Int. J. Environ. Res. Public Health 2012, 9 27 mental health professionals and services, and the public health perspective of policy development and general population strategies. 4.1. Postvention from the Clinical Perspective Jordan, Feigelman, McMenamy and Mitchell [16] noted that many mental health treatments are created “top-down” by (well meaning) clinicians and researchers and suggested inclusion of the “bottom-up” approach which takes into account the “hard-won wisdom” of people bereaved by suicide (p. 116). Indeed, listening to survivors themself and exploring their needs and experiences, as well as engaging them as active partners in research [17], should be the first step in establishing effective services. Certain focus areas, such as management of the risk of psychopathology, seem the obvious goals for postvention. For example, Brent et al. [18] showed that children of parents who died by suicide (or in an accident) had higher rates of current and incident depression up to 21 months after the death than the non-bereaved and children of parents who died by sudden natural death. The children bereaved by suicide had also a higher rate of alcohol or substance abuse. Dyregrov and Dyregrov [19] reported that siblings of suicide victims, particularly adolescents, experienced depression, anxiety, post-traumatic and grief reactions. However, the aftermath of suicide is not limited to mental health problems. A wide variety of psycho-social needs of suicide survivors which should be met by postvention programs have been identified. These include difficulties related to the disruption of family relations and routines, functional impairments in daily activities, difficulties with social and familial relationships, spiritual struggles as well as financial and juridical problems [10,20-23]. In addition, the mechanisms of identification with the deceased, social modelling, punishment for perceived self-blame as well as genetic factors might be accountable for the increased risk of suicidal ideation and behaviour, and at-risk behaviours observed among some of the survivors [24]. Such increased risk of suicidality has been observed in both adolescent [25] and adult samples of survivors [5]. Suicide survivor support groups and psychotherapy seem to be promising forms of help addressing the wide variety of problems and needs of the survivors. The former may be helpful for suicide survivors in general, while the latter might be helpful especially for survivors who develop psychological and/or psychiatric problems [26]. However, the number of controlled studies regarding the effectiveness of suicide survivor support groups is limited [27-30] and the more severe the grief process (irrespective of the cause of death), the more chance that therapeutic interventions will have positive results [31]. In addition, only a minority of survivors attend support groups and/or other services. A study by Provini et al. [23] showed that while 72% of survivors expressed the need for professional help, only 47% actually received it; an observation confirmed in other studies, e.g., [32]. It has been estimated that while there were over 50,000 suicides per year in Europe, only 10,000 survivors attended survivor groups and there are significant differences in the availability of this form of help in Europe. In general, the Western and Northern European countries offer more peer support opportunities than countries in Eastern and Southern Europe [33]. Besides the sheer availability of peer support, also other psycho-social factors determine how many survivors and who will use this type of support [10]. For some of the bereaved the informal help offered by family or friends is sufficient, others might fear