A patient who recently experienced the murder of a loved one would do well to turn to their primary care provider for help. Too few survivors take this important step. Hopefully, friends of the co-victim will make this recommendation and offer to drive them to the appointment if necessary. One way for the health care provider to bring this stressor to light is to add one question about homicide on their regular health intake forms, similar to what is done with domestic violence: (“Have you ever had to cope with the murder of someone close to you?”)
There are at least six important ways a PCP could help in a fifteen-minute appointment.
The acronym “murder” will aid in remembering the six objectives.
MEDICAL and MENTAL HEALTH CONDITIONS
“What’s going on with your previous XYZ conditions?”
“Anything new develop?”
The two-way mind-body connection is well-known and painfully obvious when a person is under acute stress. Assessment of worsening premorbid conditions and new complaints, such as headaches, teeth-grinding, HTN, and insomnia are good places to start. Of course, dehydration, poor diet, noncompliance with prescribed meds, smoking, and drug abuse will only intensify these setbacks. It doesn’t hurt to ask about thoughts of self-harm, especially if they have been depressed, with a weak support system, or have additional risk factors. In the event this is an issue a call to 988 is in order.
UNPROTECTED
“Is there reason to worry about your safety?”
In some instances, the still-on-the-loose perpetrator or their supporters can harm homicide survivors over retribution, the belief they have incriminating evidence, to prevent them from cooperating with law enforcement or to stop them from testifying at trial. The days after the homicide and the days leading up to the trial are especially tense. It’s common for homicide co-victims to overlook the most basic precautions like leaving yard lights on, being accompanied while in public, and so on. This is made worse by media attention. Safety needs are something a good friend can assist with. If necessary, encourage them to document their concerns and reach out to the assigned homicide detective. Another alternative is to register with “VINE.” It stands for “Victim Information Notification Everyday.” It is free, is available in about 200 languages, and is available around the clock nationwide except in Maine and Nebraska. The primary intent of VINE is to provide alerts via text, phone or email about the status of someone in custody. Some states also include valuable connections to resources (such as a provider directory). It can be found at www.vinelink.com. Victims of federal crimes can obtain information through the free federal Victim Notification System at https://www.notify.usdoj.gov/ The federal automated system is in English and Spanish.
RECRUIT
“It’s wise not to go this alone.”
Encourage them to meet with a victim advocate, trauma-informed mental health professional, support group, victims’ rights attorney, or clergy for support. The new homicide co-victim is starting a long-distance marathon, not a sprint, and they are likely woefully unprepared. It’s common for friends, neighbors, and coworkers to begin distancing themselves from the homicide survivor within three months of the death. Families who’ve lost someone to murder become “that” family in “that” house with “that scandal.” One way to prepare for this is to enrich their support system early. If it was a minor child who was murdered, a contact with Parents of Murdered Children is helpful (in Canada and the U.S.) here https://www.pomc.org/ or on Facebook. On the other hand, if your patient is a minor who has lost an important person to murder, a great resource is The Dougy Center at https://www.dougy.org/
DE-ESCALATE
“There are some do-it-yourself ways to reduce stress at home.”
Reduce their crisis response by encouraging them to try calming techniques such as deep breathing, listening to music, accompanied daily walks in nature, journaling, yoga, planned periods of turning off their phone, avoiding social media, jogging, and limiting their exposure to the news. People who’ve just lost someone to homicide feel a loss of control. Recommending DIY ways to de-escalate is a subtle way of returning some control back to them.
ENCORE
“I’d like to see you again in three weeks.”
Inform the homicide co-victim when they need to return to see you. What should they be looking out for in the meantime? Invite their Victim Advocate, friend, or other involved support person to their return appointment with you if your patient is open to it.
RESOURCES
“There are resources out there to help.”
Encourage the griever to connect with virtual and community resources. You may know of some local resources or have an in-house social worker. They should contact the District Attorney’s Office to reach their victim advocate if they haven’t done so already.
Here are some virtual assistance resources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10108408
Directory of Crime Victim Services http://ovc.ncjrs.gov/findvictimservices
National Organization of Parents of Murdered Children. 1-888-818-POMC www.pomc.com
The Compassionate Friends 1-877-969-0010
My book, “What Now?” (available on Amazon)
Do not underestimate the importance of your calm presence in the face of this unimaginable tragedy. Homicide survivors feel adrift, frightened, exhausted, and confused. In short order, they will feel stigmatized, embarrassed, and angry. Your familiar, steady support is invaluable.
Empathy has no script. There is no right or wrong way to do it.
It’s simply listening, holding space,
and calmly communicating that incredibly healing message of
‘You’re not alone.’
—Brene Brown
For information on the value of emotional service animals click here: https://jancantyphd.com/emotional-support-animals-and-homicide-survivors/
For information on the value of volunteering as part of recovery click here: https://jancantyphd.com/volunteering-to-combat-grief/
For information on the stigma of a PTSD diagnosis click here: https://jancantyphd.com/the-stigma-of-a-ptsd-diagnosis/
For information on the cost of one gun shot victim click here: https://jancantyphd.com/whats-the-pricetag-for-one-gunshot-victim/
