, and showcase best practice in supporting families following a road death or serious injury.

Following a judging process, an awards ceremony will take place in summer 2019.

Three categories will be open for nominations in 2019:

  • Outstanding Officer Achievement Award

This award is open for peer entries from Police staff, and we are encouraging nominations from all 43 forces in England and Wales. This award seeks to recognise significant, ongoing contribution to victims’ families from an FLO.

Outstanding Officer Achievement Award entry form
Outstanding Officer Achievement Award guidance notes

  • Family Award

This prize is open for families who were supported by a Police Family Liaison Officer. We would encourage anyone who would like to share their experiences of support from a Police Family Liaison Officer to nominate their FLO for this award.

Family Award entry form
Family Award guidance notes

  • Award for Excellent Longstanding Service

This award, newly introduced in 2019, aims to recognise outstanding commitment and dedication to family liaison.

Award for Excellent Longstanding Service entry form
Award for Excellent Longstanding Service guidance notes

Nominations for these awards are open from 8 November 2018. The deadline for entries is 15 March 2019.

If you would like any further information or guidance about entering the award, please email floaward@brake.org.uk.

The award winners will be invited to present their case studies at Brake's annual 'Police family liaison following road death and serious injury' Conference, which will be held in the West Midlands in October 2019. 

Details of the winners of the 2018 Awards can be found on our website here.

Brake Family Liaison Officer Handbook: Breaking the bad news

Telling someone that a loved one has just lost their life is often said to be the hardest part of a police officer's work. It is certainly the worst possible news that anyone could receive. The way in which the message is delivered will always be remembered.   

When someone dies in a road crash, the circumstances are usually traumatic; the deaths untimely and sometimes involve more than one member of the family. The officer delivering the message is not immune to the trauma, particularly if the person who has been bereaved reminds them of their own family or background. Breaking the news to a personal friend or former colleague is particularly difficult.   

It is difficult to envisage a 'best way' of breaking bad news, but there are many things that can make a bad experience even worse.    

Case study: making a bad experience worse   
"I was woken at about 8 a.m. by a knock on the front door. I went downstairs and opened it to find two police officers, who were clearly nervous. One of them told me, "Your partner has been involved in an accident on the motorway. Do you recognise these?" He held up a plastic bag with a watch, a ballpoint pen and a wallet. I recognised them as belonging to Peter who had left for work as a taxi driver the previous night. There was blood in the bag and on the items. We went into the lounge and the officer said that they understood that Peter had been trapped in the wreckage, but did not know any more than that. They handed me a piece of paper with a handwritten telephone number and told me I should ring it for more information. Then they told me that they had another job to go to, asked me to sign for Peter's property and left the house. The whole episode took about five minutes. I rang the number, but it was incorrect and got me through to an elderly lady who had no idea what I was talking about. I rang my local police force, who had no record of an accident and they suggested I try neighbouring forces. Eventually I found a helpful inspector, who said he would make enquiries and get back to me. He phoned back about twenty minutes later and gave me another police force phone number to ring. I rang it, and was told that I should have had a message to ring the Coroner's Officer and meet him at the mortuary. This was the first I knew that Peter was dead. Peter died six years ago and I feel bitter about the way in which I was told."   

The good news is that there are 'good practice' methods that officers can follow when breaking bad news. These are not necessarily the methods that have been passed down over the years for example, delivering a death message used to be seen as a 'rite of passage' for new officers; a practice which is unacceptable, given the potential for getting it wrong.       

In some forces, it is usual for a trained FLO to deliver a death message after receiving a briefing from the Senior Investigating Officer (SIO) at the scene of the crash. This may be an officer who is 'called out' specifically to perform this role and will be in a position to continue to act as the FLO.       

In other forces, it is rare for the officer who will eventually act as FLO to be in a position to deliver the news themselves - the force's callout system, the geography of the police force area, a particular need for urgency, or duties at the crash scene can prevent them making a local notification straightaway. This means that the burden of delivering the death message may fall on section staff who are also called upon to deliver messages on behalf of other forces, or for deaths which result from suicide, drugs overdose, industrial accidents, sudden medical emergency and those which occur overseas. For example, Cumbria Constabulary stipulates that if an FLO cannot deliver the news themselves, a sergeant, tutor, or other experienced officer should deliver the message.   

Best Practice

Most work on determining best practice for basic death notification procedures has been carried out in the United States and includes a model published in 1992 by the Iowa Department of Justice. The model is summarized as:    

In Person

In Time

In Pairs

In Plain Language

and With Compassion.   

This model is used by a number of North American police departments and has been adapted by some British police forces, such as Cumbria. It is similar to training given to doctors on how to break bad news to patients.   

In Person
Anyone who could be described as a 'primary bereaved person', such as a partner, parent or child of the person who has died, should be informed face to face. Human presence is an important factor, as there is an immediate need for compassion and support. On learning that a loved one has been killed in an unexpected, violent manner, many people suffer a severe traumatic shock reaction and the officer carrying out the notification may be the only person available to offer support. Notification in person is common practice in the UK, with details being passed to other force areas for delivery by a local FLO when necessary. Telephone notification is not an acceptable practice. It is also important that no personal details be passed by insecure radio links, the situation can only be made worse if someone who has been bereaved finds out first from the media or third parties of the loss of their loved one.   

In Time
All 'primary bereaved' people should be notified as soon as possible after the event. No matter what the time of day or night, there is no benefit in saving the news till a 'better' time. There is no good time, full stop and US research shows that many bereaved people resent any unnecessary delay in informing them. When someone has been critically injured in a crash; prompt notification can be even more important - it might give a loved one the chance to see the injured person in hospital before they die.   

While there should be no unnecessary delay in carrying out a death notification, it is crucial that there is a very high degree of certainty of the identity of the person who has died. Death notifications are made even more difficult if, for example, the notifying officer has to confirm that someone owns a particular vehicle before they are able to say that someone has died. If a mistaken notification is made, albeit in good faith, initial relief may be replaced by anger at the unnecessary emotional suffering that someone has been put through.   

In Pairs   
Two people should attend to make a notification of unexpected sudden deaths. Immediate traumatic shock reactions vary from case to case and can include severe distress, withdrawal, outright denial, hysteria and even violence. Any such reaction is considered natural in such traumatic circumstances.   

Normally both of the people attending should be police officers although there are circumstances in which an officer might be accompanied by a member of the clergy, a doctor, a family friend or even a traumatic bereavement support worker. It can be preferable for a familiar face to be present to offer immediate support, as long as this does not cause any delay. For example when carrying out a notification in the workplace a supervisor or a close colleague, could be present. When visiting the home of the person who has been bereaved to break the news this is not often possible. In that case it is best for at least one of the notifying officers to be of the same gender as the bereaved and generally it is considered that a female/ male combination of officers works best.   

If the notifying officers travel in separate vehicles this increases their flexibility after the message has been delivered, for example, one of them could leave to collect a close friend, relative or child to be with the bereaved person. When a pair of officers attends to notify the bereaved, they should prepare themselves in advance by ensuring that they both know the names of the person who has died and the person who has been bereaved. They should decide in advance who will deliver the message itself.   

In Plain Language
With the exception of regular offenders, most people have very little personal contact with the police. They will naturally assume the worst if two police officers knock at their door late at night. In such a situation, fear and panic may set in, and they may not be able to focus on what is being said to them. The notifying officer must therefore deliver the message straight away and in simple, unequivocal, terms.   

The Iowa model calls for the notifying officers to identify themselves, ask to come in and get the person to sit down, confirming that they are the right person. In many cases it is the person who has been bereaved that answers the door. They want to know immediately why the police are calling and may not want to wait until they have taken the officers through to the lounge or kitchen and sat down. In such circumstances it may be appropriate just to ask to come in and speak inside, saying that there is urgent news to pass on. Once inside, out of view of neighbours or passers-by, the message should be delivered without delay.   

A useful phrase is "I have some very bad news I must tell you", followed by a direct statement of what has occurred, such as "Your husband has been involved in a car crash and I am sorry to have to tell you that he has died". It is much more effective to use the words 'dead', 'died', or 'killed'' rather than euphemisms such as "he didn't make it", "she was fatally injured", or "he's not coming back". Such phrases might seem easier to utter but they are very easily misunderstood by a bereaved person in their initial shock. It will often be necessary to repeat the message or to have to convince a bereaved person that you are telling the truth.   

Once the news starts to sink in, the bereaved person will need more information about circumstances, location, time of death, and so on. Officers should answer any questions the bereaved may have to the best of their ability, but should not speculate. A straightforward notification form outlining the circumstances of the crash, such as that used by Cumbria police, can be helpful. Forms can be faxed from one police station or force to another and serve as a useful aide-memoir for the notifying officer. They are not designed to be used as the means of breaking bad news.   

Working in pairs can be advantageous as one officer can remain with the bereaved whilst the other makes discreet follow-up enquiries. Depending on the exact working circumstances it can be useful to be able to make phone contact with an officer at the scene, though this should be done away from the person who has been bereaved, who might otherwise insist on speaking to the OIC directly.   

It is really important to refer to the person who has died by their name rather than as 'the body' or 'the deceased', which can sound unsympathetic, and the bereaved person will probably find it easier to be told that their loved one will be taken "to the hospital" rather than "the mortuary". It will almost always be appropriate to tell someone who is bereaved "I am sorry that this has happened".   

With Compassion   
The Iowa model states, "Your presence and compassion are the two most important resources you bring to death notification". Officers should try to react in a supportive way to the emotions of bereaved people and should also cultivate awareness of their own emotions. It is not unnatural to feel sympathy for people who have been bereaved, and this may even be expressed by the officer shedding a tear. This is far better than attempting to suppress emotions and appearing cold, callous and uncaring.   

Unless it is clear that the bereaved person and the officer share common beliefs, religion is a topic that is best left alone. Bereaved people in the US also report that phrases such as "I know what you are going through", "She wouldn't have known much about it"or "He had a good innings", which are uttered in a vain attempt to offer comfort, do not.   

Unless the bereaved person specifically requests it, the officers should never just deliver their message, then leave. Officers should allow plenty of time to provide information and support for a bereaved person and should make every effort to find and bring a close friend or relative to them.   

There may be a need for formal identification, but even when there is not, a bereaved person may still want to see the body of the person who has died. They should always be given this option, even when the person who has died has suffered horrific injuries an officer should never assume that someone will not want to see the body of a loved one, however badly it is damaged. In addition to providing transport to the hospital/mortuary, the officer can also prepare them for seeing the body by making them aware of what to expect in terms of apparent injuries.   

There may be personal items belonging to the person who has died which must be preserved and returned to the 'primary bereaved' person/ people. These should not be taken with the officers at the time of notification, but can be passed on later, in a caring manner and in an appropriate carrier. South Yorkshire Police, for example, have dark blue property bags marked with a simple force crest for returning personal items.   

Exit Strategy   
Once the message has been delivered and understood, a friend or relative is looking after the bereaved and arrangements are in hand for the deceased to be formally identified, it is time to consider the exit strategy.    

The officers who have carried out the notification should ensure that they leave the bereaved person with contact details for the FLO (if neither officer is going to act as FLO), the SIO or officer in the case and the Coroner's Officer. If the death has occurred in a different police force area, one of the notifiers should be prepared to act as a local contact. Ideally, if neither officer is going to act as FLO, they should wait until the FLO arrives, so they can introduce him/her to the bereaved person. If that is not possible, they should find out when the FLO will be making contact with the bereaved person and make sure that they have this information.   

Before taking their leave, the officers should ensure that a bereaved person has suitable transport to the hospital or morgue: the first priority of many bereaved people is to see their loved one's body immediately. Wherever possible this transport should be provided by the officers, as a bereaved person is likely to be in shock and unable to drive themselves anywhere safely.   

Case study
"My husband of six weeks had gone to work the previous evening and I was expecting him home at any time. At about 9.30 a.m. the police came to my house. There was a male sergeant and a female PC. The sergeant asked if they could come in as they had to talk to me urgently. As they stepped into the hall I asked what they wanted. The sergeant said that they needed to know if we owned a red Ford Escort and he told me its registration number. It was our car, I told him, and added that my husband Tom had taken it to work. He said that the car had been involved in a serious collision about an hour earlier and they believed that the driver was my husband. The sergeant said he had some bad news, that the driver had died in the collision and they needed to identify him. He asked if I had a photograph of my husband and when I showed him one he told me that it looked like the description of the driver. He asked if there were any children in the house and whether the police could contact anyone for me. I said that I wanted to go to my parents who lived nearby. The police officers took me there, and explained to my parents what had happened. They stayed with us until they were told that Tom had been taken to a hospital, and then arranged for my father and me to be taken to the hospital to identify him. They spoke to other members of my family and kept everybody informed about what was going on. The sergeant said he had to take some details and luckily my brother was available to help him with these as I was too upset. He added that he would need to get a statement but could leave that for a day or so until I felt ready to speak to him. The sergeant then gave me the names and telephone numbers of the officer who was dealing with the crash, and also the Coroner's Officer. Then they left the house so that I could get to the hospital to be with Tom."  

 Author: Simon Hepworth     Edited by: Cathy Keeler     Date written: 2005     Date updated: 2006    

Brake Family Liaison Officer Handbook: Civil claims

Some police officers working with bereaved and injured families express wariness of personal injury solicitors and civil claims generally. When it comes to professional personal injury solicitors with a specialism in fatal and serious injury road crash civil claims, this wariness is unfounded and potentially damaging to families, preventing them accessing vital funds. While money cannot replace a loved one, it can pay for things that make life more tolerable for families who are facing the worst time of their lives.   

For many people bereaved or injured by a road crash a successful civil claim provides an essential financial life line and, critically, can be pursued at no or very limited cost to the victims themselves.   

For people who have been bereaved by a road crash, a successful civil claim can provide vital financial assistance; particularly, but not exclusively, for those families where a main breadwinner has been killed and there are dependents such as children or elderly people. Claims can provide for a range of costs, from funeral expenses, to providing extensive, on-going living costs for a family raising children in order to cover a lost salary.  

For people seriously injured and their families, a successful civil claim can pay for necessary care in the home and additional health services above and beyond those that the NHS can provide.   

Civil claims often proceed even where criminal prosecutions haven't.   

It is particularly important for police to remember that the burden of proof required in a civil claim is generally lower than that required to proceed with a criminal prosecution. This means that a civil claim against a third party driver may still be possible even if that driver is not being prosecuted with a criminal offence, and even if the person who died or was injured may partly have been to blame (for example, they were a pedestrian who walked into the road).    

It is important to be aware that families will generally not know the above, and may think that because a criminal prosecution is not going ahead, they definitely don't have a civil claim; when they may indeed have a very good claim.    

Police can therefore be an enormous assistance to families by encouraging them to contact a personal injury solicitor with an expertise and experience in dealing with fatal road crashes. This can easily be achieved by calling the Brake helpline on 0808 8000 401, who can provide contact details for your police force areas. A family's initial consultation with a solicitor to find out if they have a claim is generally free.    

It's important to contact a specialist personal injury solicitor reasonably quickly.   

Personal injury solicitors need to, obviously, prepare their cases, and the more time they have, the better. While some information may not be available to them from the police until an investigation is complete, it can help a civil claim if a family's personal injury solicitor is hired in time to attend any inquest or other proceeding that is taking place, gain evidence of injuries, or even consider with the family a second post mortem.    

It is therefore not a good idea to advise a family to delay hiring a personal injury solicitor - this could damage their claim substantially, and after certain lengths of time claims cannot be made at all.    

It is therefore helpful if you can direct families to a specialist personal injury solicitor, to find out if they may or may not have a claim, quite soon after the crash, perhaps in your second or third contact with a family.    

Avoiding sharks and charlatans   

Claims assessors are not personal injury solicitors and are not qualified or regulated. They may offer families a contingency fee, where the family pays a percentage of their awards to their claims assessor if they win. In the case of big claims, this means a family may end up paying an enormous and totally unreasonable amount. You can help families by warding them away from claims assessors and ringing the Brake helpline to contact a specialist personal injury solicitor for a family.   

Brake also has experience of some solicitors offering to take on fatal or serious road crash civil claims when they have little experience in this area. It is very important that families seek the advice and assistance of a solicitor who is a specialist and experienced in dealing with a case such as theirs, and that they don't just hire the solicitor they know who maybe wrote their will or sold their house. Claims for compensation following an injury or death are not always straightforward and it is vital that an expert is found especially if the matter is severe involving the loss of a limb, a head or spinal injury, the death of a loved one, or if the claim concerns potentially negligent medical treatment.   

Further reading   

Read the information in the civil claims section of the Brake bereavement pack Advice for bereaved families and friends following a death on the road for more background knowledge of civil claims in bereavement cases. You can also read Brake's guide for serious injury victims for information about civil claims in serious injury cases.

Brake Family Liaison Officer Handbook: Faith issues following a death on the road

We need to be sensitive to cultural or religious issues that may arise when liaising with families, particularly those from ethnic minority groups. Below are some guidelines about general customs and religious practices relating to death and funerals in some of the major religions practised in the UK today. This list is not exhaustive and is offered only as a general guide. Above all, we should remember that people are individuals and what is right for one person may not be right for another. If in doubt, it is best to ask - very few people will be offended and many will appreciate this.

General tips for FLOs and other support workers:

Many people in the UK refer to their 'Christian name' and 'surname'. However, asking for a 'Christian name' may be offensive to non-Christians. Asking for a 'first name' and 'second name' may lead to confusion with some naming traditions. It is best to ask for someone's 'full name'. If you need to distinguish between different parts of a person's name, you can ask for their 'personal name' and 'family name'.    

In the UK, it is traditional to cross the arms of a dead person across their chest. However, it should be noted that this is a Christian tradition (the sign of the cross is a sign of Christianity) and may be offensive to non-Christians. It is best to make sure that the arms of the dead person are not crossed before family and friends view the body.   

In the UK, it is traditionally a sign of respect to remove headgear when entering a house. In some traditions, the opposite is true. It is best to check whether someone would like you to cover or uncover your head and whether or not they wish you to remove your shoes before entering their house.   

Many people find their faith and religious community a comfort in time of crisis. However, it is also common for a traumatic event, such as a death on the road, to lead people to question the assumptions they hold about the world and this may include questioning their religious beliefs. Individuals may or may not feel strongly about different aspects of their faith.

Christians    

Christianity is the most common religion in the UK, although numbers of practising Christians are declining. The Christian holy book is the Bible. Most Christians in the UK belong to the Church of England and are known as 'Anglicans', but there are significant numbers of Christians from other churches. These include Catholics (sometimes called 'Roman' Catholics), Methodists, Baptists, the Salvation Army, Orthodox Christians, Pentecostal Christians, Quakers and others. Their beliefs are very similar, but some beliefs and practices differ.   

Religious leaders and places of worship:Each type of Christian church has a slightly different religious hierarchy, but local religious leaders are usually ordained 'priests' (sometimes known as 'ministers', 'vicars' or 'pastors'), although for Quakers, they will be a leader appointed from the community. The Christian place of worship is a 'church', although the Quaker place of worship is known as a 'meeting house’.

Some Christians may wish a religious leader from their own church to be present after someone dies. It is particularly important to Catholics (and some Anglicans) to have a priest perform the 'last rites' (also known as the 'sacrament of the sick') when someone dies.   

When contacting a Christian Church, it is usually best to ask to speak to the priest.  

Holy days:The Christian holy day is Sunday, when Christians usually attend a church service.   

Beliefs about death:Christians believe in life after death, where everyone will be judged by God and sent, accordingly, to heaven or hell. However, these beliefs are open to a wide variety of interpretation. For example, some Christians believe that everyone will go to hell when they die, unless they repent of their sins and accept Jesus, the son of God, as their 'saviour' - others interpret the notion of hell more symbolically, as a state of existing 'without God'.

Practices following death     

Positioning the body:Traditionally, Christians may cross the arms of a person who has died, or place the hands together, as if in prayer.   

Personal possessions:Some Christians may wear jewellery in the shape of a cross, or a fish. There are no particular religious reasons for offence if this jewellery needs to be removed.     

Funeral:Christians often bury their dead, due to the traditional belief that the physical body is resurrected after death. However, many Christians believe in a spiritual, rather than a physical resurrection. There is no restriction on cremation for Christians, which is becoming more popular.   

Procedures following a death on the road

Post-mortems:Most Christians have no religious objections to organ post-mortems, although those who Christians who hold the traditional belief that the physical body is resurrected after death may object.   

Organ and tissue donation:Most Christians have no religious objections to organ and tissue donation although those Christians who hold the traditional belief that the physical body is resurrected after death may object.    

Speaking to Christians

Names:Christians tend to follow the naming system of the country they live in.

Visiting a Christian home 

Entering a Christian home:Some items of particular religious significance may be found in some Christian homes, including: the Bible; a cross or crucifix; and rosary beads, which are used in prayer. These items should not be touched without permission.   

Muslims   

The Muslim religion is called 'Islam'. Its holy book is the Quran or Koran, which Muslims believe to be the word of God (Allah) conveyed through his prophet Mohammed. Most Muslims in the UK are Sunni Muslims or Shi'ite (pronounced 'shee-ite') Muslims. Their beliefs are very similar, but their practice of Islam differs.   

Religious leaders and places of worship:A Muslim religious leader may be called an 'imam', but this term means different things to Sunnis and Shi'ites, who have different ways of appointing their religious leaders. The Muslim place of worship is a 'mosque', which is run by a committee of local Muslims, rather than an ordained religious leader. It is not necessary to have a religious leader present after someone dies, as family members or any practising Muslim may perform the necessary rites. However, a bereaved Muslim may wish to contact the imam at the local mosque, particularly if they have no family present.   

When contacting a Muslim mosque, it is usually best to ask to speak to the Secretary of the Committee.

Holy days:All Muslims say set prayers five times every day, but on Fridays male Muslims go to pray at the mosque. Women and children usually say their prayers at home, but some mosques may provide a separate room for them to worship.  

Beliefs about death:Muslims believe in life after death, and that they will be judged by Allah on the life they have led and sent, accordingly, to heaven or hell. They believe that the physical body is resurrected after death. Some Muslims may try not to show grief following a death, to show that they accept it as being Allah's will, and that death is only a temporary separation.

Practices following death

Time factors: Muslim tradition requires the dead to be buried as soon as possible.   

Positioning the body:Traditionally, Muslims close the eyes and straighten the limbs of a dead person before wrapping them in a white sheet and turning their head to face their right shoulder so that they can be buried to face Mecca. Further preparation for burial, including washing the body will be carried out, by the family, at the person's home, at the mosque, or at the funeral director's before burial.   

Touching the body: Many Muslims prefer that the body is not touched by anyone who is not a Muslim themselves. If this is necessary, the non-Muslim should wear disposable gloves.    

Viewing the body: It is important that the head of the deceased Muslim is covered before the family sees it.   

Personal possessions: Some Muslims may wear a 'taviz' (a small piece of cloth, leather or metal inscribed with words from the Quran) on a black string around their arm, waist, or neck. This should not be removed without permission from the family.   

Funeral: Traditionally, Muslims bury their dead, but do not use a coffin and do not mark the grave, though the ground is raised. They are never cremated. However, for burials in the UK, it is a legal requirement to use a coffin and mark the grave. Some local authorities provide a specific area for Muslim burials, but others do not, which may cause distress. If possible, a Muslim funeral director should be used. Some Muslim families may wish to take their dead to a Muslim country so they can follow traditional requirements for burial.

Procedures following a death on the road:    

Time factors: Muslim tradition requires the dead to be buried as soon as possible. The procedures that follow a death on the road may delay burial, which can cause distress. The need for these procedures should be explained sensitively.   

Identification procedures: It is important that the head of the deceased Muslim is covered before the family sees it.   

Post-mortems: This is a legal requirement following fatal road crashes, but it is a procedure that is unacceptable to many Muslims. The need for a post-mortem should be explained sensitively.   

Organ and tissue donation: Strict Muslims will not want any part of a body to be donated, but some may consider it acceptable.    

Speaking to Muslims   

Names: As the naming system is very different to the traditional system used in the UK, care should be taken when addressing or referring to Muslim men and women. In order to avoid any confusion it is always best to use the full name (eg. Mohammed Khalid; Fatma Bibi). Avoid the use of Mr or Mrs unless you use it in conjunction with two personal names (eg. Mrs Fatma Bibi NOT Mrs Bibi, which could refer to a number of different women).   

Speaking to a Muslim woman: When speaking to a Muslim woman, it is preferable if a relative or a female police officer is present.    

Visiting a Muslim home   

Entering a Muslim home: It is polite to offer to remove your footwear before entering the house of a Muslim family.   

Sikhs   

Sikhism is based on belief in one God and the teachings of the ten Gurus (teachers), who were the first leaders of the Sikh religion. These teachings are found in the Sikh holy book, the Guru Granth Sahib. Some Sikhs are baptised and wear the five signs of Sikhism: Kesh (uncut hair, often concealed beneath a turban or scarf); kangha (a comb); kara (a steel bangle); kirpan (a symbolic dagger); kaccha (special underwear). Other Sikhs may or may not be baptised and may wear some or none of the five signs.   

Religious leaders and places of worship:Sikhs worship in the prayer room of a temple (Gurdwara). There is no religious hierarchy in Sikhism. Any Sikh can act as a 'granthi' (person who reads the Guru Granth Sahib). A scholar and preacher is known as a 'giani'. The temple is run by an elected lay committee.    

When contacting a Sikh temple, it is usually best to ask to speak to the Secretary of the committee.   

Holy days: Sikhs usually visit the temple on Sundays.   

Beliefs about death: Sikhs believe in reincarnation - that each soul is re-born until it reaches perfection and avoids returning to earth. They believe that a person's 'karma' - behaviour, thoughts and deeds from their past life - influences their current life, but that karma can be improved by the grace of God. The attitude towards death is not one of sadness.   

Practices following death

Time factors: It is customary that cremation takes place as soon as possible, usually within 24 hours.   

Positioning the body: The eyes and mouth should be closed, limbs straightened and body wrapped in a plain sheet.   

Touching the body: Sikhs have no religious objection to health workers or funeral directors touching the body, but Asian Sikh families may prefer to wash and lay out the body themselves.   

Personal possessions: The five signs of Sikhism should not be removed from the body.   

Funeral: Sikhs are traditionally cremated, accompanied by the five signs of Sikhism and their ashes are scattered in a river, at sea, or in a holy place. Sikhs wear white clothing at funerals.  

Procedures following a death on the road

Time factors: It is customary that cremation takes place as soon as possible, usually within 24 hours. Sikhs tend to accept that the procedures that follow a death on the road may delay burial. The need for these procedures should be explained sensitively.     

Post-mortems: Sikhs have no religious objection to post mortems.   

Organ and tissue donation: Sikhs have no religious objection to organ transplants.

Speaking to Sikhs

Names: Some Sikhs in the UK have re-adopted their family name, which may be used after their religious name. If the family name is used instead of the religious name, it is important to note whether the person is male or female (as this is impossible to tell from a Sikh's personal name).   

Speaking to a Sikh woman: A Sikh woman may feel more comfortable if other family members are present when a male officer visits her home.   

Visiting a Sikh home

Entering a Sikh home: Some Sikh families may keep a complete copy of their holy book, the Guru Granth Sahib, in a special room in their home. No-one should enter this room without an invitation. If invited, you should offer to remove your footwear and cover your head. Other prayer books should also be treated with respect and never placed on the floor.

Hindus   

Hinduism is not only a religion, it is a social system as well. As there is no one holy book and there are hundreds of Hindu gods, Hindus follow their religion in diverse ways and will celebrate different festivals and in different ways depending upon their social and geographical background.

The three most important Hindu gods are Brahma (the creator), Vishnu (the protector) and Shiva (the destroyer). Whichever god/s they tend to worship, Hindus are united in believing in one supreme spirit, Parabrahma (or Paramatma), 'karma', which is the force that provides natural rewards and punishments for behaviour; and the cycle of reincarnation, through which everyone must progress in order to be reunited with Parabrahma.   

Religious leaders and places of worship: Hindu worship may take place at shrines in the mandir (temple) or in the home. Hindus have religious teachers, called 'gurus', but they do not run the mandir: it is run by an elected committee of local Hindus.   

When contacting a Hindu mandir, it is usually best to ask to speak to the Secretary of the Committee.

Holy days: Hindus worship at the mandir or in the home. There is no particular day set aside for worship. The holy days they celebrate may vary.   

Beliefs about death: Hindus believe in reincarnation - that each soul is re-born until it reaches perfection and avoids returning to earth. They believe that a person's 'karma' - behaviour, thoughts and deeds from their past life - influences the state their soul is born into in their current life. Hindus believe that when a person's soul becomes pure enough, it is united with Brahma.

Practices following death

Time factors: It is customary that the funeral takes place as soon as possible.  

Positioning the body: The eyes should be closed, limbs straightened and body wrapped in a plain sheet, but permission to touch the body should be gained from the family before doing this, if possible.   

Touching the body: The body should not be touched, if possible, until permission is given by the person's family. It may cause some Hindus distress if the body is touched by a non-Hindu.   

Personal possessions: Any jewellery worn by a Hindu may have religious or social significance and should not be removed without permission. Many Hindus wear a necklace and a thread which passes diagonally across their body, from shoulder to waist. These have special religious significance and should not be removed. In addition, many Hindu wives wear a brooch given to them by their husband, which denotes their married status (sometimes worn on a necklace of gold or black beads). They may also wear glass and/ or gold wedding bangles as well as one or more wedding rings.    

As Hindus consider the feet to be the dirtiest part of the body, shoes should not be returned in the same bag as other possessions. In particular, holy books should not be placed on the floor, or near feet or shoes.   

Funeral: Hindus are always cremated and their ashes are sprinkled into the sea, or a river. Some Hindus travel to India, in order to sprinkle a loved one's ashes into the river Ganges, which has special religious significance for Hindus.   

Procedures following a death on the road

Time factors: Cremation takes place as soon as possible after death.   

Post-mortems: Although this is a legal requirement following fatal road crashes, officers should be aware that this procedure is considered deeply disrespectful in Hinduism. Officers should use tact and sensitivity when explaining the need for this procedure.    

Organ and tissue donation: Hindus have no religious objection to organ and tissue donation.   

Speaking to Hindus   

Names: Hindus usually have a personal name, followed by a middle name (which is usually their father's name) and a family name, which denotes the person's social status.   

Speaking to a Hindu woman: Male officers should not speak to a Hindu woman on her own, another family member should be present.  

Visiting a Hindu home  

Entering a Hindu home: It is polite to offer to remove your footwear before entering the house of a Hindu family.   

Entering a room containing a shrine: Most Hindu homes contain a room with a small shrine where the family can worship. The shrine usually consists of statues of one or more gods, pictures of gods and saints and incense. There may be symbolic offerings of food left at the shrine. You should not enter this room, or touch anything on the shrine, without an invitation to do so. Anyone still wearing footwear should offer to remove it before entering and women should offer to cover their heads.   

Jews   

Judaism is one of the world's oldest religions. Jews believe that there is one God and that they are his 'chosen people'. The Jewish holy book is called the 'Torah' and Jews believe that it reveals God's will. The Ten Commandments are a central part of God's instructions for his people. There are several different groups of Jews: Orthodox Jews, who follow the instructions of the Torah very strictly; and non-orthodox Jews, who may be part of the Reform, Progressive, Conservative or Liberal movements, who believe that the Torah's teachings may be adapted to modern life.   

Religious leaders and places of worship: Jewish teachers are called 'rabbis' and will often lead the service at the 'synagogue', the Jewish place of worship, although any Jew may do this. The synagogue is often run by a committee of local Jews and not every synagogue in the UK will have its own rabbi.   

When contacting a Jewish synagogue, it is usually best to ask to speak to the Secretary of the committee.   

Holy days: The Jewish holy day is the Sabbath, which runs from sundown on Friday to sundown on Saturday. Jews are forbidden from doing any work on the Sabbath, which is set aside for prayer and visiting the synagogue. For many Jews, the restriction on working on the Sabbath extends to activities such as driving a car, using the telephone, cooking and watching television.   

Beliefs about death: Jews believe in life after death, when their soul will be resurrected to be with God in heaven. Some Orthodox Jews believe that their body will be resurrected as well as their soul.   

Practices following death

Time factors: It is Jewish custom to bury the dead as quickly as possible, usually within two days, but not on the Sabbath or another holy day.   

Positioning the body: The eyes and mouth should be closed, limbs straightened and arms placed by the side of the body, with the hands unclenched.   

Touching the body: Jews will wish to wash the body and cover it with a white sheet to prepare it for burial. It is usual for a group of Jewish men to prepare a male body and a group of Jewish women to prepare a female body for burial.

Viewing the body: Jews will not want the body to be left unattended until the time of the funeral and it may be upsetting if this is not possible.  

Personal possessions: Some orthodox Jewish men wear a 'kippah' (skull cap) or wide-brimmed hat. If possible, this should not be removed. 

Funeral: The majority of Jews are buried, although nowadays some are cremated. The funeral is often followed by a seven-day mourning period, called 'shiva', in which friends and family visit the immediate family of the person who has died to comfort them and pray with them. Some Jews may also observe a 30-day period of mourning called 'shaloshim'. During 'shiva' and 'shaloshim' Jews may not cut their hair, wear new clothes, or attend any celebration, including listening to music.   

Procedures following a death on the road

Time factors:It is Jewish custom to bury the dead as quickly as possible, usually within two days.   

Post-mortems: Although this is a legal requirement following fatal road crashes, this procedure is unacceptable under Jewish law. Tact and sensitivity should be used when explaining the need for this procedure.  

Organ and tissue donation: Orthodox Jews are unlikely to agree to organ and tissue donation, but some other Jews may. It is best to ask, but with tact and sensitivity.   

Speaking to Jews

Names: Jews tend to follow the naming system of the country they live in, but may have a Hebrew name in addition to the name they use.   

Visiting a Jewish home

Entering a Jewish home: It is polite to ask if Jews would like you to cover your head before entering their home. Some Jews may prefer not to be visited on the Sabbath, but if in doubt, check. Some Jewish houses may have a small container (a 'mezuzah') fixed to the door post. This contains words from Jewish holy scrolls and Jews often touch it when entering or leaving the house.   

Items in a Jewish home: Some items in a Jewish home, including some candlesticks and silver cups, may have great religious significance and should not be touched. If in doubt, ask.   

Buddhists   

Buddhism is more a philosophy, or way of life, than a religion. It incorporates a number of different beliefs and practices, but all Buddhists seek 'Nirvana', a state of enlightenment in which personal needs and wishes are unimportant and suffering does not exist. Buddhists do not believe in any god or gods, but in the cycle of life and the desirability of achieving a state of Nirvana. There are two main traditions of Buddhism: 'Theravada' and 'Mahayana'. Customs and practices vary in these traditions.   

Religious leaders and places of worship: As Buddhists do not believe in a god or gods, they do not worship: instead they meditate, or reflect, in temples or 'viharas' which are smaller meeting houses. Temples and viharas are often run by Buddhist monks or nuns, known as 'venerables'. Many Buddhists homes also contain a shrine, where the family meditates.   

Beliefs about death: Buddhists believe that their life force is passed on when they die in the form of a new person. Buddhists accept death as part of the natural cycle of the universe.   

Practices following death

Time factors: In the Mahayana tradition, the body is usually left untouched for at least eight hours after death. In both traditions, a Buddhist monk should be called immediately to perform prayers over the body.   

Touching the body: There is no restriction as to who may touch the body, but it should always be handled in a respectful way.   

Personal possessions: Some Buddhists wear a necklace with a Buddhist picture or icon on it and chanting beads on their wrists. These should not be removed unless necessary.   

Funeral:
Buddhists may be either buried or cremated. Funeral ceremonies and traditions for Buddhists can vary depending on their country of origin.   

Procedures following a death on the road

Post-mortems: The need for a post-mortem should be explained with tact and sensitivity as although there is no religious objection, some Buddhists may consider it disrespectful.   

Organ and tissue donation:
There is no religious objection to organ and tissue donation, although some Buddhists may consider it disrespectful. If in doubt, ask.   

Speaking to Buddhists

Names: Buddhists tend to follow the naming system of the country they live in.  

Eye contact: Some Buddhists, particularly those from Asian cultures, may interpret direct eye contact as confrontational. In some Buddhist countries of origin the police are feared, hence Buddhists may appear hesitant and reserved in their dealings with them.  

Visiting a Buddhist home

Entering a Buddhist home: It is polite to offer to remove your footwear before entering the house of a Buddhist family.   

Entering a room containing a shrine: Most Buddhist homes contain a room with a small shrine where the family can meditate and reflect. The shrine usually consists of a small table with a statue of Buddha, flowers, candles and incense. You should not enter this room, or touch anything on the shrine, without an invitation to do so. You should offer to remove footwear and headgear before entering a room containing a shrine.      

Brake Family Liaison Officer Handbook: FLO Coordinators and selection and training of FLOs

Police forces are now frequently appointing senior managers as Family Liaison Officer Co-ordinators and this is good practice. These officers should have received training and development in this role to ensure that are effectively prepared. The co-ordinator is responsible for administration and support functions.       

FLO Co-ordinators should administer supervision of the FLO system and maintain a register of all trained FLO's including details of their diversity including ethnic or cultural origins. There should be a comprehensive list of information on their FLO experience including the types of cases they have been deployed to and any brief synopsis of specific skills utilised and enhanced such as dealing with 'split families', suspects within a 'family', families with children or of a particular ethnic background, or any unique situation.       

The register should contain a list of other skills or qualifications held by the officer such as Sexual Offences Liaison trained, language or cultural skills.       

The FLO Co-ordinator should act as support for SIO's. An SIO may require advice and assistance in complex cases where multiple deployments of FLO's may be required.       

FLO Co-ordinators should also maintain a register of contact details of appropriate organisations or persons that may assist in Family Liaison. They need to share good practice both locally and nationally by networking and promoting the family liaison function. They need to facilitate peer group support through 'buddy' systems, monitor workloads and ensure the monitoring of mandatory attendance at welfare and occupational health units.       

The ACPO National FLO Strategy is quite prescriptive in indicating that FLO Co-ordinators should meet formally with all FLO's regularly and arrangements may be made for FLO's to get together on an informal basis to provide support, share good practice and update themselves on knowledge, understanding, skills and legislation.        

FLO Co-ordinators should be trained effectively and be able to:       

  • Describe the roles of SIO, Senior Identification Manager (SIM), FLO Co-ordinator, FLO and FLO Advisor (these may be adopted in some Police Services and role is similar to that of FLO Co-ordinator and should be trained to same level).       
  • Identify suitable support for families to cope with media interest and press matters.       
  • Identify principles involved in diffusing/de-briefing FLO's and issues of trauma risk management including therapeutic de-briefs and benefits of occupational health facilities.
  • Ensure effective risk assessments are conducted and managed appropriately.
  • Identify components of an effective FLO Strategy.       
  • Identify tactics, strategies and best practice involved in Family Liaison.       
  • Identify issues and factors relative to selection, training and effective deployment of FLO's.       

Selection of FLO's       

Family Liaison Co-ordinators may be involved with managers at a local level in identifying and selecting potential FLO's.       

Those performing the role of an FLO should do so with the highest degree of professionalism and integrity with duties being carried out with the utmost sensitivity to the needs of others.       

Careful selection procedures should be undertaken as to the suitability and intentions of applicants and they should be volunteers having a clear and reasoned motive for undertaking the role.       

Good practice suggests that FLO's should possess the following qualities, knowledge and competencies in particular:            

  • Be able to display good interpersonal skills.
  • Possess good communication and listening skills.
  • Be confident, self-assured, flexible and non-judgemental. 
  • Have the ability to manage own stress, having an understanding of the principles of stress management and work alone with minimal supervision. 
  • Be able to make accurate records.   
  • Possess a good knowledge of professional support services.
  • Possess a good knowledge of communities that they serve. 
  • Have a good knowledge of legal and procedural issues that encompass Family Liaison.     
  • Have proven investigative skills. 
  • Be trained in Investigative Interviewing in accordance with 'A Practical Guide to Investigative Interviewing'and to at least Tier 2.
  • Be experienced in dealing with exhibits.       

Training of FLO's   

FLO's should receive effective learning and development prior to performing the role of FLO. If an FLO is deployed and they are untrained then an SIO may have to answer policy issues as to why an untrained FLO was deployed.       

FLO's should receive effective learning and development, through an initial training course lasting no less than five days, and on-going refresher and specialist training annually or more frequently, and be able to, following this training:       

  • Explain the function of an FLO and the main responsibilities associated with the role.      
  • Explain the function of an SIO and the main responsibilities associated with the role.       
  • Explain the function of an FLO Co-ordinator and the main responsibilities associated with the role.
  • Identify action that should be taken on appointment as an FLO. 
  • Explain the function of, purpose of, and how to complete an FLO log.
  • Outline issues that should be considered in relation to identification of the family and when working with them. This to include ethnicity, cultural and lifestyle diversity.      
  • Possess knowledge and understanding of issues relating to road traffic law.     
  • Possess knowledge and understanding of issues relating to witness intimidation/harassment.       
  • Outline the role of the coroner and procedures in respect of coroner's courts and inquests.      
  • Outline procedures relating to body identification including access to, release of, organ/tissue donation and retention.  
  • Outline issues relating to property retrieval, retention and return. 
  • Outline the criminal justice system for purposes of giving information to a family, and also have a basic understanding of the value of the civil law system. 
  • Outline the grieving process including factors that affect it such as violent or sudden death and the criminal justice process.
  • Describe the main cultural and ethnic differences in death rites.  
  • Outline the process of media involvement. 
  • Possess knowledge of and an understanding of support agencies. 
  • Recognise where specialist intervention may be required. 
  • Outline responsibilities in cases involving family representatives and Independent Advisory Groups. 
  • Describe exit strategies and potential problems associated with this. 
  • Recognise the potential impact of emotional trauma on performance including dealing with aspects likely to be of a high stress level.
  • Recognise the impact of decisions made by the Crown which may adversely affect the family.           

Copyright Dave Morgan

Brake Family Liaison Officer Handbook: Handing out and using Brake support packs

It's one thing to have a really useful set of literature for giving to families affected by road crashes. But it's no good whatsoever unless the right literature is passed on to families in an empathetic and timely manner. That's your job, and this guidance document tells you how to do it in the best possible way, focussing on helping families who have been bereaved.    

'Information and Advice for bereaved families and friends following a death on the road' - the navy blue Brake folder, containing two books   

The FLO Strategy Manual by ACPO recommends that you hand out Brake's bereavement folder, 'Information and Advice for bereaved families and friends following a death on the road' in all cases of road death, and so does the Government's Code of Practice for Victims of Crime (section 5.13). It is free to you as it is funded by the Government.    

This folder of information, which you should already be familiar with, includes a YELLOW book about emotional responses and support agencies, and a RINGBOUND book about procedural and practical concerns. It is updated in wide consultation every year and is widely respected by a range of professionals, as well as widely applauded by families themselves.    

Read the below bullet points to hand out this pack in an empathetic and timely manner to bereaved families:   

  • Hand out more than one folder. This folder is funded by Government agencies. There are enough stocks available for you to hand out, for free, TWO EXTRA copies of the small YELLOW book to each family, and TWO copies of the navy blue folder (including both yellow and ringbound books) to each family. This is especially useful for split families, girlfriends, boyfriends, adult offspring, etc.   
  • Hand the folder and extra yellow books out right away. Although it is challenging professionally, you need to hand the packs out in the same meeting in which you deliver the death notice. [NB: If the bereaved family includes children, you should also at this stage hand out our children's book ('Someone has Died in a Road Crash') and its accompanying guide for carers of children. If you do not have copies of this widely-acclaimed resource, which is free and funded by BBC's Children in Need, contact us on 0808 8000 401 immediately.   
  • Open the folder at page one (labelled 'important contacts'). This is important as this is where you are asked to record your contact details, including your name, phone numbers and times you can be contacted. This is vital for the family, having it written in the pack is better than on a card, as they may lose a card. However, you could also slip a business card in the plastic flap at the front of the pack.   
  • Alert families to the helpline number on the front of the folder, and call the helpline if necessary. Direct the family to the Brake helpline number on the front of the folder. This helpline is not available 24 hours a day, but if you reach an answer machine we will call you back when you say you want us to. We are there to help you with your questions on behalf of the family, or to talk to the family directly if they prefer. We are there for emotional support and also to provide procedural advice on a range of points covered in the folder that are outside the remit of a police officer, ranging from wills to civil claims to accessing an assessment for Post Traumatic Stress Disorder. The helpline is staffed by paid, trained professionals directly employed by the charity Brake, not volunteers or outside contractors.    
  • Topics covered in the folder that need to be read right away (this can be done by you or someone else on behalf of the family)You can use the folder as a way of helping a family deal with difficult topics that need addressing early on. The section called 'What happens now?' has a box opposite page 13 about organ donation. [Click here to read our advice on organ donation,][1] a vitally important subject area. Page 13 also has important information about viewing a body which is really valuable for families to read, or have read to them by you or someone else, very early on, before they view a body.   
  • Please use the plastic flaps at the front and back of the folder for important local information, for example your business card or information about local health and support services. However, please do not use it for commercial information or for information of fringe interest to families or for information that is not entirely empathetic or appropriate at this terrible time. Families have been upset in the past by inappropriate information being inserted in this way.

 Use of the folder throughout your involvement with a family   

You will find the folder very useful throughout your involvement with a family. Families often keep the folder close by - it is designed to be durable and not easy to lose (unlike a leaflet) - and may ask you questions that can be answered within the folder, using their copies or a copy that you keep on you (keep one on you at all times). You can work with families to seek the answers they need by reading the folder with them, and if necessary reading the folder to them (although the folder is written in plain language, using large font size, some families find it difficult to read at certain times when in crisis - you, or a relative or friend can help them to do this).    

In particular:

Practical issues: This section of the ring bound part of the folder is very useful to help you work with the family to identify practical concerns they may have and to help them solve them. This could be through a range of measures such as support with media queries, or help informing others about a death.    

Criminal charges and court procedures:These two sections of the ring bound part of the folder are very useful to help families to understand charge structures and what may happen in court.    

Civil claims: It is not your remit to be an expert in personal injury compensation, yet you may be asked by families about it. There is a very useful section on this in the ring bound part of the folder. You can help families by reading this section with them. It is most important that a family consults an expert personal injury solicitor to find out if they have a claim, and this shouldn't cost them anything. Brake's helpline can help them find such a solicitor.   

Assessment of medical needs: Many people bereaved by road crashes develop Post Traumatic Stress Disorder. It is not your job to act as a family's trauma therapist or to diagnose whether they indeed need therapy or not, but you can help them access a medical assessment of their needs, and consequently the right sort of therapy if appropriate, by helping them to read the section about this on this in the yellow book. This is appropriate about two months after a death, not earlier.    

Keep abreast of the folder's contents   

It is very important that you read the folder annually from cover to cover to note updated sections and keep abreast of issues of concern to families aside from the criminal investigation: it is a very useful reminder training tool for you. This gives you a much broader understanding of what they are 'going through'. If there is anything in the folder that you do not understand, or which you think needs improving, contact the helpline on the front of the folder. We value your feedback immensely, and appreciate the challenges of your demanding role.    

Other guides by Brake
If you are based in Scotland, Northern Ireland or Wales, there are regional versions of the bereavement folder produced by Brake, which are distributed in the same way and are freely available.    

If you are a police officer working in one area of the UK, but are helping a family affected by a road death in another area, you may wish us to send you the relevant folder for that area to answer specific questions of the family. Scotland, in particular, has procedures that are somewhat different in many ways to the UK.    

Brake also produces guides on serious injury and on Intensive Care Units. These guides are also available for free and available through the Brake helpline on 0808 8000 401.    

Feedback
We value all feedback, but particularly from families - this helps us continue to obtain funding for these free guides. If you are working with a family who has appreciated the literature we have provided, please encourage them, at the appropriate moment, to fill in the freepost feedback forms we provide with most of our literature with their comments - and return it to us. Many thanks for this help.     

Need more folders or other guides?   
If you have run out of Brake literature, contact the Brake helpline on 0808 8000 401 and we will replenish your stock free of charge.     

Author: Mary Williams    Last updated: Jan 2008     Copyright Brake    

Brake Family Liaison Officer Handbook: Helping bereaved families with the media

Journalists from newspapers, radio or TV programmes often want to cover crashes and court cases that follow. You cannot stop the media from reporting on a case or publishing a family's name and where they are from. Journalists may publish or broadcast stories about a case without talking to a family, or they may phone a family, knock on their door without warning or approach them at a court hearing for a comment. They may ask for a photograph or home video of someone who has died. They may ask to interview or photograph a family member.   

Different people feel differently about the media. Some families may feel grateful for media coverage, or resent it, or feel disappointed that there isn't as much media coverage as they would like. It is up to them whether they talk to journalists or not. They may decide to talk to journalists to help raise awareness of road safety, or to help the police to find witnesses to the crash. They may find that they prefer to talk to some journalists but not to others. They may develop close relationships with some journalists and feel they have become friends. They may decide not to talk to journalists, for personal reasons.    

If a family isn't contacted by journalists but want media coverage, they can contact them themselves, or you may feel able to put in an initial call for the family (see below, however, for official police media relations regarding crashes) to find a relevant, interested journalist to prevent a family feeling snubbed or fobbed off by a busy and potentially rude journalist. A family might want to talk to their local newspaper, radio or TV station. Ring up the news room and ask to talk to the news editor or transport correspondent and take it from there.    

It is vital to tell families if there is anything they shouldn't talk about to journalists. If someone is accused of a death, it is important not to make comments that could create problems for a police investigation or a court case. As well as consulting your SIO, it may be relevant to consult the CPS or Procurator Fiscal (in Scotland) or suggest to the family, also, that they should speak to their personal injury solicitor.

Police help with the media   

The police can often help a family to manage their relationship with the media, particularly in the first few days after the crash or around any court case. The Police Family Liaison Strategy Manual by the Association of Chief Police Officers recommends that police work with families to develop a 'media strategy' that takes into account views of the family on whether they want coverage or not. You can download this strategy from this website.   

The police often release their own statements about crashes and resulting court cases to the media. If you do, it is important to inform the family about your intention to do this, and to give them a copy of anything you produce. It is also important to give families an opportunity to be involved, should they so wish, such as by including a photo or home video they provide, or a statement. In some cases, it may be helpful to organise a press conference for a family, so the majority of media interest is dealt with in one go. This might happen at the end of a court case, or as part of an appeal for witnesses.    

Choosing a photo or home video

When a family is choosing a photo or home video of someone who has died to pass on to the media, it is helpful to advise them to consider how that person would have wanted to be remembered. You can help by arranging for a photo to be altered if necessary- for example, taking a loved one's image from a group photo. Ensure you take good care of the photo and give it back promptly in good condition, particularly if it is an original. If possible, get copies of the photo for the family so they have spares for giving out to other family members or journalists. This is an easy, cheap but incredibly beneficial service for some families - photos are very precious.    

A few families have given the media a photo of a loved one's dead body, or of them critically ill in hospital before they died. They have done this as part of an appeal for witnesses or to explain to the public the horrors of road crashes. Brake has produced a separate Brake briefing on this topic which you can view on this website.    

It is possible to ask the media to use a photo for a specific purpose and on just one occasion, accompanied by specific words from the family, and then ask for the photo not to be used again. It is also possible to release a photo to just one journalist or lots of journalists.    

You are advised not to give original photos or home videos to the media in case they lose them. News rooms can be hectic, messy places.

Being interviewed by a journalist

Being interviewed by a journalist can be hard, particularly if they are a stranger and they are asking a family to talk about how they feel. It can also be particularly hard to do interviews that are being broadcast on radio or TV. If a family decides to talk to a journalist, it can help to ask in advance what questions they want to ask, and to think in advance about what the interviewed person might want to say. If they are doing an interview at a radio or TV station, you might want to offer to accompany them to the interview for support, or ask on behalf of the family if the interview could be done at their home instead.

Brake Family Liaison Officer Handbook: Liaising with other agencies providing practical and emotional support

There are a number of key national agencies that can be of enormous assistance to FLOs working with families bereaved by road crashes. Some of them, including Brake, are listed on this webpage within the Brake site.    

In addition, there are many organisations that operate regionally only, from specialist services for children, to more general bereavement care services. It is enormously beneficial to families if you can keep an up to date list of such local agencies, and act as a signposter to these agencies, contacting them on behalf of families if necessary to find out more about their services and any charges.    

Brake Family Liaison Officer Handbook: Logbooks

When an FLO is deployed they must commence an FLO log. The main function of this log is to keep all records of contact with the family and any representatives and other parties connected to them. The log also increases the ability of the police to liaise professionally, particularly if there are several cases being dealt with at any one time.       

The log book is an official police document and is maintained and kept by the FLO. It is supervised and checked at regular intervals by the Senior Investigating Officer (SIO) or FLO Co-ordinator, dependant on local policy. Processes will need to exist to retain these records.       

Keeping accurate records is a fundamental principle in the role of family liaison. It provides for effective management of the liaison and ensures an accurate and transparent record of any future review process. The integrity of log keeping is essential and log book pages need to be numbered consecutively.        

Individual police policy will dictate how log books are to be maintained but fundamental principles are that they will be 'original notes' and are bound by disclosure rules by virtue of the Criminal Procedure and Investigations Act 1996. This basically means that police have to record, retain and reveal notes that are made in relation to an investigation.       

It may be that an FLO suspects a member within a family of being involved in an offence or there may be other sensitive issues that need to be brought to the attention of the investigating team. Applications for Public Interest Immunity regarding the disclosure of such issues can then be considered at a later stage.        

A police FLO log will contain some or all of the following types of information:      

  • Details of all strategic and tactical decisions agreed by the Senior Investigating Officer (SIO) or FLO Co-ordinator.       
  • Date and Time of all contacts made including meetings and with whom.       
  • Method of contact made, location and whether personal, telephone or other.       
  • Purpose of the contact and information regarding that purpose.       
  • Details of any complaints made by the family/next of kin and action taken to inform the Senior Investigating Officer (SIO) and/or FLO Co-ordinator.       
  • Details of any request made by the family/next of kin that has not been acceded to and action taken to inform the SIO and/or FLO Co-ordinator.       
  • Details of who initiated the contact i.e. police, family/next of kin, others.   
  • Details of persons present at meetings including non family/next of kin members.      
  • Details of attempts made to contact family/next of kin, or other persons without success.       
  • Details of attempts made to contact family/next of kin, or other persons which were refused or declined and reasons given for such.       
  • Signatures of FLO, SIO and/or FLO Co-ordinator.        
  • FLO log books may be disclosed in a Criminal, Coroners, Civil Court or public enquiry.
  • Some police services may have their FLO log book sheets in self-carbonating duplicate.       

Copyright David Morgan

Brake Family Liaison Officer Handbook: Managing a family's expectations and having an exit strategy

It is important that families have clear expectations of what their police contact can provide, and what they can't.    

Ideally, the police contact provided to a family is a) an FLO, and b) the police force they belong to is following the guidelines laid down in:   

  • the ACPO (or ACPOS in Scotland) Road Death Investigation Manual;   
  • the ACPO Family Liaison Strategy Manual; and    
  • (in England and Wales) the Government's 'Code of Practice for Victims of Crime'.

Links to these and other relevant 'standards' documents can be found here.   

What can I show to families to help them to understand my role as a police officer?   

Look on the back of the 'Important contacts' cardboard tab in the Brake pack 'Information and advice for bereaved families and friends following a death on the road' for a useful summary, that you can show to families, of the police role and how it can help families.    

You can use the page opposite to insert your details, including when you can be contacted and how, and, if families leave a message, how quickly you will be able to call them back. It is important that families know when and how they can reach you, otherwise they rightly can feel excluded and let down.    

There is also space below on the same page to record the SIO's details, giving you a further opportunity to explain the difference between your role as an FLO or supportive police contact, and the role of the SIO.    

Later, you can help families by showing them the 'investigation and criminal charges' section of the pack, which explains the investigative role of the police.    

What can I say to families to help them to understand my role as a police officer supporting them, and when my role will end?   

The simplest way to explain your role to families is to say something like:    

'I am here to offer you support, with respect for your traumatic bereavement, throughout the police investigation and any criminal prosecutions - should there be any. I have been trained to provide you with practical support and help with issues relating to the police investigation, some immediate, others in the future. This includes, for example, seeing your loved one's body, helping you to access information about what happened in the crash, understanding what stage the police are at in our investigation, and helping you to liaise with any media interest. I aim to be as supportive as possible within my role.

I am not a counsellor, and there are many support organisations that can help you access counselling and other forms of support, such as Brake and other charities.

I am also not an expert in certain specialist areas in which you may need professional advice, such as claiming compensation. Brake can advise you further about relevant specialists who can help you with this and other issues unconnected with the police investigation. If you do not feel able to call the Brake helpline (0808 8000 401) then I can call it for you with your question.

I am here to give you information and advice, based on my knowledge and using other tools, such as the Brake bereavement guide, which I can help you to read. I am not here to tell you what to do, but to give you choices based on facts.  

I will record our meetings and phone conversations in my 'log book' so I can remember how I have helped you, and whether there is anything outstanding that I need to do for you, such as get you a particular piece of information.

There may be some things I can't tell you, such as particular details of the criminal investigation. I will let you know if there is something I cannot tell you, and if there will be a time in the future when I will be able to tell you this information.

My contact with you will end when the criminal investigation and any resulting criminal proceedings have ended. It is impossible at this stage to say how long that will take.   Charities or counsellors can continue to support you after my contact with you has ended, if you want that support. I can help put you in contact with these support workers, at any stage, if you want me to."   

You may want to communicate these messages over the first few days and weeks in different conversations, rather than right at the beginning, when much of what you say may not be remembered.    

You may have to repeat these messages as you go along, many traumatically-bereaved people have memory problems.    

Is it a good idea to put the above in writing?

You may be able to give families a written 'contract' which your force produces, that explains the above, and more, and references the manuals that are referenced at the top of this briefing.    

If you don't have such a contract in place, you are recommended to ask your superiors to produce one. Ensure it is written in plain English and very clear.    

As well as explaining your remit, it should also explain your complaints procedure in case things go wrong.    

If you would like Brake to 'check over' a contract you are producing, to ensure it is empathetic and appropriate for bereaved road crash victims, we can do this for a small fee.    

Who should I talk to in a family?

It may be necessary to have more than one police contact, in cases where families are split. If you are dealing with a close family unit, however, you may want to decide with the family who you will aim to talk to, within the family, on a regular basis. This person will come to you with questions, and you will go to them with information and answers. It helps if you recommend that this person takes notes; at the front of the Brake pack for bereaved families (see above) there are empty pages for notes. Encourage your family contact to use these pages to note down key things, as well as to use the contact detail pages where they can write down your details but also the details of their solicitor, funeral director, the coroner, and other key contacts.    

Professional boundaries and 'exiting' from contact with a family

You will inevitably build up a close relationship with many families that you work with. This is natural and humane. Equally, many families supported by excellent FLO's rightly become very attached to their FLO, who might also be a resident in their community. Ending this relationship can be emotionally difficult.    

As outlined above, it is imperative that you explain, at an early stage, that you will cease contact with the family at the end of the criminal process. It is also advisable for you to remind the family occasionally that this will happen, so they can prepare for it. As long as the family is prepared, they shouldn't feel 'let down' when you no longer are available to them.    

Signposting families on to support agencies, by working with the Brake helpline who can access these agencies for you, can help families not to feel 'abandoned'. You can call the helpline as well as families themselves.    

It is not advisable to continue contact with a family beyond the required period. There will be other, new families who sadly need your assistance, and you need to be able to focus on providing them with support.    

It is not advisable to see a family you are supporting outside your professional 'boundaries'; for example it is not advisable to take up offers of Sunday lunch at their house, or to offer to do unconnected tasks during your time off such as mow the lawn for a bereaved widow. If you do take up such offers, you will still be providing support, but in an unprofessional way, and doing so on your days off as well as at work. You will rapidly become exhausted and consequently a less-effective police officer.    

Brake Family Liaison Officer Handbook: Organ and tissue donation

Many police officers shy away from mentioning organ or tissue donation to families. This is for several obvious reasons:

  • Officers are not experts in the area - they aren't health professionals
  • Organ donation is nothing to do with police procedures
  • Officers are concerned about offending families at a terrible time, some families will not want to consider donation, and may be angry if it is raised
  • Officers imagine that someone else would raise the possibility of donation if it is possible, or officers presume that donation is not possible, because the death happened by the roadside rather than in hospital, and injuries were very severe.    

There are, however, some very important reasons why it is helpful for officers to have some knowledge of organ and tissue donation and that officers are able to broach the subject with families. Some police officers regularly do this following a death on the road, and find that this provides a very useful service to some families that these families would not otherwise receive. The quote below, and further information below, explains why.    

A victim's perspective

"We knew, when we thought about it afterwards, that our daughter had always wanted to be a donor if she died, but at the time we were told about her death it was the last thing on our minds. When we finally asked about it, we were told by our police contact that it wouldn't have been possible anyway, because she died at the scene of the crash. However, we have now found out that it would have been possible to donate tissue and other parts. We are really sad that we weren't given this opportunity, and that our police officer was misinformed (which didn't give us confidence in his knowledge in other areas), and that, ultimately, we didn't get the opportunity to respect our daughter's wishes and potentially save someone's life, or their eyesight, or their skin."   Mother bereaved by a road crash.   

The donation myth

It is not true that donation can only take place if someone dies while on a life support machine in hospital. In most cases, it is possible to donate major organs only if someone dies in this way, as organs such as the heart and lungs deteriorate very rapidly. However, if someone dies at the scene, or in an accident and emergency department after arrival in hospital, it is often possible to donate other body parts. These parts include corneas, skin, and bones.   

Corneas can save eyesight, and skin and bone can save the lives and improve the quality of life of seriously injured burns victims, cancer victims, and many others.    

Donation of these body parts can take place up to 24 hours after someone dies, and sometimes longer.

Information and opportunity brings comfort

While some families do not want to consider donation, or their loved one who died objected to donation, many other families take enormous comfort from knowing that their loved one's death saved someone else's life. Families who are not given the opportunity to consider donation can feel angry and excluded and disrespected.   

What can a police officer do?

If a death occurs at the roadside or shortly after arrival in hospital?

A police officer can:

  1. Raise the topic with the family towards the end of the first meeting. It is not a police officer's job to explain whether donation is going to be possible or not. But it is possible for a police officer to show the family the relevant page in the Brake bereavement guide (familiarise yourself with this beforehand in the What happens now? section) and to tell the family they can talk to a health professional if they want to find out if donation is possible. A police officer can make a judgment at the time about who it may be best to address this point to. It may be the whole family, or it may be one family member who is most calm at this time.    
  2. Make a phone call for a family that wants to find out if organ or tissue donation is going to be possible. In England and Wales there is a pager number that can be rung (and then a health professional calls you back). This number is 07659 180773 and should be called within 8 hours of a death, although you can still call if a death happened up to 24 hours ago. This number is also printed in the English and Welsh version of the Brake bereavement guide in the 'What happens now?' section.   
  3. In Scotland, there is currently no central number to call. Families must ring up their local main hospital and ask to speak to the transplant and tissue coordinator. It can be very difficult for a newly bereaved family to do this, as they may have to battle through a hospital switchboard. This is a task that a police officer, or someone else on behalf of the family, can easily do for the family, with their permission.    

If a death occurs in hospital, after a period on a life support machine?
In this case, it is probable that hospital staff will raise the issue of donation with the family. However, if this doesn't happen, it is possible for a police officer, or someone else acting on behalf of the family, to discuss options with medical staff, with the family's permission.    

What is the law on donation?

It is possible for someone to express a wish before their death that they would like organ or tissue to be donated. This wish can be expressed in the following ways:   

  • By registering on the UK Transplant register (which you can do online)
  • By holding a donor card
  • By telling someone   

It is the job of transplant professionals to try to respect this wish.    

However, even if someone had expressed this wish, medical staff will still want to talk to the next of kin or nearest relative, as medical staff would prefer to transplant with the support of the family, and may also need information regarding the health and medical history of the person who has died.    

If someone did not express a wish for their organs or tissue to be donation, then permission is required from the next of kin and medical staff must consult with the next of kin.    

What if a family is likely to have faith objections to organ or tissue donation?

Different religions have different views on organ or tissue donation. However, it is not the job of a police officer to presume that, for example, someone of a particular skin colour or dress practises a particular religion, or that they practise it in a particular way. It may not be possible to identify these things in a first meeting. Therefore, it is still usually appropriate to inform the family about their options, including the possibility of finding out if organ or tissue donation is possible.

I am worried that families will get angry if I raise the issue of transplantation.

You are not proposing that families consider donation. You are merely explaining that the bereavement guide includes information about what to do if they want to find out if donation is possible. If you have had the experience of a family getting angry, you may need to consider more carefully your word choice, or accept that anger is a normal part of the traumatic grieving process and the family is not angry at you, but angry at the whole situation. You should also weigh up a family's anger against the feelings of other families if you exclude them from receiving this important information that could bring them comfort.     

For more information go to:

NHS organ donation www.organdonation.nhs.uk

Brake Family Liaison Officer Handbook: Personal Perspectives

Reading case studies can be useful because they show some of the different responses bereaved individuals may have following the death of a loved one. They demonstrate just how varied responses can be, and provide examples of some of the aggravating factors which can make the bereavement even harder for families to bear.

While many families we have spoken to have been more than happy with the way they have been treated by the police, these case studies have been chosen because they illustrate a range of experiences. We have printed these documents for police officers so that they can learn from others' experiences and develop their own good practice in this very difficult and demanding role.

Sara Turner's story: concerning the death of her son and the horror of losing a child

Tracey Cusick's story: concerning the death of her fiancee and resulting problems with police liaison

Pam Surman's story: concerning the death of her son and the mixed standards of support she received, including some poor support from coroners' officers and the police

Nova Storey's account of her son's death and the invaluable support she received from the police

Brake Family Liaison Officer Handbook: Post mortem examinations

There are a host of issues around post mortem examinations concerning the way they may impact upon a bereaved family.    

Following a death on the road there is invariably a post mortem examination.   

This may raise issues concerning:    

  • faith; in some faiths interference with the body by a stranger, or delays to a funeral, is against their beliefs;   
  • the invasive nature of a post mortem examination;    
  • a lack of understanding of what a post mortem examination entails, and feelings of shock or concern when this understanding is gained;   
  • a lack of understanding of why a post mortem examination is necessary if it is appears clear what caused a death;   
  • concerns about retention of organs or tissue;   
  • concerns about the findings of a post mortem examination and requests for, and rights to have, second post mortem examinations.   

Introducing the concept of a post mortem examination to a family   

Using the Brake bereavement pack, which has a section of post mortem examinations, you can help a family by explaining that after someone dies on the road there is a post-mortem examination of their body because the death was sudden. This is a medical examination to determine the cause of death. It is carried out by a specialist, expert doctor called a pathologist. A post-mortem examination is carried out on behalf of the coroner in England and Wales. The coroner is the public official who investigates all sudden deaths. In nearly all cases of death on the road the coroner asks the pathologist to surgically open and examine inside the body. The body is then closed again. This is called an invasive autopsy. Some families have objections, for faith or other reasons, to an invasive autopsy. If they have objections or concerns about the way it will be carried out, they, or you on behalf of the family, can tell the coroner's office as soon as possible so discussions can take place regarding these sensitivities.   

A post-mortem examination also includes a toxicology report. This means that the pathologist studies blood and tissue to find out if there are any toxic substances, such as alcohol or drugs, which may have contributed to death.   

Understanding what happens in a post mortem examination can help a family to prepare themselves for any possible results of the post mortem examination.    

Legal representation at a post mortem examination and second post mortem examinations   

A family is legally entitled to be represented by a medical professional during the postmortem examination. This could be a GP or another pathologist of their choice.   

If a family is not satisfied with the information they receive about the cause of death, they may be able to instruct a second post mortem examination, carried out privately for them, by another pathologist of their choice. This requires the agreement of the coroner in England and Wales. If the family has a solicitor they will be able to advise the family and instruct a pathologist on their behalf. Alternatively, the family can talk to the coroner.   

In rare instances a second post-mortem examination may be carried out on behalf of someone who is accused of a criminal offence in connection with the death.   

Organ or tissue retention   

Some post-mortem examinations involve the taking of small tissue samples, known as 'tissue blocks'. These are less than six millimetres thick and are embedded in wax or resin. From them, very small amounts of tissue, thinner than a hair, are placed on glass slides so they can be examined under a microscope. These slides are used to help confirm the cause of death. Very rarely, a pathologist may need to temporarily retain and more closely examine a whole organ to help them confirm the cause of death. After the post-mortem examination you can decide if any temporarily retained tissue or organs should be reunited with the body (which sometimes means you have to delay a funeral); be buried or cremated later on; or be disposed of by the pathologist in a respectful way. The coroner should explain these options to you and discuss with you what you want to do. Sometimes medical personnel want to retain and use organs or tissue for research, education or training purposes. They can only do this with the authorisation of the person who died (if they were an adult) or their nearest relative.   

The law on organ and tissue retention is explained in the Human Tissue Act 2004, available to download here. The coroner or the pathologist can provide more information about the law.   

The Post Mortem Examination Report   

In England and Wales, bereaved families can get a copy of a loved one's post mortem examination report. They may or may not want to see it. The coroner's office can arrange for it to be sent to a family's GP who can help explain it. There is unlikely to be a charge. Sometimes a family cannot see it until after any criminal proceedings. A pathologist may also be able to meet with a family at their offices to discuss the report.   

Delays to a funeral   

In England and Wales, a funeral can only take place once the coroner has given permission. To find out how long a post mortem examination will take, or if a family has objections to a funeral being delayed, the family, or you on behalf of the family, can talk to the coroner's office.   

Scotland and Northern Ireland   

For a particular understanding of the law relating to post mortem examinations in Scotland and Northern Ireland, read the Brake bereavement guides for those two countries. Click here to view.

Brake Family Liaison Officer Handbook: Return of belongings

Introduction       

In the 'bad old days' before Family Liaison Officers, it was not uncommon for families to have to ask for belongings to be returned, or to be given them without warning in a wholly inappropriate way, such as in a black bin liner. Brake has endless case studies of families receiving belongings in ways that have severely upset these families. This Brake briefing aims to help you return belongings sensitively and at the right time, and with the right levels of communication.        

Should all belongings be returned?   

This is a question for the family. They should be given a full inventory of what is in the possession of the police, so they can decide what they want or don't want. It may be that they don't want some belongings returned, such as damaged, bloody clothing that has been ripped or cut off someone who died. On the other hand, they may want absolutely everything that has been close to their loved one.

Should blood-stained clothing be cleaned?   

The question whether or not blood-stained clothing should be cleaned is, again, one for the family. A family may want clothing cleaned. Or they may want it returned smelling of their loved one. Give the family as much information as you can about the condition of belongings to enable them to make informed decisions, and prevent nasty unnecessary shocks.        

Have you definitely found all belongings and collected them together?   

Brake has case studies of cars being sent to scrap yards or garages still with personal belongings in them, such as phones, coats, or even a boot full of perishable shopping. It is important to check that you have collected everything and that, if it includes anything perishable, that it is returned in a timely manner.        

Who should I return belongings to?   

Belongings should be returned to the next of kin. There can, however, be issues of ownership. For example, someone who died may have been carrying something that belonged to someone else, for example a young woman who dies has a boyfriend's ring on a chain round their neck as a keepsake. Be aware of issues like this. At times of great shock and stress ownership of such items can become critical issues that cause great upset, particularly if there were previous frictions, for example between a son's mother and their girlfriend. Again, the best policy is good levels of communication and sensible consideration at all times.        

Advance warning of return of belongings   

You should give advance warning of return of belongings by calling a family on the telephone and arranging a time. Belongings should be returned by you, in a meeting, preferably at the family's home. The return of belongings can be an upsetting time, so it is a good idea to carry out this meeting in the familiar and safe surroundings of someone's home.

Brake Family Liaison Officer Handbook: Roadside memorials

Introduction   

Families bereaved in road crashes frequently wish to place flowers, cards or other mementos, and subsequently sometimes more permanent memorials, at the place where their loved one or loved ones died. This is very normal behaviour for families who have been violently and suddenly bereaved by a horrific event. However, in recent years, some local authorities have developed policies that aim to restrict this practice, for a variety of stated reasons. Furthermore, people who live in communities where memorials are placed sometimes complain about those memorials, for different stated reasons, sometimes comparatively trivial. These policies and complaints have caused predictable upset to families bereaved by road death.    

How Brake can help   

Brake believes that all families bereaved by road death should be able to, if they wish, place flowers and other memorials that are safe and reasonable at the place where their loved ones died. We know that these memorials are of comfort to many families, and that they provide a stark reminder to other drivers of the consequences of bad driving.    

Many local authorities are happy for small memorials to be placed at the roadside, such as small plaques, wooden crosses and flowers. However, sadly, some local authorities object to permanent memorials, even small ones, and even go as far as restricting the length of time that flowers can be placed at the scene of a crash. Brake can help families to liaise with their local authority to find out what is possible in your area. FLOs can call our helpline on 0808 8000 401 on behalf of families to discuss this service. In many cases, we have been able to negotiate with a local authority and achieve a memorial that is both safe and in line with a family's objectives.    

Brake has also helped some families, who wish to have a roadside memorial, by producing the roadside memorial for them. For this service, we only charge the cost of production of the memorial. For example, we have produced 20cm tall wooden crosses that are suitable for attaching to lamp-posts. If you want Brake to help you in this way, with a memorial of any kind, call our helpline on 0808 8000 401.    

Read on for Brake's policy statement on roadside memorials

This policy aims to explain Brake's perspective on roadside memorials, as advocates for families so traumatically bereaved, to help inform local authorities' decisions and the decisions of bereaved families.    

An insight into a death on the road:

Roadside memorials, either temporary or permanent, may bring comfort, and therefore aid recovery, for many bereaved families. Death on the road is devastating and literally rips families apart. People who die on roads are frequently young adults, in the prime of their lives with loving, close families, or children, who leave behind devastated parents and siblings. Their deaths are violent and horrendous, often caused by massive internal organ injury, bleeding, crushing, decapitation or limb loss, or burning. A loved one may be unrecognisable after death, and the family therefore has no chance to say goodbye to the person as they knew them. Sometimes, people who are killed in road crashes die slowly, after a time in an intensive care unit. This in itself is extremely distressing for the family, who may have to face their loved one going through multiple operations or being pronounced brain stem dead, and ultimately dying after a terrible battle for life. None of these deaths is expected. All are shocking and result in traumatic grief for the family and close friends left behind.  

Frequently, people who die on roads do so through no fault of their own, the victims of speeding, drunk, drugged, illegal or otherwise dangerous drivers. Frequently, the criminals who caused their death are let off with minor punishments, causing additional distress to bereaved families.    

Why are roadside memorials, temporary or permanent, important to many bereaved families?

  • Across the world, bereaved people find that gestures and ceremonies that enable them to honour a person who has died are very significant in the grieving process, particularly if the death was traumatic, violent and unexpected.   
  • Visiting the scene of a crash, and laying flowers there for example, is therefore a very normal and comforting thing for families bereaved by that crash to do. Sometimes families are able to do this within hours of receiving the terrible news. For others, who live further away, it may require a long journey. Equally understandable, some families may find that, due to the traumatic nature of their grief, that they find it difficult, or even impossible, to visit the scene of death.   
  • Having a temporary or permanent memorial at the site of the crash helps many families to connect to the event that caused their loved one(s) death(s). Often, the bereaved family were not involved in the crash, and heard about it when a police officer knocked on their door, miles away and hours after the event. Many families subsequently have an urgent need to know, and remember, the details of the crash that killed their loved one(s). Visiting and respecting the scene of their death or fatal injuries is critical to this. This is similar to the needs of families bereaved by the two great wars who have visited over the years the sites in France and elsewhere of their loved ones' deaths, which are often marked with significant memorials.    
  • Re-laying fresh flowers, weekly or on anniversaries, is a way families can express that they have not forgotten, and are continuing to honour the way their loved one or loved ones died, and are keeping their memory alive.    
  • Arranging for a permanent memorial, such as a small wooden cross, to be placed at the scene of death, is also normal. Fatal train disasters are another type of transport disaster that is frequently commemorated in this way. There is a permanent plaque at King's Cross to commemorate the people who died there in the Underground Fire. Equally important, a memorial garden has been built next to the railway line on which 10 men died in the Selby Rail Disaster.    
  • These memorials, either temporary or permanent, carry enormous significance to many bereaved families, in addition to graves or places where ashes have been scattered or kept, particularly, perhaps, if there had been little of the body left to bury or cremate, following the violence of a crash.    
  • Many families bereaved by road death perceive roadside memorials as a vital reminder for other drivers and for communities in which there have been deaths on the road. Again, this is similar to the 'Lest we Forget' message on many war memorials. Many families bereaved by road death do not want their loved ones to be forgotten by drivers who use the roads, and have the view that out of respect for those who have died, and to prevent further tragedies, their deaths should be constantly remembered by passing motorists.    

Advice to Local Authorities and Police when formulating policies on roadside memorials   

It should firstly be remembered that bereaved families will be highly grief struck, but also are, in the vast majority, reasonable human beings who do not wish to contribute to further road crashes or environmental problems. However, discussions with bereaved families should be handled with extreme sensitivity, by bereavement experts, in recognition of the deaths they have suffered and their needs.    

Brake takes the following position on policy decisions relating to roadside memorials:   

1. FLOWERS AND OTHER MOVEABLE ITEMS   

  • Bereaved families should have the default right to lay flowers or other small items at any time at the site of their loved one's crash, such as on verges and tied to lamp-posts. To prevent unnecessary environmental pollution, families are advised to remove any unnecessary packaging, particularly plastic packaging around flowers. However, if packaged flowers are placed, or any other semi-permanent items such as cards or teddy bears, bereaved families should not be penalised in any way by the authority. If items such as teddy bears are thought to be causing an obstruction or to have entirely decayed, the authority should follow a process of mediation led by a bereavement officer, as outlined further below, before deciding on appropriate action.    
  • There should be no restrictions on the length of time that flowers or other small items can be laid or re-laid. Traumatic grief can take years to recover from, and bereaved families never forget. Placing a time limit on flowers is placing a time limit on grieving, which is inhumane, impossible to communicate without appearing cruel and unreasonable, and also complex for an authority to enforce.    
  • If flowers or other items are placed on grass that is cut by the local authority, grass cutting staff should be advised to lift the items with care and then replace them once the grass underneath has been cut.    
  • If flowers or other items have completely decayed (to the extent they have turned black/mouldy/are falling to pieces), then the council has a reasonable right to remove them. Before removal, however, the authority should, through the police family liaison officer, inform the family of its decision, and allow a period of time in which the family can visit the scene and see for themselves that the items have decayed. In many cases, if a family performs this visit, they may decide to remove the items themselves and possibly replace with fresh items.     
  • If a complaint is made by a member of the public about the placing of flowers or other items, that complaint should only be given consideration if the items are immediately outside that person's house, for example on a lamp-post directly next to their front gate, or a verge directly next to their drive. The complaint should also only be given consideration if more than 6 months has passed since the time of the crash. It should never be considered on or around an anniversary of the death.    
  • Genuine complaints that meet the above two criteria should result in a period of mediation between the member of the public and the bereaved family, with a mutually-satisfactory resolution reached. An example of satisfactory resolution could be, for example, a smaller flower arrangement, or flowers only placed at certain times, such as birthdays and anniversaries of the death or deaths. This mediation should take the form of phone calls or meetings, not impersonal letters, which should always be undertaken by a trained bereavement officer, and not by staff who are inexperienced in working with bereaved people, such as a highways officer. A bereaved family should never be forced to meet a complainant face to face, but if they wish to do so, to state their case, then the complainant should be given that opportunity. If a face to face meeting is arranged, it should always take place in a confidential environment and in the presence of the mediator. Bereaved families should be able to bring along a relevant advocate, such as a police family liaison officer. If a resolution cannot be reached, external organisations such as Brake should be consulted and involved, although this is unlikely to be necessary in most cases.    
  • Flowers or other objects should not be removed on the basis that they are posing a distraction to other motorists. The argument that temporary or permanent road death memorials are a distraction is entirely moot when considered against the many other distractions on the edge of our roads, some of them floral (for example, colourful flower beds planted on verges and on roundabouts by local authorities, sometimes spelling out the name of a town or a message). Other distractions obviously include signposts to tourist destinations, shop fronts, bill boards, and many other items, including people on pavements and other road users. If a driver notices bunches of flowers placed in memory of someone who has died, then it is highly likely that they will also recognise these flowers as an important reminder that someone has died on this road and it is important to drive carefully. In that sense, flowers are a less invasive or hazardous road safety message to drivers than road signs saying 'X people killed on this road in X years' which are commonly placed by authorities themselves. Flowers are biodegradable, and unlike road signs (which are made of metal), pose no danger to vehicle occupants in a road crash.    

2. ERECTING OF PERMAMENT MEMORIALS   

  • Families bereaved by road crashes should be able to follow a simple application process if they wish to place a permanent memorial at, or near, the site of their loved one's death. This application should require just a simple letter or phone call outlining what the family wish to erect (including height and size) and exactly where. This application should be handled by the authority by a skilled bereavement officer, who can act as an intermediary between the family and the relevant highway authority representative. The application can be submitted by either the family, or an advocate acting on their behalf, such as Brake, or a police family liaison officer, or a solicitor.    
  • When considering applications, the authority should be reasonable and aim to achieve compromise where possible if an application is unlikely to be granted.Many families are satisfied with a permanent memorial that is modest in size and environmental impact and therefore reasonable for a local authority to allow. For example, a small cross (or other religious sign) or plaque on a small stone, or a plaque or religious sign attached to a post that is already there. However, if a family wished to erect something that an authority objected to, then a process of discussion should follow, aiming for compromise. For example, if a family wished to have a one metre high memorial stone in the middle of a grass verge on a bend in a road, the authority may argue that the stone poses a hazard to other motorists, should they veer off the road at that point. However, a compromise could, for example, include incorporating the memorial stone into part of an existing dry stone wall at that point on the road. 
  • The location of a permanent memorial should also consider whether traffic would pose a risk to people wishing to visit that memorial. It is reasonable for consideration to be given to whether it is possible for people to reach a memorial in safety, either by foot, bicycle or vehicle. In some instances, a family may wish to place a memorial at the site of the crash despite its danger to visitors, and commit to not visiting it without police help. However, the safety of the general public should also be considered. Where there is very significant risk to people visiting the memorial, a family may wish to place a memorial elsewhere in order to eliminate the risk of members of the public being tempted through curiosity to visit a memorial in a dangerous place, posing risk to their own lives.
  • Authorities should also consider having a permanent memorial to road death victims in a local park, onto which names can be carved as deaths occur. However, such memorials should not be used as a way of then arguing against allowing families to discuss with local authorities memorial possibilities at the sites of the deaths of their loved ones.    

3. COMMUNICATING A COUNCIL OR POLICE POLICY ON ROADSIDE MEMORIALS

In the past, there has been some extremely insensitive literature on roadside memorial policy produced by councils which has proved highly offensive to families so violently and tragically bereaved.

Any local authority or police authority considering writing a policy on roadside memorials, and writing publicity materials that communicate that policy to bereaved families, should consult Brake and any other local agencies that support road crash victims prior to publication.    

For a small fee, Brake can give advice on draft documents, including providing advice on appropriate language to use when communicating with people recently bereaved by road death (Brake is the national police provider of road death support literature).    

The production of local policies should always be led by a council or police bereavement officer, in consultation with relevant highways authority personnel and support agencies, and aim to follow the advice in this Brake policy document.    

The most effective way that local authorities and the police can reduce road death memorials is to reduce road deaths themselves, through implementation of road safety measures such as lower speed limits and enforcement.   

All comments on this policy are welcomed. Please send to brake@brake.org.uk.    

Prepared by Brake, the national road safety charity     Last updated December 2008.

Brake Family Liaison Officer Handbook: Standards of care for police officers working with families

There are a number of vital documents that contain expected standards for police officers when liaising with families, and when conducting road crash investigations. There are different documents for officers working in England and Wales, Scotland or Northern Ireland.   

It is extremely important that all officers working with families read these documents regularly and aim to meet the standards within them, with the support of managers. These documents may be updated over time, and it is important to ensure you are reading the most up to date document.  

You can access these documents by following this link.    

Brake Family Liaison Officer Handbook: Supporting families with children

The advice on this web page for police has been written to accompany a Brake children's book called Someone has been killed in a road crash. You can get a copy of this for free for families you are working with by calling the Brake helpline on 0808 8000 401. You can also look at the children's guide online here. This guide takes you through the content of the children's book and the academic thinking behind it. By doing so, it helps inform you about the needs of children.       

Introduction   

Many people bereaved by road crashes are children. These children often experience one of the worst bereavements of all, often the death of a parent or guardian, or both parents or guardians, or a sibling or siblings, when it was least expected, usually in the prime of life, and in very violent circumstances. Sometimes, a surviving child was in the crash and witnessed family members dying, either at the scene or in hospital. A child who was in the crash may themselves have serious injuries that will last a lifetime, such as brain injury or spinal injury, or have a surviving parent or sibling who has serious injuries. Sometimes, a child's entire family is wiped out and they are the sole survivor, meaning they are grieving and also facing the very difficult challenge of adjusting to a new life in a new home with new adult carers. Always, a child bereaved by road death needs love and support and care to enable them to grieve and have the best chance of a full and happy life. You can help.

How do children grieve?    

Children are often described as 'the forgotten mourners' because they are frequently excluded from having a full and active role in the grieving process. This exclusion is usually, and misguidedly, in the belief that the less a child knows, and the more they are diverted from the topic of the death or deaths, the less it will hurt them. In reality, children have a right to know what has happened, and a right to grieve, just like everyone else. Hiding a child from the truth is only storing up trouble and potential resentment for later. There is a wealth of academic research to show that it is much better to tell children things than to keep them in the dark. Children have active imaginations and if you don't tell them things, their imaginations will fill in the gaps with something that may be even more horrendous than the truth.

Children grieve in different ways at different times. At different times they may cry, get angry, be quiet, be noisy, talk about the person who died, not talk about them, and play or behave as though nothing had happened. All these reactions and many more are natural. You can help by answering questions honestly, and helping children feel safe and loved.

Case study:    Daniel knew his dad had been killed in a collision between his car and a tanker. He suddenly got very upset a year later. Through conversation, it emerged that it had struck Daniel that the tanker must have been very big, and that his dad must have been very slowly crushed to death when the tanker fell on top of his car, and his dad must have been very frightened before he died. In truth, his dad had died quickly on impact, and the tanker hadn't toppled slowly on top of the car. Daniel had never been told this. Once he knew this, he felt a bit better.

Advising parents and carers to make use of the children's book Someone has been killed in a road crash  

You should give the book Someone has been killed in a road crash to an adult carer or parent and encourage them to start reading it with their children as soon as possible. The book has been proven to be invaluable to families and police FLOs. Read this quote from a fellow officer:       

"I am a police officer working with a family whose 13 year old son was killed as he walked home from school. The boy had a younger brother. On my first visit I left your children's book "Someone has died in a road crash". I went to see the family yesterday and they said they found it invaluable. It has helped a young boy understand what has happened and to talk about it with his parents.”       

You should encourage the carer or parent to read the children's book thoroughly themselves before reading it with their children, particularly the 'Listen Up, Grown Up' section at the very front of the book. As parents or carers are also likely to be grieving, it's important that they remember to think about their own well being too. So don't forget to provide the adult support literature from Brake and our helpline number.       

The children's book can be read to siblings of different ages from the same family at the same time. It is for all children, whatever their age. Brake has developed Someone has been killed in a road crashto work on different levels for different aged children. Older children can read the text and younger children can look at the colourful images and listen to the descriptions read by the parent or carer. It is very important that the book appeals to children of different ages. This is because there is often more than one bereaved child in a family unit.

It is very appropriate for adult carers to read the book aloud to a group of siblings. Grieving children should not be talked down to, or kept in the dark. They should be given the opportunity to ask questions and share their feelings. The children's book encourages discussion and honesty between children and adult carers, using simple language and an open tone.

The book includes:   

  • Opportunities for adult carers to share information about the crash and the death(s)  
  • Questions for the children, to encourage them to share their feelings and thoughts    
  • Opportunities for children to write down memories and carry out activities   
  • A promise for carers and children to read and sign, to enable them to support each other through their grief   

These are simple ways for families in distress to share emotions and support each other.       

The book is narrated by two children Ben and Amy, who have both been bereaved on the road and are recovering from their grief. Many children do not know anyone else who has been bereaved, and this can make them feel isolated. The characters Ben and Amy can help them feel they are not alone. Through simple actions Ben and Amy illustrate and describe a range of emotions from anger and sadness, to feeling better. Often, Ben and Amy are pictured doing ordinary, every-day things, such as eating cornflakes, walking to school, and even bouncing on space hoppers. This is important, as it helps demonstrate to a bereaved child that it is possible to resume doing normal, fun things in time. It helps to know you are not alone.   

A step by step guide to the contents of the children's book and the academic thinking behind it

The book starts with an introduction to death, shock and sadness. It then gives opportunities for frank discussion about what happened in the crash, what it feels like to die and what happens to the body. This is followed by different emotions that bereaved children often feel and how to cope. The book ends with a section on how to remember the person who has died, including space to write down memories in the book itself.

It is difficult for children to comprehend the enormity of death, and to understand why it has happened. Why did they die? (page 3) covers the kind of questions children may ask right away. Younger children may not grasp the finality of death and think, unless told, that the dead person will wake up.       

I don't believe it has happened! (page 4) Children, like adults, find it hard to understand that something terrible has changed their lives forever, and will often be in complete denial about what has happened. The initial shock of the death is often replayed in the child's mind, for example on waking up each morning.       

Children may feel unwell, or be visibly very upset. Some children, particularly younger children, may not appear to react to the death at all, or may say things that seem insensitive, such as asking to go out to play straight after being told. All about shock (page 5) explains the emotional and physical reactions to shock and looks at comforts such as food, warmth and love. These things can help children feel better.       

Like adults, children dip in and out of grief, but feelings of sadness can seem overwhelming and never-ending. Feeling sad (page 6) shows children that their unhappiness is a normal part of the grieving process. It also reassures them that they won't feel sad forever, and that good things will happen again.      

Road crashes are often called 'accidents' (not by well trained FLOs!), but there is always a reason behind a crash, and it can be helpful for children to understand why it happened. After all, 'Why?' is the most common question asked by a child. Why do road crashes happen? (page 7) explains some of the actions that cause crashes, such as speeding and drink-driving.        

What happened in the crash? (page 8) allows children to ask questions about the crash. It is better for children to know the facts than to be kept in the dark, however horrific the circumstances, because they may imagine something even worse.       

It can be reassuring for children to know that everything possible was done to save the life of their special person. All about the emergency services and All about the police (pages 9 and 10) describes the kind of care and treatment that is given to road crash victims by paramedics, police, firefighters and doctors. Many emergency workers are happy to talk to bereaved families.       

You may feel it is appropriate to suggest to an adult carer or parent that they find out if an emergency service is able to talk to the family about what happened. Children, particularly boys, are often fascinated by the details of a death, and may want to know exactly what happened, even if this seems gory to adults. Boys are more likely to ask about the details; girls usually want to know too, but may be more reluctant to ask. Why do road crashes kill people?(pages 11 and 12) explains how a crash can affect parts of the body and why this can cause a person to die.       

Very young children may not have been taught about death, and may be very interested in what death feels like, and whether the dead person felt any pain. What does it feel like to die in a road crash?(page 13) deals with children's natural curiosity about the death and re-enforces the message that dead people don't have any feelings.        

The role of A&E and Intensive Care Units are discussed in Dying in a hospital (page 14), to help children understand how hospitals try to save lives and why this often doesn't work when someone is hurt badly in a road crash. Families often spend tortuous days, weeks or even months waiting in a hospital while doctors try to save a road crash victim's life and then ultimately fail. Being caught between hope and the likelihood of death during this time is an additional, extreme stress for families who are then ultimately bereaved.       

Giving parts of a dead body to someone who is alive to help them get better (pages 15 and 16) raises the issue of transplants and how organs or tissue from a dead person can sometimes be used to help other people. For some families, it is a source of comfort to know that a dead person's body has been used to help other people live, although donation is not possible in all cases.       

Children, like adults, are often encouraged not to view a body and to remember the dead person as they were. However, research suggests that it is better to give children a choice, based on clear communication of what a body will look like (some bodies are very badly damaged and do not look like the person at all). Can I see their body? and Seeing a body (pages 17 and 18) helps the adult carer or parent to explain what a body looks like and then gives them a chance to offer the child a choice to see or not to see a body. Viewing a dead body can help children to understand the finality of death and to say goodbye to their loved one, but it is a personal choice and viewing may not always be the right decision for a family.       

After a road crash, there will usually be an autopsy to determine the cause of death. What happens to my special person's body now?(page 19) discusses the role of an autopsy in finding out how the crash caused the person to die.       

Children want to know what happens to the body, and may ask questions about burning bodies, or bodies decaying underground. What happens to the body then? (page 20) looks at the differences between burial and cremation and what each process involves.       

We are having a funeral (page 21) helps children to prepare for what to expect at the funeral and to open a discussion about attending. Many adults think that the formal setting of a funeral is inappropriate for a child, but children may benefit from taking part if they know what to expect.       

A death on the road often results in criminal proceedings against a driver thought to be at fault. Children can be prepared for this process. This is particularly important for older children who may read about it in the paper, or hear other children talking about it at school. Children also need to be prepared for the fact that sometimes no one is punished. Punishing dangerous drivers (pages 22 and 23) tackles who is to blame for the crash, and what can happen to drivers who are at fault.       

Common feeling 1: I want to cry (page 25) shows crying as a normal part of the grieving process. Children should be encouraged to express their emotions, instead of copying the behaviour of a parent or carer, who is 'putting on a brave front'.       

Common feeling 2: I'm really angry (page 26) gives examples of safe ways to express anger, such as hitting a cushion. Children should be encouraged to channel their anger into behaviour that does not harm themselves or other people.       

Common feeling 3: It was my fault(page 27) tackles common feelings of guilt children experience after a death on the road. It is vitally important to tell children they are not to blame for a death. Many children believe their thoughts or behaviour are to blame for a death, or that the crash is their fault because they were not there to prevent it.       

Common feeling 4: I feel alone (page 28) deals with the isolation that children often feel following a bereavement. Children can be excluded or even teased by other children because someone has died. They can also feel lonely if they do not know any other children who have lost a loved one.       

Common feeling 5: Things other people say (page 29) highlights some of the insensitive sayings children hear from well-meaning friends or adults, such as 'you're the man of the house now' or 'you're young, you'll get over it'. Children may act like 'little adults' following a death, but they should not be encouraged to take on the responsibilities of the dead person.       

Common feeling 6: I just don't want to do anything any more (page 30) deals with feelings of despondency and lack of motivation. Encouraging children to take up a new activity or hobby can help them to feel normal again.       

Common feeling 7: I can't get the crash out of my head (page 31) explores the difficult memories and thoughts children experience about the crash, whether or not they witnessed the event. Encouraging children to write down or draw their experiences can help them to make sense of their feelings.       

Common feeling 8: Are other people I know going to die in a road crash? (page 32) explores the common fears that children experience following the death of someone close. Children may be excessively worried about the health of surviving relatives and friends, and will need reassurance, particularly about the dangers of roads.        

It can be difficult for children to think about the future, and many worry that they will always feel sad. When will I feel better? and Having fun is good for you (pages 33 and 34) reassure children that they will have fun and feel happy again.

It's important to encourage children to commemorate special occasions such as birthdays or anniversaries. How to remember (pages 35 and 36) deals with ways of keeping memories alive by remembering significant places or events, or creating a memory box for special mementos. The idea for a memory box is inspired by the children's bereavement charity Winston's Wish.      

All about them (page 37) encourages children to write down the important things they remember about their special person. This can help them remember why the dead person was special to them. Expressing grief creatively through drawing or writing can really benefit children. My poem (page 38) uses a simple formula to enable children to create their own poem about the person who died.        

There are lots of things we can do to be as safe as possible on the roads(pages 39 and 40) asks children and their parents or carers to sign up to Brake's Stay Safe Family Promise. By agreeing to cross the roads safely, take extra care in the car and wear seat belts, parents and children are making a commitment to keeping as safe as possible on the roads.       

Children often find it hard to express their emotions, so it can be helpful to set out 'rules' allowing them to express themselves, and saying how they'd like to be treated. Our promise(page 41) is based on postcards developed by the Childhood Bereavement Network that allow children to choose how their parents or carers interact with them.

Organisations that can help you (page 43) is a list of bereavement services for children and their families. Bereaved families can access support through a range of organisations working locally and nationally.

What else you, as a police officer, can do to help children bereaved by road crashes   

As well as helping bereaved families to read the book Someone has been killed in a road crashthere are other things you can do to help.   

General support and signposting:   
Provide general practical and emotional support, after studying this guide and the accompanying children's book carefully to ensure your support is empathetic and appropriate to your role as an FLO. Practical support could include informing a child's nursery or school about the bereavement, and the need for the child to be given support in the nursery or school environment.   

Signpost bereaved families to local bereavement counselling services. If you do not have local contacts, you can call our helpline on 0808 8000 401 and we will research local agencies for you. Bereaved families do not want to spend time wading through the phone book.   

Signpost parents to the national bereavement services listed at the bottom of this page, including the Brake helpline, websites for bereaved children and bereavement workbooks for children.       

Case study:    Emma's class was going to make Mother's Day cards, but her mum had been killed in a road crash two years ago. Emma's teacher talked to Emma and her dad in private. Emma decided she wanted to take part in the lesson because making cards was fun, and she remembered her mum really well and wanted to carry on remembering her. Emma decided to make a card to put on her mother's grave. She decorated it with tissue paper daffodils because she remembered that these were her mum's favourite flowers.       

Child protection issues:   
Notice warning signs of bereaved parents who are struggling to cope and inform social services if you are concerned for a child's safety in line with your police procedures. Due to alcohol or drug abuse, or mental illness, some vulnerable bereaved families may be, at least temporarily, unable to care for children without support from social services, other family members, or good health care. With this support, it can be possible to prevent a complete breakdown of a family.       

The difference between shock and Post Traumatic Stress Disorder
In the first days and weeks after a sudden death it is normal for bereaved people to suffer extreme shock and emotions. However, over time this shock should subside, and although grief and sadness remain, the bereaved person is able to begin to recover. However, it is not uncommon for a sudden and violent bereavement to trigger Post-Traumatic Stress Disorder (PTSD) in either children or adults, which can be diagnosed after about three months or at any time after this.

Symptoms include physical illness, stuttering, jumping at loud noises, extreme emotions, and inability to get on with normal life. It is common to be scared of the outdoors, be unable to work or hold down relationships, or eat properly. If you know someone who is displaying these symptoms it is possible for them to have an assessment for PTSD.

If diagnosed, the condition can be treated through cognitive behavioural therapy (CBT), a form of talk-based counselling provided by therapists who are experienced in working with families who have suffered something terrible such as a sudden death. To find out more about the signs of PTSD and for help accessing an assessment for PTSD call the Brake helpline on 0808 8000 401.

Reading list   

A Child's Grief, Winston's Wish   

Children and Bereavement, 2nd edition, Wendy Duffy   

Getting Over an Accident, Child Accident Prevention Trust   

Good Grief, Under Elevens, Barbara Ward and Associates   

Grief Encounter, Shelley Gilbert   

Helping Children Cope with Death, The Dougy Center   

Helping Children Cope with Grief: Facing a death in the family, Rosemary Wells   

Helping Children Cope with Separation and Loss, Claudia Jewett, Sudden Death Association   

I Can, You Can Postcards, Childhood Bereavement Network   

Interventions with Bereaved Children, Susan C Smith and Sister Margaret Pennells   

Life & Loss, a Guide to Help Grieving Children, Linda Goldman   

Loss, Change and Grief, Erica Brown   

Mental Health and Growing Up, 2nd edition,

Death in the family: helping children to cope, The Royal College of Psychiatrists   

My Father Died, Cruse Bereavement Care   

My Mother Died, Cruse Bereavement Care   

Muddles, Puddles and Sunshine, Diana Crossley, Winston's Wish   

Ordinary Days, Shattered Lives, Child Bereavement Trust   

Our Surviving Children, The Compassionate Friends   

Post Traumatic Stress Disorder, David Kinchin   

Sudden Death, a Research Base for Practice, Bob Wright

Talking about Death, Earl A Grollman   

Talking with Children and Young People about Death and Dying, Mary Turner   

The Forgotten Mourners: Guidelines for Working with Bereaved Children, 2nd edition, Susan C Smith   

The Sudden Death of Our Child, The Compassionate Friends   

Then, Now and Always, Julie A Stokes, Winston's Wish   

Waving Goodbye, The Dougy Center   

When Someone Very Special Dies, Marge Heegaard   

35 Ways to Help a Grieving Child, The Dougy Center

Brake Family Liaison Officer Handbook: Traumatic grief: control measures, outcomes and effective support

What is traumatic grief?    

"When traumatic circumstances surround the sudden death of a loved one, or when the bereaved was also involved as a victim in the event or witnessed the death, the bereaved must cope with both trauma and grief." 

Mental Health Response to Mass Violence and Terrorism, page 18, US Department of Health and Human Services, 2004   

Introduction    

Because death on the road is so common, and treated by the media as an everyday event, it can be forgotten that people bereaved by road crashes are as traumatically bereaved as people bereaved by terrorist bombs or by homicide. Their emotional needs are just as severe. While it is not the job of a police officer to provide counselling, or even to identify that someone needs therapy of any kind, it is vital that police officers working with families bereaved by road crashes have a good understanding of traumatic grief: this understanding is of enormous benefit to professional communication and relationship-building with these families within the remit of police duties.    

Death on the road is traumatic for the bereaved because it is incredibly violent, unexpected, and indiscriminate. The people killed are often in the prime of their lives – young adults, parents and children - devastating families and communities.

It is also important to remember that the deaths are traumatic because the victims die in the most appalling ways including, for example, being burnt to death, bleeding to death, or being crushed to death, sometimes with loss of limbs or decapitation. Bodies are sometimes unrecognisable to the bereaved families. Sometimes bodies are so badly disfigured they cannot be identified other than by dental records. Fatal road crashes also frequently kill more than one member of a family, or leave other family members maimed, with loss of limbs, paralysis or brain damage.

Fatal road crashes are often witnessed by family members. Some families witness their relatives' deaths because they were with them at the time of the crash. Others witness their relatives' deaths in A&E and ICU departments after agonising attempts by medical staff to resuscitate or operate. Some deaths are slow and lingering, which is, in itself, traumatic for the bereaved. Those family members who don't witness the deaths, face the horror of being told the news by a police officer on their doorstep; an unexpected event that everyone dreads, and which can leave people as traumatised as if they were actually in the crash: imagination can be a powerful thing.

The confusion of feeling grief stricken and traumatised

When someone suffers a traumatic bereavement, grieving may initially be blocked; the trauma overrides the ability to mourn, and while experiencing both the bereaved person may find emotions and symptoms are intensified. Trauma and grief can be experienced simultaneously or separately and this may cause distress and confusion to that person and to those around him/her as s/he struggles to understand complex and sometimes frightening emotions.

The complexity of a death on the road

Any bereavement is accompanied by distress and pain but people bereaved by a sudden, unexpected death, such as a death in a road crash, may have to face innumerable other factors which may aggravate their situation and hinder the normal grieving process. The legal and (sometimes) criminal procedures that often have to be faced after a traumatic death may compound other feelings, creating additional problems. Grief is an intensely personal experience and additional external factors make it very difficult for a bereaved person to begin their grieving process.

This training sheet takes you through the symptoms of traumatic bereavement, expected outcomes, and provides advice about how the police can help - within your remit.

How do people typically react at first when told of a death on the road?

Shock affects people in different ways. You may find that families are quiet, uncontrollable, collapse or faint, are aggressive or shout, or sit shaking and crying. All these reactions are very normal and police officers should expect them when informing a family of a death on the road. These reactions are not indicative of normal character and solely due to the shock.

Traumatic bereavement symptoms and outcomes

The way people react when they are first told about their bereavement are their first symptoms of post traumatic stress. This is NOT the same as the diagnosed condition

Post Traumatic Stress Disorder (described later in this information sheet).

It is estimated by the NHS that about one in three people involved in a traumatic event still suffer symptoms of post traumatic stress more than a month after the event, a sign that they are at risk of developing a long-term condition such as Post Traumatic Stress Disorder or clinical depression. For people bereaved by road crashes, who experience one of the most traumatic events possible in life, the figure is undoubtedly much higher than one in three. There is extensive practitioner evidence that PTSD may be even more common following fatal road crashes. For example, even in cases primarily involving injury not death. Post traumatic stress symptoms are different to the normal range of symptoms experienced by someone who is simply grieving the death of a loved one, such as the death of an elderly relative or someone who has suffered a long-standing illness and been expected to die.    

Extremely upsetting and common post traumatic stress symptoms experienced following a road death, all of which are indicative of the traumatic nature of the death, are normal and which can occur at any time, include:   

  • Intrusive recollections, images or thoughts: remembering the crash in an involuntary and distressing way (or imagining it if the bereaved person was not in the crash). Thoughts re-emerge without warning and can cause great distress;
  • Flashbacks, when the individual feels that the event is actually reoccurring;
  • Nightmares and inability to sleep;
  • Inability to resume normal activities: for example inability to use roads without distress, or inability to work, or inability to leave one's home;
  • Hyper-arousal: exaggerated startle responses, irritability, difficulty in concentrating, extreme anger, poor breathing;
  • Physical symptoms such as stutters, shakes, poor digestion, general feelings of being unwell;
  • Emotional numbing: feeling detached from others, lack of ability to experience feelings, or giving up previously significant activities such as sport or hobbies.   

Not all victims will suffer all these symptoms of post traumatic stress, and some symptoms may develop at different times to other symptoms. All symptoms are shocking and distressing for the sufferer and their family and friends.    

These symptoms are, of course, experienced in addition to initial shock symptoms, and the feelings of deep grief and loss which are normal following any death of a family member. If someone who has been bereaved in a road crash is recovering well, their normal grieving should continue long beyond the length of time that symptoms of post traumatic stress last.

If people bereaved in road crashes are not well supported by a range of professionals, including police, during the first days, weeks and months of their bereavement they are frequently, in Brake's experience:   

  • Terrified of their trauma symptoms and feel isolated, let down by the system, and unsupported / excluded; 
  • More likely to suffer on-going symptoms, for years in many cases, which become conditions such as Post Traumatic Stress Disorder or clinical depression; 
  • May have long-term difficulty recognising their symptoms as being either in existence or something they could ever recover from, even when their symptoms are extreme, damaging, and clearly apparent to carers. The person may firmly believe that they will never recover from their symptoms and that it is 'their lot' to carry on suffering; 
  • Unlikely to look for support for themselves, or, if they do look for it, fail to find appropriate support and instead struggle on without help, or are given inappropriate help (for example, they become dependent long-term on anti-depressants or sleeping tablets).  

In many cases people who are bereaved by road crashes, who do not receive early support, and who do not receive treatment for subsequently diagnosed conditions such as Post Traumatic Stress Disorder, may face any number of poor outcomes and social exclusion, including:    

  • unemployment due to inability to work;  
  • breakdown of family life, including divorce;  
  • debt, leading to worse outcomes such as decline in living standards or even homelessness; 
  • withdrawal from social contact and hobbies;  
  • alcoholism and drug dependency; and  
  • suicide   

These outcomes place a significant economic burden on society as well as being fundamentally inhumane and unacceptable in a civilised, wealthy country.

How do we enable recovery from post traumatic stress symptoms?

The ideal process of recovery following a death on the road:   

  1. Learn the bad news   
  2. Suffer traumatic stress symptoms but have good early intervention support from others, who are specifically trained in early emotional or practical support including good support from trained FLOs   
  3. Recover from traumatic stress within a few months and then grieve normally, recovering from grief over time     Or    
  4. Develop a diagnosable condition such as Post Traumatic Stress Disorder or Clinical Depression but obtain effective and timely treatment leading to recovery, then grieve normally, recovering from grief over time   

Currently, it is a sad fact that this process of recovery does not occur in many cases. This is because there is not, to quote the flow diagram, 'good early intervention support from others, who are specifically trained in early emotional or practical support', and neither is there the understanding of diagnosable conditions and promotion and take up of appropriate treatment. Instead, what can, and frequently does, happen is:   

  1. Learn the bad news
  2. Suffer traumatic stress symptoms that do not subside
  3. Develop a diagnosable condition such as Post Traumatic Stress Disorder or Clinical Depression 
  4. Fail to receive appropriate treatment and continue to suffer, with poor consequences such as family breakdown, loss of job, etc.   

Effective 'early intervention support' for people bereaved in road crashes    

People bereaved by road crashes need to receive 'early intervention support' to assist them to recover from their post traumatic stress symptoms, to prevent development of debilitating conditions such as Post Traumatic Stress Disorder, and, if such conditions do develop, to help them to seek appropriate medical help.   

Early intervention support should take the form of emotional and practical support from the time of bereavement, helping support victims through the often terrifying period of initial shock and development of trauma symptoms, and helping them through a significant number of confusing practical issues, which can range from dealing with the CJS process, to dealing with someone's will, to arranging a funeral or contacting an appropriate solicitor to handle a civil claim. This wide ranging support must be provided by a range of skilful, highly-trained carers who are experienced in working with people who have been recently traumatically bereaved, and who work within clearly defined roles and to high and monitored standards. This includes the work of the police.    

It is the job of the police to provide information about, and support through, the police investigation. It is not the job of the police to provide any form of counselling. However, the police can provide empathetic support, within their remit, and particularly during the first two to three months, which can aid recovery from post traumatic stress symptoms.    

Here is some basic advice about how police can assist recovery from post traumatic stress symptoms:   

  1. Follow Brake's advice on 'breaking the bad news', one of the other information sheets in this series. This is vital to ensure that your relationship with a bereaved person starts on the right foot.   
  2. Ensure that you are always professionally empathetic, regardless of the manner of the person you are helping. You may need constantly to remember that their behaviour, if poor (for example, over-demanding, angry, or tearful), is a symptom of their traumatic grief and not indicative of their normal character.   
  3. Always explain what you are doing to help the person, several times if necessary. Write it down for them on the blank pages in the front of their blue Brake bereavement pack. Traumatised people often struggle with their memory.    
  4. Ensure you are consistently available. Explain when you are not available. Provide them with contact details. Write this down for the person in the designated place in their blue bereavement folder.    
  5. Do what you can, if you have the permission of a bereaved person, to help them to seek appropriate emotional support as soon as possible, if they are not receiving this support already. See further down this information sheet for more information on this.     1.  Explain the nature of your role (which is to help the person through the CJS process), and ensure you have an exit strategy. Do not give mixed messages. You are not a friend, and you are not a counsellor. You are a police officer with a clear role which you intend to carry out as professionally and empathetically as possible.    
  6. Never underestimate the positive effect of good practical support delivered in a timely manner, providing 'value added' service. This could include, for example, arranging for a qualified colleague in another force area to, at the request of a bereaved person, visit another close relative and inform them of the bad news in person. Or it could mean offering to escort a person to the place where a crash happened, or offering to call up a hospital to find out about opportunities to donate tissue, or calling up a school or employer to explain that someone has died and therefore will not be going to school/work. One of the main triggers for post traumatic stress is a feeling of being helpless, frozen, unable to act, while wanting, desperately, to do something, and while not having anyone providing the help that is needed. You can, with permission, perform simple practical tasks for someone who is bereaved that are enormously helpful, build bridges with the person you are supporting, and yet take up little of your time.    
  7. Use the blue Brake bereavement pack. This is a useful reference tool for you as well as for the bereaved person. You can help encourage the bereaved person to read the yellow book in the pack, 'Coping with Grief', which explains symptoms of traumatic grief and provides simple advice on how to cope. You can also provide more copies of this book for other family members and close friends. Call Shane Bates at Brake on 01484 559909 if you run out of stock.   
  8. Use the Brake bereavement helpline 0808 8000 401. This helpline is for you as well as for people bereaved in road crashes. It is staffed by an experienced operator who can talk to you about how best to assist people bereaved in road crashes. The helpline operator can also talk directly to people bereaved in road crashes.    
  9. Ensure you are offered, and attend, regular confidential debrief sessions with a police counsellor. This is vital for your own welfare and to ensure you continue to perform well in the role.    

Who can provide emotional support in the early weeks and months?    

As soon as possible following bereavement, someone bereaved by a road crash needs to understand two things:   

  1. that their shock and trauma symptoms are normal, may manifest themselves in different ways at different times, and that there are ways to help them cope with these symptoms (to help prevent the symptoms being so overwhelming); and    
  2. that they have the opportunity, and are recommended by the NHS, to seek an assessment of their needs and appropriate treatment if their shock and trauma symptoms do not start to subside within two months.    

These two things are explained in the yellow book 'Coping with Grief' in the blue bereavement folder. You are strongly advised to read this yellow book to have a better understanding of bereavement in a road crash.    

However, as well as reading the yellow book, it is enormously helpful if the bereaved person has someone specifically on hand in the early weeks to help them with their emotional needs. This person:   

  • should not be there to provide bereavement counselling. In the early weeks, when the bereaved person is dealing with shock and extreme symptoms of traumatic stress, counselling is not appropriate.   
  • should have experience of caring, in the early weeks, for people who have been traumatically bereaved. This is not the same as caring for people who have been bereaved in a 'normal' way, for example by old age or a long-standing illness.   
  • should have a good understanding of the development of Post Traumatic Stress Disorder and other conditions that can occur following a traumatic bereavement, and be able to explain these to the bereaved person, be able to encourage them to seek an assessment of their needs if it appears that such conditions may be developing, and encourage them to get appropriate treatment from a specialist health professional if such a condition is diagnosed.    

Who can offer this emotional early intervention support?    

At present, there is no national face to face support service for road crash victims (scroll down for details of local face to face support services). Brake, which is a specialist charity working in this area, is the national provider of Government funded support literatureand road crash helpline (0808 8000 401, 10am-4pm, Mon-Fri). The Brake helpline provides emotional support over the phone and by email; and can help road crash victims find face to face or specialist support. While funding for a national face to face support service is not available, the Brake helpline, in particular, remains a very important resource for people affected by road death and injury. Its operators can:     

  • provide emotional support
  • re-explain or read out relevant sections of the Brake bereavement pack
  • source medical assessment for Post Traumatic Stress Disorder or other conditions resulting from the traumatic stress of the bereavement if symptoms do not subside
  • seek out and signpost local emotional care agencies
  • seek face to face or specialist support
  • provide practical assistance (for example, sourcing a personal injury solicitor)
  • arrange a phone conversation with someone else who has also been bereaved in a similar way, if this is what the person wants (not everyone does)   

The helpline operators are paid professionals who are trained in traumatic bereavement and operating a helpline and also are experts in the blue Brake bereavement pack. The helpline is not a recruitment tool for Brake and does not encourage callers to campaign for road safety.   

In addition, there are three organisations known to Brake that provide face to face, one on one, support for people bereaved in road crashes in the regions. Not all regions are covered:

  • Aftermath Support(call 0845 634 4273 or 0151 777 2562) (Merseyside) (care provided by trained volunteers)
  • Road Victims Trust(call 01234 843345) (Bedfordshire, Cambridgeshire and Hertfordshire) (care provided by trained volunteers)
  • Assist(call 01788 560800) (West Midlands) (care provided by trained therapists)   

In addition, there are organisations that offer support and friendship through mailings and local groups, mainly from people who have themselves been affected by a road crash, including:

It is worth bearing in mind, however, that while some people bereaved by road crashes will want to talk to someone who has also been bereaved, others won't.   

In addition, there are local bereavement services, many increasingly being operated by hospitals, but also by local charities such as the Gloucestershire-based Winston's Wish which specialises in supporting bereaved families and children. There are also national charities, such as Cruse and The Samaritans, that specialise in bereavement and crisis, but not necessarily in traumatic bereavement. More organisations are listed in the yellow book called 'Coping with Grief' within the blue Brake bereavement folder.   

Police are advised to encourage families to think about the advantages and disadvantages of any agency. Different agencies have different training for staff, and some may have waiting lists. It is best to know what an agency can and can't offer to avoid disappointment. Brake can help you understand and find out what an agency has to offer. You can call the helpline for this information and help searching for local agencies, the helpline is for the police as well as for people who are bereaved. Call 0808 8000 401.    

Treating Post Traumatic Stress Disorder   

Definition of PTSD     

"Post Traumatic Stress Disorder develops following a stressful event or situation of an exceptionally threatening or catastrophic nature, which is likely to cause pervasive distress in almost anyone.   

PTSD does not therefore develop following those upsetting situations which are described as 'traumatic' in everyday language, for example, divorce, loss of job, or failing an exam.   

PTSD is a disorder that can affect people of all ages.   

Around 25-30% of people experiencing a traumatic event may go on to develop PTSD."   

Post Traumatic Stress Disorder (PTSD): The Management of PTSD in adults and children in primary and secondary care, page 6, National Institute for Clinical Excellence, Clinical Guideline 26 March 2005. ISBN 1-84257-922-3    www.nice.org.uk/CG026NICEguideline    

Even with good emotional early intervention support, Post Traumatic Stress Disorder can still develop following a bereavement by a road crash. But if good early intervention support is being provided it means that this condition, or any others resulting from the bereavement, are noticed earlier, may be less severe, and can be treated sooner and easier. To read a description of Post-Traumatic Stress Disorder by the NHS, click here.

If post traumatic stress symptoms persist for more than two to three months despite support, a person should obtain a professional assessment of their needs and are most likely to be diagnosed as suffering from Post Traumatic Stress Disorder, or possibly another condition such as clinical depression. In these cases, appropriate treatment is advised to aid their recovery and enable them to go on to grieve normally and move forward positively.    

NICE (The National Institute for Health and Clinical Excellence) recommends that when trauma symptoms do not begin to show some improvement after 4-6 weeks it is advisable to seek a professional assessment and, if diagnosed as requiring it, appropriate treatment. NICE recommends cognitive behavioural therapy (CBT) expert talk-based therapy rather than drugs if Post Traumatic Stress Disorder (the most likely condition) is diagnosed. If left untreated, symptoms are likely to worsen.    

Trauma-focused CBT includes learning skills that help sufferers to change negative thought processes. It includes the use of mental imagery of the traumatic event and an understanding of their symptoms as normal reactions to help sufferers work through the trauma and gain control of their fear and distress.    

Obtaining an assessment of someone's needs, and treatment for PTSD or other conditions if diagnosed    

A GP should, in theory, be able to organise an assessment for PTSD and other conditions and subsequent expert treatment if required. The NHS employs expert therapists who can provide assessments and treatment. In 2007, more funding was announced by the NHS for more 'CBT centres' around the UK employing these therapists.    

However, many GP's are still not yet familiar with caring for people who have suffered traumatic bereavement, and may not even know the relevant experts who can provide assessments and treatment. These GP's may, erroneously, refer someone to their in-house counsellor (who is highly unlikely to be appropriately trained to treat PTSD) or simply prescribe anti-depressants.    

If a family you are working with are planning to visit their GP to seek an assessment of their needs, it is important to advise them to take the yellow Brake book 'Coping with Grief' with them and to refer to the section called 'Seeking Professional Help'. Police will also benefit from studying this section.   

Brake's helpline 0808 8000 401 can also directly seek out local experts who can assess someone's needs and diagnose PTSD or other conditions.    

To read the full NICE guidelines on recommended treatment for PTSD, click here

It is worth noting that children can also suffer from PTSD and will experience the full range of symptoms, although they may not present in the same way. A young child may have sleeping problems or behavioural difficulties not apparent before the event. Some children may regress to previous patterns of behaviour and begin to function at the level of a younger child. Adolescents may become more preoccupied with death and danger or may have feelings of guilt about various aspects of the loss.   

More information    

More information about PTSD and CBT can be found on the websites of a number of expert centres that treat people with PTSD. Here are a selection:   

Brake   

The Centre for Trauma Resilience and Growth  

Aberdeen Centre for Trauma Research   

PTSD 999

Assistance Support & Self-help in Surviving Trauma (ASSIST)  

UK Trauma Group   

British Association for Behavioural and Cognitive Psychotherapies  

National Institute for Clinical Excellence 

International Society for Traumatic Stress Studies  

MIND (National Association for Mental Health)      

Post Traumatic Stress Disorder: The Management of PTSD in Adults & Children in Primary & Secondary Care, National Institute for Clinical Excellence, 2005, Mirza et al, published in the British Journal of Psychiatry (1998, 172: 443-447)   

Post Traumatic Stress Disorder: The Management of PTSD in Adults & Children in Primary & Secondary Care, National Institute for Clinical Excellence, 2005

Author: Simon Hepworth and Mary Williams     Edited by: Mary Williams     Date written: 2005     Date updated: June 2007