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Fontao MI, Bulla J, Ross T. Prison and forensic mental health staff after suicides in their care. A narrative review of international and German national evidence. Front Psychiatry 2024; 15:1400604. [PMID: 38938459 PMCID: PMC11209187 DOI: 10.3389/fpsyt.2024.1400604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 05/30/2024] [Indexed: 06/29/2024] Open
Abstract
There is a growing body of international research investigating the impact of patient suicide on mental health professionals. The experience of losing a patient to suicide can have a significant and, in some cases, long-lasting (negative) impact on mental health professionals. However, the nature and extent of the impact on prison staff or forensic mental health professionals in particular is less clear. This narrative review summarises both quantitative and qualitative studies and key findings in this area, focusing on the above professions. A literature search was conducted using PsychInfo and Google Scholar, covering the period from 2000 onwards. The vast majority of findings relate to mental health professionals in general. We were unable to identify any published reports on the responses of forensic psychiatric staff. The majority of identified studies in the prison context are qualitative. Studies from German-speaking countries are particularly scarce in both the prison and mental health contexts. We conclude that there is a profound lack of knowledge about the impact of client/patient suicide on the subgroups of (German) prison and forensic psychiatric staff. Clearly, more research is needed on both the nature and extent of the impact, as well as on the specific organisational and supportive factors that help to mitigate the negative effects of suicide.
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Affiliation(s)
| | - Jan Bulla
- Forensic Psychiatry and Psychotherapy, Reichenau Psychiatric Center, Reichenau, Germany
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Thomas Ross
- Forensic Psychiatry and Psychotherapy, Reichenau Psychiatric Center, Reichenau, Germany
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
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Luce A, Turner G, Kennedy L, Bush-Evans RD. "Quite simply they don't communicate": a case study of a National Health Service response to staff suicide. MEDICAL HUMANITIES 2024; 50:116-124. [PMID: 38195242 DOI: 10.1136/medhum-2023-012722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 01/11/2024]
Abstract
Workplace suicide can have significant knock-on effects within an organisation, yet research has shown within the healthcare profession, not all staff receive suicide prevention training, and few employers take the time to reflect on the need to change workplace policies or practices following the death of a staff member to suicide. How staff suicide is communicated across an organisation and to family members is important. Effective crisis communication is critical for effective management for a timely and sensitive response to a staff suicide within an organisation. By doing so, workplaces can help to reduce the significant emotional trauma suicide can have on an employee, and support good mental health across its workforce. This study aimed to explore and understand the communication processes around staff suicide across a National Health Service (NHS) Trust and to provide recommendations based on these findings. Semi-structured interviews were conducted with 29 participants, each lasting approximately 90 min. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were followed. Thematic analysis was used to analyse the data, resulting in seven themes being identified based on communication. Findings indicated that the Trust had no clear communication strategy in place for tackling staff suicide. Each suicide was handled differently, training across staff roles was lacking and operational procedures were deemed insensitive. This paper aimed to provide insight into the communication strategies used in the aftermath of a staff suicide. These findings highlight the inconsistency of the communication, lack of clear policy and guidance and the negative impact this had on staff. Further research is needed across NHS Trusts nationwide to gain insight into the current communication strategies in place to develop a national approach to clear communication following the death of an NHS worker to suicide. Tweetable abstract: Effective communication is critical in the aftermath of an NHS staff suicide. By doing so, NHS Trusts can help to reduce the trauma suicide can have on an employee and support good mental health across its workforce @stann2.
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Affiliation(s)
- Ann Luce
- Department of Communication and Journalism, Bournemouth University, Poole, UK
| | - Georgia Turner
- Department of Communication and Journalism, Bournemouth University, Poole, UK
| | - Lauren Kennedy
- Department of Communication and Journalism, Bournemouth University, Poole, UK
| | - Reece D Bush-Evans
- Department of Communication and Journalism, Bournemouth University, Poole, UK
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Rajagopalan A, Teck SCE, Sng ATT. Shared Fragility-Contemplating the Impact of Patients' Suicides on Clinicians. Psychodyn Psychiatry 2023; 51:409-433. [PMID: 38047664 DOI: 10.1521/pdps.2023.51.4.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
The experience of patient suicide can have a profound impact on clinicians, yet there are limited opportunities for them to express and process their emotional responses. We organized a reflective group session for psychiatrists in Singapore who had encountered patient suicides. Ten psychiatrists participated, with five in the "inner" group (those who had experienced patient suicide) and the remaining five forming the "outer" group. Led by a senior psychiatrist trained in psychodynamic psychotherapy, the inner group shared their reflections on patient suicides, while the outer group provided their insights thereafter. Participants provided written feedback about their session experiences. The session was recorded, transcribed, and analyzed to identify key themes. Three main narrative themes emerged from the analysis. Firstly, there was the acute response to the suicide, involving intense emotional reactions. Secondly, the relationship between clinicians and patients with suicidal thoughts was explored, encompassing countertransferential responses, superego defenses, and resulting anxiety. Lastly, the study examined how clinicians feel about suicidality itself, shedding light on complex attitudes and perceptions. Our findings confirm previous research, indicating that the response to patient suicide is stressful and traumatic for clinicians, who grapple with emotions such as grief, guilt, incompetence, and fear. Moreover, we delve into the intricate connections clinicians have with the concept of suicidality, shaped not only by their own experiences but also by the insights of those who have yet to confront patient suicide. The reflections shared by the participants emphasize the significance of establishing therapeutic spaces for clinicians to process these complex emotions effectively.
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Affiliation(s)
- Arvind Rajagopalan
- Department of Psychological Medicine, Changi General Hospital, Singapore
| | - Samuel Cheng Eng Teck
- Grad. Dip. in Psychotherapy (Psychodynamic Track), M.Sc. (Epidemiology), Department of Psychological Medicine, Changi General Hospital, Singapore
| | - Andre Tay Teck Sng
- Department of Psychological Medicine, Changi General Hospital, Singapore
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Cohen Ben Simon O, Brunstein Klomek A, Pomerance Y, Idelman L, Lavidor M, Gvion Y. When a Patient Dies From Suicide: A Survey Among Mental Health Professionals in Israel. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231215841. [PMID: 38124326 DOI: 10.1177/00302228231215841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Death of patients by suicide can have powerful impacts on mental health professionals (MHPs). The National Program for the Prevention of Suicidality and Suicide at Israel's Ministry of Health decided to invest in MHPs who have lost patients by suicide. Two hundred and two MHPs completed an online self-report survey regarding their emotional response, professional identity, and clinical practice, and the aid they felt would be supportive following a patient's suicide. Results indicated that 35% of MHP experienced at least one death of a patient by suicide. Respondents experienced difficult emotional reactions, and many felt responsible for the suicide. Nearly 50% reported that the patient's suicide affected their clinical practice. Most respondents reported the need for a support framework and information about the processes following a patient's suicide. It is important to increase awareness of the possibility of losing a patient by suicide and offer an appropriate supportive framework.
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Affiliation(s)
| | | | - Yael Pomerance
- The National Program for the Prevention of Suicidality and Suicide, The Israeli Ministry of Health, Jerusalem, Israel
| | - Liza Idelman
- Public Engagement, The Israeli Ministry of Health, Jerusalem, Israel
| | - Michal Lavidor
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - Yari Gvion
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
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Alshutwi M, Alawad M, Alammari M, Almanea M, Alhumaid R, Alkhalifah AS, Alosaimi FD. Perceived impact of patients' suicide and serious suicidal attempts on their treating psychiatrists and trainees: a national cross-sectional study in Saudi Arabia. BMC Psychiatry 2023; 23:607. [PMID: 37596547 PMCID: PMC10439610 DOI: 10.1186/s12888-023-05042-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/21/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Patient suicides are significant events that tremendously affect psychiatrists- personally and professionally. Very few studies have focused on studying the impact of both serious suicidal attempts and completed suicide on psychiatrists and psychiatry trainees. AIM This study assessed the prevalence and impact of patient suicide and serious suicidal attempts on psychiatrists and psychiatry trainees in Saudi Arabia. METHODS This national cross-sectional study of psychiatrists and psychiatry trainees was conducted in Saudi Arabia. Participants completed an online self-administered questionnaire to assess emotional and professional impacts and the traumatic impact of patient suicide using the Impact of Event Scale-Revised (IES-R). RESULTS 178 psychiatrists were enrolled in this study. The prevalence rate of patient suicide among participants was 38.8%, and they experienced adverse emotional reactions. Additionally, among those who were not exposed to patient suicide, 12.9% reported exposure to serious suicide attempts, and almost all of them experienced related negative emotions. The most frequently reported emotions were sadness (61.95%), shock (48.91%), and guilt (25%), and these emotions lasted longer in completed patient suicide cases than attempted suicide. Nearly 84% of participants who experienced suicide reported its impact on their profession. The most reported professional impacts were increased focus on suicide cues, attention to legal aspects, and a tendency to hospitalize. Of participants who experienced suicide, 75.4% reported that the overall impact of suicidal events on their professional practice had improved. Of the total number of respondents who experienced either suicide or serious suicidal attempts, 10.9% reported symptoms of PTSD. CONCLUSIONS The study highlighted the emotional and professional burden that psychiatrists and psychiatry trainees experience due to patient's completed suicides and serious suicidal attempts. Additionally, it emphasized the need for further research to study the benefits of implementing preparatory and training programs to help trainees and psychiatrists in such instances.
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Affiliation(s)
- Maha Alshutwi
- Saudi Commission for Health Specialties, Riyadh, Saudi Arabia.
| | - Moayad Alawad
- Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | | | | | - Rayan Alhumaid
- College of Medicine, Qassim University, Buraydah, Saudi Arabia
| | | | - Fahad D Alosaimi
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Velasco J, Sanmartín FJ, Gálvez-Lara M, Cuadrado F, Moriana JA. Psychological Effects of Professional Exposure to Trauma and Human Suffering: Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:1656-1676. [PMID: 35202557 DOI: 10.1177/15248380221074314] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Over the past decades, a growing interest has emerged toward understanding the impact that the exposure to human suffering produces in mental health professionals, leading to the identification of three constructs: vicarious traumatization (VT), compassion fatigue (CF), and secondary trauma (ST). However, little is known about how these conditions affect psychologists. A systematic review and a meta-analysis were conducted to examine the evidence about the effects of occupational exposure to trauma and suffering in studies that included psychologists among their samples. Fifty-two studies were included comprising 10,233 participants. Overall, the results showed that most professionals did not experience relevant distress due to their work, yet some of them developed clinically significant symptoms (i.e., PTSD). However, solid conclusions could not be drawn due to the numerous methodological difficulties found in this research field (i.e., group heterogeneity, lack of comparison groups, and conceptual overlap). Thus, it is necessary to further investigate this topic with scientific rigor to understand these stressors and develop evidence-based interventions.
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Affiliation(s)
- Judith Velasco
- Department of Psychology, University of Cordoba, Spain
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Spain
- Reina Sofia University Hospital, Spain
| | | | - Mario Gálvez-Lara
- Department of Psychology, University of Cordoba, Spain
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Spain
- Reina Sofia University Hospital, Spain
| | - Fátima Cuadrado
- Department of Psychology, University of Cordoba, Spain
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Spain
- Reina Sofia University Hospital, Spain
| | - Juan A Moriana
- Department of Psychology, University of Cordoba, Spain
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Spain
- Reina Sofia University Hospital, Spain
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Yule AM, Basaraba C, Mail V, Bereznicka A, Cates-Wessel K, Levin FR. A cross sectional survey of provider experiences with patient drug overdose death. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 148:209008. [PMID: 36921768 PMCID: PMC10423649 DOI: 10.1016/j.josat.2023.209008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/13/2022] [Accepted: 02/27/2023] [Indexed: 03/16/2023]
Abstract
INTRODUCTION A record number of drug overdose (OD) deaths occurred in the United States in 2021. We know little regarding the impact of patient drug OD deaths on providers within health care settings. The aim of this study was to assess provider preparedness and experience with patient drug OD death. METHODS The study distributed an email invitation to individuals in the Provider Clinical Support System database in December 2020 to complete an anonymous web-based survey. We used multiple choice questions to assess provider demographics, preparedness to cope with patient OD death, and experience with patient OD death. The study evaluated stress associated with patient OD death using the Impact of Event Scale-Revised. We summarized responses using descriptive statistics. Associations between high stress after patient OD death and the impact of the death on clinical practice and the helpfulness of individuals and processes were assessed using Chi-square and Fisher's Exact tests. RESULTS Among the 12,204 individuals who read the email invitation, 1064 opened the survey link, and 523 completed the survey. Participants were predominantly physicians (40.2 %) and counselors (25 %), 70 % female, 78.4 % white, with a mean age of 52 years. Among the participants 26.4 % felt at least very well prepared to cope with an OD death, and 27.7 % felt at least very well prepared to support a colleague with a patient OD death. Most respondents (55.1 %) had a history of a patient OD death. Many patient OD deaths were not discussed by providers with other colleagues, but when providers did discuss these deaths providers identified colleagues as being very helpful. Compared to providers with low stress after patient OD death, those with high levels of stress were more likely to refer patients to a higher level of care (p = 0.035). CONCLUSIONS Many providers did not feel prepared themselves to cope with a patient OD death or support a colleague following this type of event. Patient OD deaths were a common experience, and providers did not frequently discuss their patient's deaths with others. A patient OD death can change clinical decision-making for providers experiencing high levels of stress related to the OD death.
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Affiliation(s)
- Amy M Yule
- Department of Psychiatry, Boston Medical Center, 720 Harrison Avenue, Boston, MA 02118, USA; Department of Psychiatry, Boston University School of Medicine, 720 Harrison Avenue, Boston, MA 02118, USA.
| | - Cale Basaraba
- Department of Psychiatry, Columbia University, 1051 Riverside Dr, New York, NY 10032, USA; Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA
| | - Victoria Mail
- Department of Psychiatry, Boston Medical Center, 720 Harrison Avenue, Boston, MA 02118, USA
| | - Agata Bereznicka
- Department of Psychiatry, Boston Medical Center, 720 Harrison Avenue, Boston, MA 02118, USA; Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Kathryn Cates-Wessel
- American Academy of Addiction Psychiatry, 400 Massasoit Ave #307, East Providence, RI 02914, USA
| | - Frances R Levin
- Department of Psychiatry, Columbia University, 1051 Riverside Dr, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA
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Berardelli I, Aguglia A, Cassioli E, Bersani FS, Longo L, Luciano M, Minichino A, Santambrogio J, Solmi M, Rossi R, Ribolsi M, Gattoni E, Monteleone AM. Suicide-Related Knowledge among Italian Early Career Psychiatrists and Trainees: Results from a Cross-Sectional Survey. Brain Sci 2022; 12:brainsci12121619. [PMID: 36552079 PMCID: PMC9776389 DOI: 10.3390/brainsci12121619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/10/2022] [Accepted: 11/19/2022] [Indexed: 11/29/2022] Open
Abstract
The training of mental health professionals is an important component of suicide-prevention programs. A cross-sectional survey was conducted in different Italian regions to evaluate knowledge of, and attitudes toward, suicide as well as the experience of a patient's suicide or a suicide attempt in early career psychiatrists (ECPs) and trainees (N = 338). The Suicide Knowledge and Skills Questionnaire and the Impact of a Patient's Suicide on Professional and Personal Lives scale were administered. Furthermore, symptoms of intrusion, avoidance, and arousal were examined through the Impact of Event Scale in ECPs and trainees who had experienced the suicide of a patient or a suicide attempt. Participants with training were more confident in the clinical management of suicide-risk patients. The group with experience of a patient's suicide reported more suicide skills except for support and supervision. Finally, the participants who reported a patient's suicide presented a more conservative patient selection, difficulties in relationships, loss of self-esteem, dreams linked to suicide, intrusive thoughts of suicide, guilt, and anger. Our results show that knowledge of, and attitudes toward, suicide are essential in the management of suicide-risk patients.
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Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035, 00189 Rome, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, 16132 Genoa, Italy
- Correspondence: ; Tel.: +39-010-1353-7665
| | - Emanuele Cassioli
- Psychiatry Unit, Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - Francesco Saverio Bersani
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- Psychiatry and Clinical Psychopharmacology University Unit, Department of Mental Health, Azienda Sanitaria Locale (ASL) Latina, 04100 Latina, Italy
| | - Luisa Longo
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21201, USA
| | - Mario Luciano
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80138 Naples, Italy
| | - Amedeo Minichino
- Department of Psychiatry, University of Oxford, Oxford OX1 2JD, UK
| | - Jacopo Santambrogio
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON K1Z 7K4, Canada
- Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program, University of Ottawa, Ottawa, ON K1Z 7K4, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, 10117 Berlin, Germany
| | - Rodolfo Rossi
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Michele Ribolsi
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine, University Campus Bio-Medico of Rome, 00128 Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy
| | - Eleonora Gattoni
- Psychiatry Ward, Maggiore della Carità University Hospital, 28100 Novara, Italy
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Oates A, Gibbons R. After a patient dies by suicide: an illustrative case for trainee psychiatrists and trainers. BJPsych Bull 2022; 46:293-297. [PMID: 34782031 PMCID: PMC9768523 DOI: 10.1192/bjb.2021.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
One of the most challenging experiences psychiatrists will face in their careers may well be the death of a patient by suicide. This is likely to happen at least once during a psychiatrist's career, and often more. It can be an intensely complex and painful event with a wide range of emotional responses. Reflecting on the death and accessing good support helps clinicians process the emotional impact. It can also increase their resilience in the longer term by giving them a greater understanding of both their own and their patients' limitations, and in this way strengthen their capacity for compassion as clinicians. Using an illustrative case study, this article provides an insight into the experience of losing a patient to suicide and signposts to sources of support.
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Affiliation(s)
- Alice Oates
- Southern Health NHS Foundation Trust, Basingstoke, UK
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10
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Knipe D, Padmanathan P, Newton-Howes G, Chan LF, Kapur N. Suicide and self-harm. Lancet 2022; 399:1903-1916. [PMID: 35512727 DOI: 10.1016/s0140-6736(22)00173-8] [Citation(s) in RCA: 84] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/23/2021] [Accepted: 12/20/2021] [Indexed: 12/21/2022]
Abstract
Suicide and self-harm are major health and societal issues worldwide, but the greatest burden of both behaviours occurs in low-income and middle-income countries. Although rates of suicide are higher in male than in female individuals, self-harm is more common in female individuals. Rather than having a single cause, suicide and self-harm are the result of a complex interplay of several factors that occur throughout the life course, and vary by gender, age, ethnicity, and geography. Several clinical and public health interventions show promise, although our understanding of their effectiveness has largely originated from high-income countries. Attempting to predict suicide is unlikely to be helpful. Intervention and prevention must include both a clinical and community focus, and every health professional has a crucial part to play.
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Affiliation(s)
- Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka.
| | - Prianka Padmanathan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Lai Fong Chan
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Nav Kapur
- Centre for Mental Health and Safety, University of Manchester, Academic Health Science Centre, Manchester, UK; National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Academic Health Science Centre, Manchester, UK; Greater Manchester Mental Health National Health Service Foundation Trust, Manchester, UK
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Suicide-Related Knowledge and Attitudes among a Sample of Mental Health Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168296. [PMID: 34444059 PMCID: PMC8394836 DOI: 10.3390/ijerph18168296] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 12/22/2022]
Abstract
Inadequate knowledge of the potential signs and risk factors of suicide negatively affects the ability of healthcare professionals to recognize patients at risk of suicide. The principal aim of the present study is to assess the attitudes and knowledge about suicide in a large sample of mental health professionals. We examined the relationship between Suicide Knowledge and Skills Questionnaire items and the experience of a patient dying by suicide. We also examined whether various healthcare professionals respond differently to the items of the Impact of a Patient’s Suicide on Professional and Personal Lives Scale. Results demonstrated that healthcare professionals who had experienced a patient suicide reported greater skills than professionals who had not experienced a patient suicide. However, 44% of professionals who had experienced a patient suicide felt that they did not have adequate training on this particular issue. Among those who had experienced a patient suicide, there was an increased tendency to hospitalize patients with suicide risk and an increased use of collegial consultation. Concerning personal emotions, healthcare professionals reported troubled relationships with family members and friends and the loss of self-esteem. In conclusion, better knowledge and attitudes about suicide are necessary for suicide-prevention strategies.
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Causer H, Bradley E, Muse K, Smith J. Bearing witness: A grounded theory of the experiences of staff at two United Kingdom Higher Education Institutions following a student death by suicide. PLoS One 2021; 16:e0251369. [PMID: 33979333 PMCID: PMC8115842 DOI: 10.1371/journal.pone.0251369] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 04/24/2021] [Indexed: 11/21/2022] Open
Abstract
Wider networks of people are affected by a suicide death than originally thought, including those whose job-role brings them into contact with a death by suicide of another person. The impact of student suicide within United Kingdom (UK) Higher Education Institutions (HEIs) is unexplored and the experiences of staff members remain unknown. It is not known whether staff members have specific postvention needs following a student death by suicide. Any postvention support currently offered to staff members within UK HEIs lacks a context-specific evidence base. This study asked 'How is a student suicide experienced by staff members within a UK HEI and what are the features of that experience?' Staff members from diverse job-roles in two UK HEIs responded to a qualitative survey (n = 19) and participated in semi-structured interviews (n = 10). Data were transcribed and subjected to a constructivist grounded theory analysis. Participants' experiences informed the development of a core category: 'Bearing witness', which encompassed six further categories: 'Responding to a student suicide'; 'Experiencing a student suicide'; 'Needs and fears'; 'Experiences of support'; 'Human stories'; and 'Cultural stories'. The resulting grounded theory demonstrates how participants' perceptions of impact are informed by their experiences of undertaking tasks following a student suicide within the community of their HEI. Processes of constructing perceptions of closeness to the student who died are evident amongst participants who did not know the student prior to their death. Tailored postvention support is required to respond to the range and complexity of HEI staff needs following a student death by suicide.
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Affiliation(s)
- Hilary Causer
- School of Allied Health and Community, University of Worcester, Worcestershire, United Kingdom
| | - Eleanor Bradley
- College of Life, Health and Environmental Sciences, University of Worcester, Worcestershire, United Kingdom
| | - Kate Muse
- School of Psychology, University of Worcester, Worcestershire, United Kingdom
| | - Jo Smith
- School of Allied Health and Community, University of Worcester, Worcestershire, United Kingdom
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13
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de Lyra RL, McKenzie SK, Every-Palmer S, Jenkin G. Occupational exposure to suicide: A review of research on the experiences of mental health professionals and first responders. PLoS One 2021; 16:e0251038. [PMID: 33930087 PMCID: PMC8087020 DOI: 10.1371/journal.pone.0251038] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 04/17/2021] [Indexed: 12/23/2022] Open
Abstract
Exposure to suicide is a major factor for suicidality. Mental health professionals and first responders are often exposed to suicide while on-duty. The objective of this scoping review is to describe the state of current research on exposure to suicide among mental health professionals and first responders, focusing on the prevalence and impact of exposure to suicide, and to identify current gaps in the literature. We searched MEDLINE, Scopus, PsychNET, and Web of Science and identified 25 eligible papers. Between 31.5–95.0% of professionals had been exposed to suicide. Exposure to suicide had impacts on personal life, professional life, and mental health; and caused emotional distress. There was little research investigating exposure to suicide among police officers, firefighters, and paramedics. More research existed on mental health professionals, but none assessed exposure to suicide as a risk for suicide amongst this group. The review concludes that exposure to suicide is distressing for mental health professionals, and likely to be for first responder however, more research on these groups, especially paramedics, is required.
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Affiliation(s)
- Renan Lopes de Lyra
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
- * E-mail:
| | - Sarah K. McKenzie
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Susanna Every-Palmer
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Gabrielle Jenkin
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
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14
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Leaune E, Allali R, Rotgé JY, Simon L, Vieux M, Fossati P, Gaillard R, Gourion D, Masson M, Olié E, Vaiva G. Prevalence and impact of patient suicide in psychiatrists: Results from a national French web-based survey. Encephale 2021; 47:507-513. [PMID: 33814167 DOI: 10.1016/j.encep.2020.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/12/2020] [Accepted: 11/17/2020] [Indexed: 10/21/2022]
Abstract
BACKGROUND Patient suicide (PS) is known to be a frequent and challenging occupational hazard for mental health professionals. No study previously explored the prevalence and impact of PS in a large sample of French psychiatrists. METHOD A national web-based survey was performed between September and December 2019 to assess (a) the prevalence of the exposure to PS, (b) the emotional, traumatic and professional impacts of PS, and (c) the perceived support in the aftermath of PS in French psychiatrists. Participants were contacted through email to answer the online 62-item questionnaire, including a measure of traumatic impact through the Impact of Event Scale-Revised. Emotional and professional impacts and perceived support were assessed through dedicated items. RESULTS A total of 764 psychiatrists fully completed the survey. Of them, 87.3% reported an exposure to PS and 13.7% reported PTSD symptoms afterward. Guilt, sadness and shock were the most frequent emotions. Among the exposed psychiatrists, 15.1% have temporarily considered changing their career path. The most emotionally distressing PS occurred during their ten first years of practice or during residency. A total of 37.1% of respondents felt unsupported and 50.4% reported that no team meeting had been organized in the aftermath. The feeling of responsibility for the death was strongly associated with negative impacts. CONCLUSION Our results entail considerations to prevent negative mental health outcomes in psychiatrists after PS. Notably, our results advocate for the implementation of educational programs during psychiatric residency and postvention programs in healthcare settings to effectively help psychiatrists in dealing with PS.
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Affiliation(s)
- E Leaune
- Centre Hospitalier le Vinatier, Bron, France; INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response - PSYR2 Team, 69000 Lyon, France.
| | - R Allali
- CHU Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny, France
| | - J-Y Rotgé
- AP-HP, Service de Psychiatrie d'Adultes, AP-HP-Sorbonne, Paris, France; Inserm U 1127, CNRS UMR 7225, Sorbonne Université, ICM-A-IHU, "Control-Interoception - Attention", Paris, France
| | - L Simon
- Centre Hospitalier le Vinatier, Bron, France
| | - M Vieux
- Centre Hospitalier le Vinatier, Bron, France
| | - P Fossati
- AP-HP, Service de Psychiatrie d'Adultes, AP-HP-Sorbonne, Paris, France; Inserm U 1127, CNRS UMR 7225, Sorbonne Université, ICM-A-IHU, "Control-Interoception - Attention", Paris, France
| | - R Gaillard
- Université de Paris, GHU Psychiatrie et neurosciences, Paris, France
| | - D Gourion
- Paris, France; HEC Paris, Jouy-en-Josas, France
| | - M Masson
- Nightingale Hospitals-Paris, Clinique du Château de Garches, Garches, France; SHU, GHU Psychiatrie et neurosciences, Paris, France
| | - E Olié
- Departement of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, PSNREC, Université Montpellier, INSERM, CHU de Montpellier, Montpellier, France
| | - G Vaiva
- Université Lille, Inserm, CHU Lille, U1172, Lille Neuroscience & Cognition (LilNCog), 59000 Lille, France; Centre National de Ressources & Résilience pour les psychotraumatismes (Cn2r Lille Paris), 59000 Lille, France
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15
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Sanford RL, Hawker K, Wayland S, Maple M. Workplace exposure to suicide among Australian mental health workers: A mixed-methods study. Int J Ment Health Nurs 2021; 30:286-299. [PMID: 32888249 DOI: 10.1111/inm.12783] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 07/09/2020] [Accepted: 08/04/2020] [Indexed: 11/29/2022]
Abstract
Workplace exposure to suicide attempts and deaths has been widely recognized as an occupational hazard for mental health and social care workers, including mental health nurses. Research consistently demonstrates the adverse impact on professionals. This paper explores the results of an online survey examining suicide exposure and impact. Of the 3010 Australian adult participants who identified exposure to suicide attempts and/or deaths in a larger study, 130 indicated that the most impactful suicide attempt and/or death exposure was that of a client or service user. While distress levels were relatively low among participants with workplace exposure, the qualitative content from 53 participants provides illumination into this experience. Themes that emerged in the qualitative responses include impact on the professional, organization response, and lack of adequate resources and supports to prevent suicide. Previous research has examined the impact of suicide exposure among professionals specifically, but this is the first known study of participants in a community sample who identified the most impactful suicide attempt or death exposure they had experienced was that of a client in a mental health setting. Workplace exposure among mental health workers is common and can have both deleterious and positive effects. Bereavement focused outcomes, where the loss of an attachment relationship is the focus, does not capture the full range of experiences in workplace exposure. Systemic issues in mental health care contribute to further distress among exposed workers, and this requires additional investigation and response.
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Affiliation(s)
- Rebecca L Sanford
- School of Social Work and Human Service, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Katelyn Hawker
- School of Social Work and Human Service, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Sarah Wayland
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia.,School of Health, Faculty of Medicine and Health, University of New England, Armidale, New South Wales, Australia
| | - Myfanwy Maple
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, New South Wales, Australia
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16
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Leaune E, Durif-Bruckert C, Noelle H, Joubert F, Ravella N, Haesebaert J, Poulet E, Chauliac N, Cuvillier B. Impact of exposure to severe suicidal behaviours in patients during psychiatric training: An online French survey. Early Interv Psychiatry 2021; 15:149-157. [PMID: 31876396 DOI: 10.1111/eip.12923] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 11/17/2019] [Accepted: 12/14/2019] [Indexed: 01/11/2023]
Abstract
AIM Patient suicide (PS) has been identified as a frequent and stressful "occupational hazard" for mental health professionals. Studies are needed to assess the impact on psychiatric trainees of the exposure to severe patient suicidal behaviours. METHODS Our cross-sectional study aimed to measure the prevalence of exposure to PS and severe patient suicide attempts (SPSA) in French psychiatric trainees. We also assessed the emotional, traumatic and professional impacts and perceived support in the aftermath through a 62-item online questionnaire that included the French version of the IES-R, a composite emotional score and questions about professional practice and perceived support. All French psychiatric trainees were contacted regarding participation in the study through email and social networks between November 2017 and March 2018. RESULTS A total of 409 trainees participated in the survey (response rate = 16.4%). 253 trainees fully completed the questionnaire. Of the 253 trainees, 43.2% were exposed to PS and 13.8% to SPSA. The exposure mostly occurred in the early stage of the training period. Ten to 15% of exposed trainees showed a high level of traumatic and emotional impact and 8.1% exhibited clinically relevant symptoms of post-traumatic stress disorder (PTSD). We found that 21.6% received no support in the aftermath, especially after PS. CONCLUSION A large proportion of psychiatric trainees encounter severe suicidal behaviours of patients, and a substantial part of them is highly impacted. Our results thus stress the need for programmes dedicated to the prevention of the deleterious effects of the exposure to PS or SPSA in psychiatric trainees.
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Affiliation(s)
- Edouard Leaune
- Center for Suicide Prevention, Centre Hospitalier Le Vinatier, Bron, France.,INSERM U1028, CNRS UMR5292, Claude Bernard Lyon 1 University, PSYR2 Team, Lyon Neuroscience Research Center, Lyon, France.,Philosophical Research Institute of Lyon, Jean Moulin Lyon 3 University, Lyon, France
| | | | - Hugo Noelle
- Center for Suicide Prevention, Centre Hospitalier Le Vinatier, Bron, France.,Lyon-EstSchool of Medicine, Claude Bernard Lyon 1 University, Villeurbanne, France
| | - Fabien Joubert
- Center for Suicide Prevention, Centre Hospitalier Le Vinatier, Bron, France
| | - Noémie Ravella
- Pôle 69G35, Hôpital Saint Cyr au Mont d'Or, Saint Cyr au Mont d'Or, France
| | - Julie Haesebaert
- Université Claude Bernard Lyon 1, EA 7425 HESPER Health Services and Performance Research-Claude Bernard Lyon 1 University, Université de Lyon, Lyon, France
| | - Emmanuel Poulet
- Center for Suicide Prevention, Centre Hospitalier Le Vinatier, Bron, France.,INSERM U1028, CNRS UMR5292, Claude Bernard Lyon 1 University, PSYR2 Team, Lyon Neuroscience Research Center, Lyon, France
| | - Nicolas Chauliac
- Center for Suicide Prevention, Centre Hospitalier Le Vinatier, Bron, France.,Université Claude Bernard Lyon 1, EA 7425 HESPER Health Services and Performance Research-Claude Bernard Lyon 1 University, Université de Lyon, Lyon, France
| | - Bruno Cuvillier
- Groupe d'Etude en Psychologie Sociale (GRePS), Lumière Lyon 2 University, Lyon, France
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17
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Sandford DM, Kirtley OJ, Thwaites R, O'Connor RC. The impact on mental health practitioners of the death of a patient by suicide: A systematic review. Clin Psychol Psychother 2020; 28:261-294. [DOI: 10.1002/cpp.2515] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/17/2020] [Accepted: 09/07/2020] [Indexed: 11/06/2022]
Affiliation(s)
- David M. Sandford
- First Step Lancashire and South Cumbria NHS Foundation Trust Cumbria UK
- Suicidal Behaviour Research Laboratory University of Glasgow Glasgow UK
| | | | - Richard Thwaites
- First Step Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust Cumbria UK
| | - Rory C. O'Connor
- Suicidal Behaviour Research Laboratory University of Glasgow Glasgow UK
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18
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Mental Health and Social Care Professionals After a Patient Suicide: Interrelation Between Support Needed, Sought, and Received. J Psychiatr Pract 2020; 26:263-272. [PMID: 32692123 DOI: 10.1097/pra.0000000000000477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article investigates the support needed, sought, and received by professionals following a patient suicide. A self-administered questionnaire about the consequences of patient suicide and support issues was completed by 704 professionals. Profiles of support were defined using a 3-dimensional, 8-fold typology based on need for, search for, and sufficiency of support. Stress reactions, professionals' characteristics, relationship with the patient, training, and providers of support were used to characterize the profiles. Most professionals acknowledged receiving sufficient support to manage the aftermath of patient suicide. Almost two thirds of the respondents who received sufficient support reported either not needing or seeking support or both needing and seeking support. Almost 1 in 10 respondents who reported needing and seeking support received insufficient support. Stress reactions were highest among professionals who needed but did not receive sufficient support. Professionals who did not need or seek support were less often in a relationship with the patient at the time of the suicide and less frequently felt close to or responsible for the patient than those who needed and sought support. Trained professionals were overrepresented among those who reported receiving sufficient support while they were less likely to report needing and seeking support or receiving insufficient support. Findings concerning support and its relationship to risk and protective factors suggest the need to adopt a multidimensional approach that distinguishes among support needed, sought, and received. Although an association may exist between perceived stress and need for support, involvement of professionals in the patient relationship may also be linked with the search for support, while training may be associated with receipt of sufficient support.
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19
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Abstract
BACKGROUND/AIM Patient suicide is an adversity that can be considered an "occupational hazard." It has been identified as one of the most stressful adverse events during psychiatric training. The aim of this study was to systematically review the literature assessing the impact of patient suicide on trainees. METHODS We conducted a systematic review on the MEDLINE, Science Direct, Scopus, and Web of Science databases. Studies that reported prevalence of patient suicide, quantitative or qualitative assessment of psychological and professional impacts, coping strategies, and support or educational and postvention programs were deemed eligible for inclusion. RESULTS Of the 1994 articles identified, 22 were included. The literature on the topic was scarce, and the quality of the studies was moderate. No article dealt with nonpsychiatric residents. During their training, 46.4% of psychiatric trainees encountered at least one patient suicide. The traumatic impact was significantly more intense in trainees compared to senior physicians. A negative impact on their professional practice was reported by 17% to 39% of trainees. Formal institutional support for the affected trainees was described as having major shortcomings, and informal support from peers and families was reported as the most helpful response. However, 52% of impacted trainees considered encountering patient suicide a useful and beneficial experience. CONCLUSION The frequent posttraumatic symptoms and the negative professional consequences following patient suicide are worrying phenomena that highlight the need to improve suicide prevention and postvention programs during psychiatric training. Identifying trainees with personal vulnerability factors should be a major concern during the postvention process.
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20
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Leaune E, Cuvillier B, Vieux M, Pacaut-Troncin M, Chalancon B, Perez AF, Haesebaert J, Chauliac N, Poulet E, Durif-Bruckert C. The SUPPORT-S Protocol Study: A Postvention Program for Professionals After Patient or User Suicide. Front Psychol 2020; 11:805. [PMID: 32431643 PMCID: PMC7217323 DOI: 10.3389/fpsyg.2020.00805] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/31/2020] [Indexed: 01/26/2023] Open
Abstract
Background Exposure to patient or user suicide (PUS) is identified as a challenging occupational hazard for mental health and social work professionals. Professionals exposed to PUS may encounter several ranges of emotional, traumatic or professional impacts in the aftermath. A high proportion of exposed professionals reports a lack of support in the aftermath of PUS. SUPPORT is a postvention program designed to provide a comprehensive, adaptative and effective support to professionals impacted by PUS. The aims of the SUPPORT-S study are to (1) improve the design of the SUPPORT program, (2) evaluate the effectiveness of the program to buffer the emotional, traumatic and professional impacts and to improve the perceived social support for professionals exposed to PUS, and (3) provide more insights into the consequences of PUS on both professionals and organizations. Method The SUPPORT-S study is a mixed method collaborative and participatory action research. The simultaneous and complementary collection and analysis of qualitative and quantitative data will offer an in-depth evaluation of the implementation and the effectiveness of the program. The qualitative evaluation includes: (a) an ethnographic observation; (b) 25 semi-directed interviews with randomized participants; (c) an activity analysis with providers of the program; and (d) collaborative sharing of the results with providers and participants. The quantitative evaluation includes pre- and post-measures in participants of: (a) emotional impact (Differential Emotions Scale IV); (b) traumatic impact (Impact of Event Scale-Revised); (c) professional impact (non-validated questionnaire); and (d) perceived social support (Perceived Social Support Scale for Professionals). The action research design will rely on: (a) the cycling process of implementation/evaluation/data sharing/adjustment and (b) the participatory approach through data sharing with providers and participants. Triangulation, saturation, randomization, and participatory design will also reduce the risk of biases and will improve the generalizability of conclusions. Expected Results We expect the SUPPORT-S study to evaluate and improve the design of the SUPPORT program to effectively help professionals to cope with PUS. Conclusion The results of the study will allow us to disseminate an effective and adaptive postvention program for professionals and institutions encountering PUS.
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Affiliation(s)
- Edouard Leaune
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR 5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response - PSYR2 Team, Lyon, France
| | - Bruno Cuvillier
- Groupe de Recherche en Psychologie Sociale, Lumière Lyon 2 University, Lyon, France
| | - Maxime Vieux
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France
| | | | - Benoît Chalancon
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France.,CNRS, UMR 5191, Interactions, Corpus, Apprentissages, Représentations, Ecole Normale Supérieure de Lyon, Lumière Lyon University, Lyon, France
| | - Anne-Fleur Perez
- Institut Régional Jean Bergeret, Centre Hospitalier Saint-Jean de Dieu, Lyon, France
| | - Julie Haesebaert
- EA 7425 HESPER Health Services and Performance Research - Claude Bernard Lyon 1 University, Lyon, France
| | - Nicolas Chauliac
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France.,EA 7425 HESPER Health Services and Performance Research - Claude Bernard Lyon 1 University, Lyon, France
| | - Emmanuel Poulet
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR 5292, Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response - PSYR2 Team, Lyon, France
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21
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22
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Affiliation(s)
- Amy M Yule
- The Pediatric Psychopharmacology Program, Division of Child Psychiatry, Massachusetts General Hospital, and the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Yule); New York State Psychiatric Institute, Division of Substance Abuse, and the Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (Levin)
| | - Frances R Levin
- The Pediatric Psychopharmacology Program, Division of Child Psychiatry, Massachusetts General Hospital, and the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Yule); New York State Psychiatric Institute, Division of Substance Abuse, and the Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (Levin)
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23
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Hultsjö S, Wärdig R, Rytterström P. The borderline between life and death. J Clin Nurs 2019; 28:1623-1632. [DOI: 10.1111/jocn.14754] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 11/15/2018] [Accepted: 12/05/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Sally Hultsjö
- Department of Psychiatry Ryhov County Council Jönköping Sweden
- Department of Medical and Health Sciences Linköping University Linköping Sweden
| | - Rikard Wärdig
- Department of Medical and Health Sciences Linköping University Linköping Sweden
| | - Patrik Rytterström
- Department of Medical and Health Sciences Linköping University Linköping Sweden
- Department of Social and Welfare StudiesLinköping University Linköping Sweden
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24
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Mokkenstorm JK, Kerkhof AJ, Smit JH, Beekman AT. Is It Rational to Pursue Zero Suicides Among Patients in Health Care? Suicide Life Threat Behav 2018; 48:745-754. [PMID: 29073324 PMCID: PMC6586166 DOI: 10.1111/sltb.12396] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 06/26/2017] [Indexed: 10/31/2022]
Abstract
Suicide prevention is a major health care responsibility in need of new perspectives. This study reviews Zero Suicide, an emerging approach to suicide prevention that embraces the aspirational goal of zero suicides among patients treated in health care systems or organizations. Zero Suicide is gaining international momentum while at the same time evoking objections and concerns. Fundamental to Zero Suicide is a multilevel system view on suicide prevention, with three core elements: a direct approach to suicidal behaviors; continual improvement of the quality and safety of care processes; and an organizational commitment to the aspirational goal of zero suicides. The rationale and evidence for these components are clarified and discussed against the backdrop of concerns and objections that focus on possible undesired consequences of the pursuit of zero suicide, in particular for clinicians and for those who are bereaved by suicide. It is concluded that it is rational to pursue zero suicides as an aspirational goal, provided the journey toward zero suicides is undertaken in a systemic and sustained manner, in a way that professionals feel supported, empowered, and protected against blame and inappropriate guilt.
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Affiliation(s)
- Jan K. Mokkenstorm
- Department of PsychiatryEMGO Institute for Health and Care ResearchVU University Medical CenterAmsterdamThe Netherlands
- Department of Research & InnovationGGZinGeestAmsterdamThe Netherlands
- 113 Suicide PreventionPaasheuvelweg 3AmsterdamThe Netherlands
| | - Ad J.F.M. Kerkhof
- Department of Clinical PsychologyEMGO Institute for Health and Care ResearchFaculty of Psychology and EducationVU UniversityAmsterdamThe Netherlands
| | - Johannes H. Smit
- Department of PsychiatryEMGO Institute for Health and Care ResearchVU University Medical CenterAmsterdamThe Netherlands
- Department of Research and InnovationGGZin‐GeestAmsterdamThe Netherlands
| | - Aartjan T.F. Beekman
- Department of PsychiatryEMGO Institute for Health and Care ResearchVU Medical Center/GGZinGeestAmsterdamThe Netherlands
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25
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Muñoz-Sánchez JL, Sánchez-Gómez MC, Martín-Cilleros MV, Parra-Vidales E, de Leo D, Franco-Martín MA. Addressing Suicide Risk According to Different Healthcare Professionals in Spain: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102117. [PMID: 30261622 PMCID: PMC6210587 DOI: 10.3390/ijerph15102117] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 09/21/2018] [Accepted: 09/23/2018] [Indexed: 12/25/2022]
Abstract
This study analyzes the views of four groups of healthcare professionals who may play a role in the management of suicidal behavior. The goal was to identify key factors for suicide prevention in different areas of the healthcare system. Qualitative research was conducted using focus groups made up of different healthcare professionals who participated in the identification, management, and prevention of suicidal behavior. Professionals included were primary care physicians, psychologists, psychiatrists, and emergency physicians. 'Suicide' was amongst the most relevant terms that came up in discussions most of the times it appeared associated with words such as 'risk', danger', or 'harm'. In the analysis by categories, the four groups of professionals agreed that interventions in at-risk behaviors are first in importance. Prevention was the second main concern with greater significance among psychiatrists. Primary care professionals call for more time to address patients at risk for suicide and easier access to and communication with the mental health network. Emergency care professionals have a lack of awareness of their role in the detection of risk for suicide in patients who seek attention at emergency care facilities for reasons of general somatic issues. Mental health care professionals are in high demand in cases of self-harm, but they would like to receive specific training in dealing with suicidal behavior.
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Affiliation(s)
- Juan-Luis Muñoz-Sánchez
- Psychiatry and Mental Health Department, Hospital Universitario Río Hortega, C/ Dulzaina, 2, 47012 Valladolid, Spain.
| | - María Cruz Sánchez-Gómez
- Departamento de Didáctica, Organización y Métodos de Investigación, Facultad de Educación, Universidad de Salamanca, Paseo de Canalejas 169, 37008 Salamanca, Spain.
| | - María Victoria Martín-Cilleros
- Departamento de Didáctica, Organización y Métodos de Investigación, Facultad de Educación, Universidad de Salamanca, Paseo de Canalejas 169, 37008 Salamanca, Spain.
| | | | - Diego de Leo
- Australian Institute for Suicide Research and Prevention, Griffith University, Mt Gravatt Campus, Mount Gravatt, QLD 4122, Australia.
| | - Manuel A Franco-Martín
- Psychiatry and Mental Health Department, Hospital Universitario Río Hortega, C/ Dulzaina, 2, 47012 Valladolid, Spain.
- Departamento de Personalidad, Evaluación y Tratamiento psicológico, Facultad de Psicología, Universidad de Salamanca, Campus Ciudad Jardín, 37005 Salamanca, Spain.
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