The Effect of Suicide and Homicide on Clinicians & Those Left Behind: A Survey of Current Experiences and Improvement of Practice

Abstract

Aims

Experiencing the death of a patient by suicide can be incredibly difficult, often associated with feelings of guilt and isolation, as doctors can hold themselves responsible. Most psychiatrists will be involved in a suicide/homicide on at least one occasion. This can lead to a variety of emotions and impact on clinical practice. The process of investigation can add to the overall stress of the incident and exacerbate the fear of legal retribution. Lack of support and understanding by an organisation may result in fewer discharges and increased defensive practice. Aimed at reviewing how supported involved clinicians feel following a serious untoward incident (SUI), including a suicide/homicide and consider improvement methods.

Methods

A webinar was organised with a guest speaker from Royal College of Psychiatrists, Dr Rachel Gibbons. Medical students and doctors across all grades were invited with 99 people in attendance. Anonymous feedback was received through survey monkey and analysed.

Results

55 respondents found the seminar either extremely or very helpful. 40 respondents wanted to attend a similar future webinar. Of the 57 respondents, 36.8% (n=21) had been involved in an SUI during their medical career. 16 respondents (48.8%) had been involved in a suicide or homicide. Roughly a third of doctors felt supported by colleagues during an SUI and 21% felt they were not supported. In comparison, only 17% felt they were well supported by the Trust and 25% felt they were not well supported by the Trust. The bulk of respondents indicated that family/friends and colleagues were the most helpful support mechanisms. Others found defence unions, Trust support and counselling helpful. Respondents found out about the SUI in the following ways: from another team member or colleague (52%), manager/supervisor (22%), Trust investigation team (22%) and reading patient notes (13%). A third were dissatisfied with the way the found out. Finding out from managers/supervisors is preferable. A limitation to interpreting the results is that there were more responses to questions than those involved in a suicide/homicide.

Conclusion

This webinar was well received and indicated that clinicians preferred to find out about an SUI in a controlled and supportive environment. It appears that the most helpful support came from family, friends and colleagues which suggests that the Trust could be doing more. Our recommendations included to raise awareness on the trusts new People Well-being lead and other resources available locally and nationally, while ensuring adequate senior pastoral support and encourage buddying systems.