Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-08T10:31:40.622Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  19 February 2019

P. T. Murphy Open the ORCID record for P. T. Murphy [Opens in a new window] ,
L. Clogher ,
A. van Laar ,
R. O’Regan ,
S. McManus ,
A. McIntyre ,
A. O’Connell ,
M. Geraghty ,
G. Henry  and
B. Hallahan
P. T. Murphy*
Affiliation:
Galway Mental Health Service, HSE West, Health Centre, Brackernagh, Ballinasloe, Galway, Ireland Department of Psychology, HSE West, Merlin Park University Hospital, Galway, Ireland Department of Psychiatry, University Hospital Galway, Galway, Ireland
L. Clogher
Affiliation:
Department of Psychology, HSE West, Merlin Park University Hospital, Galway, Ireland
A. van Laar
Affiliation:
Department of Liaison Psychiatry, University Hospital Galway, Galway, Ireland
R. O’Regan
Affiliation:
Child and Adolescent Mental Health Services, Inpatient Unit, Merlin Park Hospital Galway, Galway, Ireland
S. McManus
Affiliation:
Department of Psychology, HSE West, Merlin Park University Hospital, Galway, Ireland
A. McIntyre
Affiliation:
Department of Psychiatry, University Hospital Galway, Galway, Ireland
A. O’Connell
Affiliation:
Department of Psychology, HSE West, Merlin Park University Hospital, Galway, Ireland
M. Geraghty
Affiliation:
Department of Psychiatry, University Hospital Galway, Galway, Ireland
G. Henry
Affiliation:
Department of Psychiatry, University Hospital Galway, Galway, Ireland
B. Hallahan
Affiliation:
Department of Psychiatry, University Hospital Galway, Galway, Ireland School of Medicine, National University of Ireland Galway, Galway, Ireland
*
*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: [email protected])
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

Impact on mental health professionalmental health professionalservice user suicidesuicidethematic analysis
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 39 , Issue 1 , March 2022 , pp. 74 - 84
Copyright
© The Author(s), 2019. Published by Cambridge University Press on behalf of The College of Psychiatrists of Ireland

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

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, 1571–1574.10.1136/bmj.320.7249.1571CrossRefGoogle ScholarPubMed
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.Google Scholar
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, 103–108.10.1192/bjp.bp.116.191817CrossRefGoogle ScholarPubMed
Bohan, F, Doyle, L (2008). Nurses’ experiences of patient suicide and suicide attempts in an acute unit. Mental Health Practice 11, 12–16.10.7748/mhp2008.02.11.5.12.c6338CrossRefGoogle Scholar
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.CrossRefGoogle Scholar
Braun, V, Clarke, V (2006). Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77–101.10.1191/1478088706qp063oaCrossRefGoogle Scholar
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, 862–867.10.1016/j.jad.2011.09.020CrossRefGoogle ScholarPubMed
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, 315–321.10.1080/07481187.2013.766651CrossRefGoogle Scholar
Central Statistics Office (2016). Vital statistics yearly summary 2016 ( http://www.cso.ie/en/releasesandpublications/ep/p-vsys/vitalstatisticsyearlysummary2016/).Google Scholar
Chemtob, CM, Hamada, RS, Bauer, G, Torigoe, RY, Kinney, B (1988). Patient suicide: frequency and impact on psychologists. Professional Psychology: Research and Practice 19, 416–420.10.1037/0735-7028.19.4.416CrossRefGoogle Scholar
Cryan, EMJ, Kelly, P, McCaffrey, B (1995). The experience of patient suicide among Irish psychiatrists. Psychiatric Bulletin 19, 4–7.10.1192/pb.19.1.4CrossRefGoogle Scholar
Darden, AJ, Rutter, PA (2011). Psychologists’ experiences of grief after client suicide: a qualitative study. OMEGA – Journal of Death and Dying 63, 317–342.CrossRefGoogle ScholarPubMed
Dewar, IG, Eagles, JM, Klein, S, Gray, N, Alexander, DA (2000). Psychiatric trainees’ experiences of, and reactions to, patient suicide. The Psychiatrist 24, 20–23.Google Scholar
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, 832–836.10.1089/jpm.2013.0391CrossRefGoogle Scholar
Figley, CR (2002). Compassion fatigue: psychotherapists’ chronic lack of self care. Journal of Clinical Psychology 58, 1433–1441.10.1002/jclp.10090CrossRefGoogle ScholarPubMed
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, 639–656.10.1080/07481180903011990CrossRefGoogle ScholarPubMed
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, 223–232.10.1017/ipm.2016.6CrossRefGoogle ScholarPubMed
Grad, OT, Zavasnik, A, Groleger, U (1997). Suicide of a patient: gender differences in bereavement reactions of therapists. Suicide and Life-Threatening Behavior 27, 379–386.Google ScholarPubMed
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, 202–210.10.1027/0027-5910/a000027CrossRefGoogle ScholarPubMed
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, 13–22.10.1007/s40596-014-0267-8CrossRefGoogle ScholarPubMed
Halligan, P, Corcoran, P (2001). The impact of patient suicide on rural general practitioners. British Journal of General Practice 51, 295–296.Google ScholarPubMed
Hawker, DM, Durkin, J, Hawker, DSJ (2011). To debrief or not to debrief our heroes: that is the question. Clinical Psychology & Psychotherapy 18, 453–463.CrossRefGoogle ScholarPubMed
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, 1442–1446.CrossRefGoogle ScholarPubMed
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, 129–135.10.1016/j.eurpsy.2009.05.005CrossRefGoogle ScholarPubMed
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, 292–302.10.1111/j.1440-1819.2012.02343.xCrossRefGoogle ScholarPubMed
Hubbard, GB, Beeber, L, Eves, E (2017). Secondary traumatization in psychiatric mental health nurses: validation of five key concepts. Perspectives in Psychiatric Care 53, 119–126.10.1111/ppc.12145CrossRefGoogle ScholarPubMed
Kendall, K, Wiles, R (2010). Resisting blame and managing emotion in general practice: the case of patient suicide. Social Science & Medicine 70, 1714–1720.CrossRefGoogle ScholarPubMed
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, 167–176.10.1017/ipm.2014.47CrossRefGoogle Scholar
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, 23–31.10.1037/tra0000199CrossRefGoogle ScholarPubMed
Landers, A, O’Brien, S, Phelan, D (2010). Impact of patient suicide on consultant psychiatrists in Ireland. The Psychiatrist 34, 136–140.10.1192/pb.bp.109.025312CrossRefGoogle Scholar
Lin, JJ, Chang, SS, Lu, TH (2010). The leading methods of suicide in Taiwan, 2002–2008. BMC public health 10, 480.CrossRefGoogle Scholar
Linehan, MM (2015). DBT Skills Manual: All Teaching Notes. The Guilford Press: New York.Google Scholar
Linke, S, Wojciak, J, Day, S (2002). The impact of suicide on community mental health teams: findings and recommendations. Psychiatric Bulletin 26, 50–52.10.1192/pb.26.2.50CrossRefGoogle Scholar
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, 909–916.10.1176/appi.ajp.159.6.909CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed
Mendes, A (2015). Coping with patient suicide and psychological debrief for nurses. British Journal of Nursing 24, 745–745.10.12968/bjon.2015.24.14.745CrossRefGoogle ScholarPubMed
Newell, JM, MacNeil, GA (2010). Professional burnout, vicarious trauma, secondary traumatic stress, and compassion fatigue. Best Practices in Mental Health 6, 57–68.Google Scholar
Pilkinton, P, Etkin, M (2003). Encountering suicide: the experience of psychiatric residents. Academic Psychiatry 27, 93–99.10.1176/appi.ap.27.2.93CrossRefGoogle ScholarPubMed
Qin, P, Nordentoft, M (2005). Suicide risk in relation to psychiatric hospitalization: evidence based on longitudinal registers. Archives of general psychiatry 62, 427–432.10.1001/archpsyc.62.4.427CrossRefGoogle ScholarPubMed
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, 1936–1941.CrossRefGoogle ScholarPubMed
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, 741–747.CrossRefGoogle ScholarPubMed
Rothes, IA, Scheerder, G, Van Audenhove, C, Henriques, MR (2013). Patient suicide: the experience of Flemish psychiatrists. Suicide and Life-Threatening Behavior 43, 379–394.10.1111/sltb.12024CrossRefGoogle ScholarPubMed
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, 197–216.10.2190/D3KH-EBX6-Y70P-TUGNCrossRefGoogle Scholar
Sansbury, BS, Graves, K, Scott, W (2015). Managing traumatic stress responses among clinicians: individual and organizational tools for self-care. Trauma 17, 114–122.10.1177/1460408614551978CrossRefGoogle Scholar
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, 38.10.1186/1471-244X-11-38CrossRefGoogle ScholarPubMed
Trimble, L, Jackson, K, Harvey, D (2000). Client suicidal behaviour: impact, interventions, and implications for psychologists. Australian Psychologist 35, 227–232.CrossRefGoogle Scholar
Tuckey, MR (2007). Issues in the debriefing debate for the emergency services: moving research outcomes forward. Clinical Psychology: Science and Practice 14, 106–116.Google Scholar
Tuckey, MR, Scott, JE (2014). Group critical incident stress debriefing with emergency services personnel: a randomized controlled trial. Anxiety, Stress, & Coping 27, 38–54.10.1080/10615806.2013.809421CrossRefGoogle ScholarPubMed
Walsh, G, Sara, G, Ryan, C, Large, M (2015). Meta‐analysis of suicide rates among psychiatric in‐patients. Acta psychiatrica Scandinavica 131, 174–184.10.1111/acps.12383CrossRefGoogle ScholarPubMed
Wessely, S, Deahl, M (2003). Psychological debriefing is a waste of time. The British Journal of Psychiatry 183, 12–14.CrossRefGoogle ScholarPubMed
World Health Organisation (2017). Mental health: suicide data (http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/).Google Scholar
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, 99–105.10.1027/0227-5910/a000062CrossRefGoogle ScholarPubMed
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, 565–570.10.1016/j.genhosppsych.2013.05.003CrossRefGoogle ScholarPubMed
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, 328–336.10.1521/suli.2010.40.4.328CrossRefGoogle ScholarPubMed
Yousaf, F, Hawthorne, M, Sedgwick, P (2002). Impact of patient suicide on psychiatric trainees. The Psychiatrist 26, 53–55.Google Scholar
Supplementary material: File

Murphy et al. supplementary material

Table S6

Download Murphy et al. supplementary material(File)
File 18.3 KB