Retrospective Fatality Analysis

Behind every suicide statistic, there is a person.

For more than two decades, I have dedicated my professional career to advancing mental health and wellness. With my extensive expertise in the areas of crisis response, suicide intervention and prevention, my commitment to advancing mental health and wellness continues with the work of Retrospective Fatality Analysis.

-Nicole Rials

Behind every suicide statistic, there is a person with a family, and suicide loss survivors who are grieving. Retrospective Fatality Analysis, also known as RFA is a comprehensive exploration of the biopsychosocial and environmental factors preceding an individual’s death by suicide or other unnatural deaths.

The purpose of RFA is to

Inform community based suicide prevention efforts

Provide meaning making for the survivors

Conduct and progress suicide prevention and postvention efforts

Assist with equivocal death determinations

Stop contagion

Offer a tool that benefits public health fatality reviews

When to use RFA

To serve a suicide loss survivor by discussing and clarifying the events that led to the suicide

To stop a diffusion (contagion) in a community

To inform community-based suicide prevention

For equivocal death determinations when the cause of death has not been determined

To provide training, to further suicide prevention research, and for case studies

Inclusive Suicide Analysis for High Risk Populations

The Retrospective Forensic Analysis service prides itself on being inclusive to all people and oftentimes covers a wide spectrum of social factors and emotional considerations.  We are especially sensitive to some of the following populations who may find themselves at risk because of unique challenges facing their particular situation.  

Studying Teen Suicide to Prevent Future Tragedies

According to the American Foundation for Suicide Prevention, teen suicide has been on the rise over the last decade. Although many people blame the rise of peer pressures related to social media use, the truth is that each individual case has its own unique story. Investigating the root cause of these tragedies could help grieving parents, and it could also save future lives. Suicide contagion is always of concern when a teen dies by suicide. A forensic analysis may uncover another peer of the person who died from suicide who may also have suicidal thoughts.

When the Response to Suicide Among First Responders Becomes a Calling

Although they are constantly responding to someone else’s emergency, Law Enforcement, Fire, EMS, and Dispatch First Responders have their own share of personal and chronic stressors. Repeatedly responding to danger and traumatic events, and dealing with unwanted outcomes can accumulate a devastating emotional toll.  As a member of a law enforcement family, Nicole Rials has the cultural competence necessary to approach these sophisticated issues with empathy and nuance.  

Farmers Facing Suicidal Thoughts May Suffer Privately

As an occupational group, farmers face an enormous amount of factors outside of their control.  Variable weather, inflation, isolation, and the pure grunt work involved is a heavy burden.  However, sadly many of our agricultural heroes live in the darkness with their deep depression.  During her career as a mental health professional, Nicole Rials has studied this risk in this industry  and recognizes that stigma can lead to a serious level of privacy on such matters.  Rials’ RFA service welcomes the families of grieving farmers with open arms with the hopes of shedding light on their situation.  

Veteran Suicide Rates Demand Action From Mental Health Community

Analyzing the suicide deaths of veterans requires a multifaceted approach that recognizes the unique challenges they face post-service. Veterans often grapple with the invisible wounds of war, including PTSD, traumatic brain injuries, and the difficulties of transitioning back to civilian life. Investigator Nicole Rials understands the importance of delving into the intricate layers of their experiences, acknowledging the impact of combat, deployment, and the complex web of emotions that can accompany military service. Moreover, approaching this community with care is paramount due to the high prevalence of mental health issues among veterans and the stigma that can surround seeking help. By conducting a thorough forensic analysis with sensitivity and respect, Nicole Rials aims to honor the memory of those who have served while also shedding light on the systemic issues that contribute to their vulnerability.

Hope for BIPOC Communities Coping with Suicide Losses

According to the American Psychiatric Association, members of the BIPOC community are less likely to receive mental health care despite being 20 percent more likely to report serious psychological distress than Whites.The impact of slavery, racism, discrimination,  microaggressions, implicit and explicit bias still impact the BIPOC culture.  As a person of color, Nicole Rials understands the historical and sociological contexts in which mental health issues occur.  She leads an ongoing workshop series aimed at confronting some of the unique mental health challenges for BIPOC people.  However, when tragedy strikes within this community, Rials takes pride in providing answers and handling the analysis with integrity and dignity.    

RFA Process

The RFA process includes three main components: 

Data Collection

The C-RFA will Identify and review various sources of available sources of data including mental health and medical records, law enforcement reports, coroner’s reports, death certificates, personal journals, academic information, and social media accounts

Interviews

The C-RFA will conduct Interviews with  family members, survivors, and those identified as being an essential part the individual’s life and/or those who might have pertinent information about the circumstances leading up to the individual’s death by suicide. 

Synthesis of Information

After all of the data has been collected and interviews have been completed, the C-RFA synthesizes the data into a report for the loss survivor.

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