Skip to main content Accessibility help
×
Home

The impact of service user’s suicide on mental health professionals

  • P. T. Murphy (a1) (a2) (a3), L. Clogher (a2), A. van Laar (a4), R. O’Regan (a5), S. McManus (a2), A. McIntyre (a3), A. O’Connell (a2), M. Geraghty (a3), G. Henry (a3) and B. Hallahan (a3) (a6)...

Abstract

Objectives

Our principle objective was to examine the personal and professional impact of service user (SU) suicide on mental health professionals (MHPs). We also wished to explore putative demographic or clinical factors relating to SUs or MPHs that could influence the impact of SU suicide for MHPs and explore factors MHPs report as helpful in reducing distress following SU suicide.

Methods

A mixed-method questionnaire with quantitative and thematic analysis was utilised.

Results

Quantitative data indicated SU suicide was associated with personal and professional distress with sadness (79.5%), shock (74.5%) and surprise (68.7%) particularly evident with these phenomena lasting less than a year for more than 90% of MHPs. MHPs also reported guilt, reduced self-confidence and a fear of negative publicity. Thematic analysis indicated that some MHPs had greater expertise when addressing SU suicidal ideation and in supporting colleagues after experiencing a SU suicide. Only 17.7% of MHPs were offered formal support following SU suicide.

Conclusion

SU suicide impacts MHPs personally and professionally in both a positive and negative fashion. A culture and clear pathway of formal support for MHPs to ascertain the most appropriate individualised support dependent on the distress they experience following SU suicide would be optimal.

Copyright

Corresponding author

*Address for correspondence: Dr Peter T. Murphy, Galway Mental Health Service, HSE West, Health Centre and Day Hospital, Brackernagh, Ballinasloe, Galway, H53 R658, Ireland. (Email: peter.murphy2@hse.ie)

References

Hide All
Alexander, DA, Klein, S, Gray, NM, Dewar, IG, Eagles, JM (2000). Suicide by patients: questionnaire study of its effect on consultant psychiatrists. BMJ: British Medical Journal 320, 15711574.
Appleby, L, Kapur, N, Shaw, J, Windfuhr, K, Williams, A, Hunt, IM, While, D, Flynn, S (2014). The national confidential inquiry into suicide and homicide by people with mental illness. Annual report: England, Northern Ireland, Scotland and Wales. July 2014. University of Manchester: Manchester (http://www.bbmh.manchester.ac.uk/cmhr/centreforsuicideprevention/nci/reports/AnnualReport2013_UK.pdf). Accessed 20 August 2015.
Awenat, Y, Peters, S, Shaw-Nunez, E, Gooding, P, Pratt, D, Haddock, G (2017). Staff experiences and perceptions of working with in-patients who are suicidal: qualitative analysis. The British Journal of Psychiatry 211, 103108.
Bohan, F, Doyle, L (2008). Nurses’ experiences of patient suicide and suicide attempts in an acute unit. Mental Health Practice 11, 1216.
Branson, DC (2018). Vicarious trauma, themes in research, and terminology: a review of literature. Traumatology, Online First Publicaton, 16 July 2018. http://dx.doi.org/10.1037/trm0000161.
Braun, V, Clarke, V (2006). Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77101.
Casey, P, Gemmell, I, Hiroeh, U, Fulwood, C (2012). Seasonal and socio-demographic predictors of suicide in Ireland: a 22 year study. Journal of Affective Disorders 136, 862867.
Castelli Dransart, DA, Gutjahr, E, Gulfi, A, Kaufmann Didisheim, N, Séguin, M (2014). Patient suicide in institutions: emotional responses and traumatic impact on Swiss mental health professionals. Death Studies 38, 315321.
Central Statistics Office (2016). Vital statistics yearly summary 2016 ( http://www.cso.ie/en/releasesandpublications/ep/p-vsys/vitalstatisticsyearlysummary2016/).
Chemtob, CM, Hamada, RS, Bauer, G, Torigoe, RY, Kinney, B (1988). Patient suicide: frequency and impact on psychologists. Professional Psychology: Research and Practice 19, 416420.
Cryan, EMJ, Kelly, P, McCaffrey, B (1995). The experience of patient suicide among Irish psychiatrists. Psychiatric Bulletin 19, 47.
Darden, AJ, Rutter, PA (2011). Psychologists’ experiences of grief after client suicide: a qualitative study. OMEGA – Journal of Death and Dying 63, 317342.
Dewar, IG, Eagles, JM, Klein, S, Gray, N, Alexander, DA (2000). Psychiatric trainees’ experiences of, and reactions to, patient suicide. The Psychiatrist 24, 2023.
Fairman, N, Thomas, LP, Whitmore, S, Meier, EA, Irwin, SA (2014). What did I miss? A qualitative assessment of the impact of patient suicide on hospice clinical staff. Journal of Palliative Medicine 17, 832836.
Figley, CR (2002). Compassion fatigue: psychotherapists’ chronic lack of self care. Journal of Clinical Psychology 58, 14331441.
Gaffney, P, Russell, V, Collins, K, Bergin, A, Halligan, P, Carey, C, Coyle, S (2009). Impact of patient suicide on front-line staff in Ireland. Death Studies 33, 639656.
Georgieva, I, Bainbridge, E, McGuinness, D, Keys, M, Brosnan, L, Felzmann, H, Maguire, J, Murphy, K, Higgins, A, McDonald, C, Hallahan, B (2017). Opinions of key stakeholders concerning involuntary admission of patients under the Mental Health Act 2001. Irish Journal of Psychological Medicine 34, 223232.
Grad, OT, Zavasnik, A, Groleger, U (1997). Suicide of a patient: gender differences in bereavement reactions of therapists. Suicide and Life-Threatening Behavior 27, 379386.
Gulfi, A, Castelli Dransart, DA, Heeb, J-L, Gutjahr, E (2010). The impact of patient suicide on the professional reactions and practices of mental health caregivers and social workers. Crisis: The Journal of Crisis Intervention and Suicide Prevention 31, 202210.
Gulfi, A, Castelli Dransart, DA, Heeb, J-L, Gutjahr, E (2016). The impact of patient suicide on the professional practice of Swiss psychiatrists and psychologists. Academic Psychiatry 40, 1322.
Halligan, P, Corcoran, P (2001). The impact of patient suicide on rural general practitioners. British Journal of General Practice 51, 295296.
Hawker, DM, Durkin, J, Hawker, DSJ (2011). To debrief or not to debrief our heroes: that is the question. Clinical Psychology & Psychotherapy 18, 453463.
Hendin, H, Haas, AP, Maltsberger, JT, Szanto, K, Rabinowicz, H (2004). Factors contributing to therapists’ distress after the suicide of a patient. American Journal of Psychiatry 161, 14421446.
Hepp, U, Ring, M, Frei, A, Rossler, W, Schnyder, U, Ajdacic-Gross, V (2010). Suicide trends diverge by method: Swiss suicide rates 1969-2005. European Psychiatry 25, 129135.
Hirokawa, S, Matsumoto, T, Katsumata, Y, Kitani, M, Akazawa, M, Takahashi, Y, Kawakami, N, Watanabe, N, Hirayama, M, Kameyama, A, Takeshima, T (2012). Psychosocial and psychiatric characteristics of suicide completers with psychiatric treatment before death: a psychological autopsy study of 76 cases. Psychiatry and Clinical Neurosciences 66, 292302.
Hubbard, GB, Beeber, L, Eves, E (2017). Secondary traumatization in psychiatric mental health nurses: validation of five key concepts. Perspectives in Psychiatric Care 53, 119126.
Kendall, K, Wiles, R (2010). Resisting blame and managing emotion in general practice: the case of patient suicide. Social Science & Medicine 70, 17141720.
Kielty, J, van Laar, A, Davoren, M, Conlon, L, Hillick, A, McDonald, C, Hallahan, B (2014). Psychiatric and psycho-social characteristics of suicide completers: a comprehensive evaluation of psychiatric case records and postmortem findings. Irish Journal of Psychological Medicine 32, 167176.
Killian, K, Hernandez-Wolfe, P, Engstrom, D, Gangsei, D (2017). Development of the Vicarious Resilience Scale (VRS): a measure of positive effects of working with trauma survivors. Psychological Trauma: Theory, Research, Practice and Policy 9, 2331.
Landers, A, O’Brien, S, Phelan, D (2010). Impact of patient suicide on consultant psychiatrists in Ireland. The Psychiatrist 34, 136140.
Lin, JJ, Chang, SS, Lu, TH (2010). The leading methods of suicide in Taiwan, 2002–2008. BMC public health 10, 480.
Linehan, MM (2015). DBT Skills Manual: All Teaching Notes. The Guilford Press: New York.
Linke, S, Wojciak, J, Day, S (2002). The impact of suicide on community mental health teams: findings and recommendations. Psychiatric Bulletin 26, 5052.
Luoma, JB, Martin, CE, Pearson, JL (2002). Contact with mental health and primary care providers before suicide: a review of the evidence. American Journal of Psychiatry 159, 909916.
Madsen, T, Erlangsen, A, Nordentoft, M (2017). Risk estimates and risk factors related to psychiatric inpatient suicide-an overview. International Journal of Environmental Research and Public Health 14, 253.
Mendes, A (2015). Coping with patient suicide and psychological debrief for nurses. British Journal of Nursing 24, 745745.
Newell, JM, MacNeil, GA (2010). Professional burnout, vicarious trauma, secondary traumatic stress, and compassion fatigue. Best Practices in Mental Health 6, 5768.
Pilkinton, P, Etkin, M (2003). Encountering suicide: the experience of psychiatric residents. Academic Psychiatry 27, 9399.
Qin, P, Nordentoft, M (2005). Suicide risk in relation to psychiatric hospitalization: evidence based on longitudinal registers. Archives of general psychiatry 62, 427432.
Qin, P, Nordentoft, M, Hoyer, EH, Agerbo, E, Laursen, TM, Mortensen, PB (2006). Trends in suicide risk associated with hospitalized psychiatric illness: a case-control study based on Danish longitudinal registers. Journal of Clinical Psychiatry 67, 19361941.
Reutfors, J, Brandt, L, Ekbom, A, Isacsson, G, Sparén, P, Ösby, U (2010). Suicide and hospitalization for mental disorders in Sweden: a population-based case-control study. Journal of Psychiatric Research 44, 741747.
Rothes, IA, Scheerder, G, Van Audenhove, C, Henriques, MR (2013). Patient suicide: the experience of Flemish psychiatrists. Suicide and Life-Threatening Behavior 43, 379394.
Sanders, S, Jacobson, J, Ting, L (2005). Reactions of mental health social workers following a client suicide completion: a qualitative investigation. OMEGA-Journal of Death and Dying 51, 197216.
Sansbury, BS, Graves, K, Scott, W (2015). Managing traumatic stress responses among clinicians: individual and organizational tools for self-care. Trauma 17, 114122.
Takahashi, C, Chida, F, Nakamura, H, Akasaka, H, Yagi, J, Koeda, A, Takusari, E, Otsuka, K, Sakai, A (2011). The impact of inpatient suicide on psychiatric nurses and their need for support. BMC Psychiatry 11, 38.
Trimble, L, Jackson, K, Harvey, D (2000). Client suicidal behaviour: impact, interventions, and implications for psychologists. Australian Psychologist 35, 227232.
Tuckey, MR (2007). Issues in the debriefing debate for the emergency services: moving research outcomes forward. Clinical Psychology: Science and Practice 14, 106116.
Tuckey, MR, Scott, JE (2014). Group critical incident stress debriefing with emergency services personnel: a randomized controlled trial. Anxiety, Stress, & Coping 27, 3854.
Walsh, G, Sara, G, Ryan, C, Large, M (2015). Meta‐analysis of suicide rates among psychiatric in‐patients. Acta psychiatrica Scandinavica 131, 174184.
Wessely, S, Deahl, M (2003). Psychological debriefing is a waste of time. The British Journal of Psychiatry 183, 1214.
World Health Organisation (2017). Mental health: suicide data (http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/).
Wurst, FM, Kunz, I, Skipper, G, Wolfersdorf, M, Bein, KH, Thon, N (2011). The therapist’s reaction to a patient’s suicide: results of a survey and implicationsfor health care professionals’well-being. Crisis 32, 99105.
Wurst, FM, Kunz, I, Skipper, G, Wolfersdorf, M, Beine, KH, Vogel, R, Müller, S, Petitjean, S, Thon, N (2013). How therapists react to patient’s suicide: findings and consequences for health care professionals’ wellbeing. General Hospital Psychiatry 35, 565570.
Wurst, FM, Müeller, S, Petitjean, S, Euler, S, Thon, N, Wiesbeck, G, Wolfersdorf, M (2010). Patient suicide: a survey of therapists’ reactions. Suicide and Life-Threatening Behavior 40, 328336.
Yousaf, F, Hawthorne, M, Sedgwick, P (2002). Impact of patient suicide on psychiatric trainees. The Psychiatrist 26, 5355.

Keywords

Type Description Title
WORD
Supplementary materials

Murphy et al. supplementary material
Table S6

 Word (18 KB)
18 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed