Dealing With Suicide on a Psychiatric Inpatient Unit

Cotton, Paul; Drake, Robert E.; Whitaker, Anne; Potter, Jan

doi:10.1176/ps.34.1.55

Cited by 36 publications

(47 citation statements)

References 11 publications

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“…Les réactions fluctuent en fonction de plusieurs facteurs, dont l'expérience clinique du thérapeute, sa personnalité et ses zones de conflits internes, la nature du lien thérapeutique établi avec le patient et le degré d'ambivalence dans cette relation, les éléments contextuels au décès incluant les réactions négatives de l'institution, les poursuites légales, les réactions hostiles de la famille du patient décédé, les événe-ments de vie stressants vécus par le professionnel au moment du suicide, ainsi que le soutien social obtenu Chemtob et al, 1988a ;Cotton et al, 1983 ;Cryan et al, 1995 ;Dewar et al, 2000 ;Goodman, 1995 ;Hendin L'impact du suicide d'un patient chez des professionnels en santé mentale Différences entre les femmes et les hommes Henry et al, 2003 ;Horn, 1995 ;Howard, 2000 ;Kleespies et al, 1990 ;1993 ;Lapp, 1986 ;M. A.ams et Foster, 2000 ;Tillman, 2006 ;Trimble et al, 2000).…”

Section: Résuméunclassified

L’impact du suicide d’un patient chez des professionnels en santé mentale

Henry

Séguin

Drouin

2009

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Résumé Cet article rapporte les résultats d’une recherche réalisée auprès de 141 professionnels en santé mentale pratiquant au Québec et ayant vécu le suicide d’un patient. Les professionnels ont réagi à cet événement différemment en fonction de leur sexe. Les femmes y ont répondu par un niveau de stress élevé au cours du premier mois, alors que les hommes ont dévoilé un niveau de stress faible. Le niveau élevé de stress relevé chez les femmes était accompagné de répercussions initialement plus intenses sur leur pratique professionnelle : tendance accrue à hospitaliser des patients suicidaires ou précautions accrues dans leur traitement, évaluation d’un plus grand nombre de patients comme présentant un risque de suicide, sentiment accru d’impuissance lors de l’évaluation ou du traitement de patients suicidaires, consultation plus fréquente de collègues et de superviseurs, attention accrue aux aspects légaux dans la pratique. L’article tente de mieux comprendre les différences entre les réactions des professionnels observées selon leur sexe, à la lumière des théories de la socialisation et du développement professionnel.

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Section: Résuméunclassified

L’impact du suicide d’un patient chez des professionnels en santé mentale

Henry

Séguin

Drouin

2009

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“…Ideally this should encourage learning from the experience. Cotton et al (1983) has suggested support is best provided in a group setting where it can have an important role in cementing a team and preventing the genesis of maladaptive and immature coping strategies. This might be useful for trainees who, by the transient nature of their work attachments, may be regarded as uniquely vulnerable.…”

Section: Commentsmentioning

confidence: 99%

The experience of patient suicide among trainees in psychiatry

Courtenay¹,

Stephens²

2001

Psychiatr. bull.

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“…Many psychiatric residents were included in this experience along with innumerable staff of other disciplines. The impact of any given suicide on staff varies, but the overall distress engendered may be substantive (44)(45)(46)(47)(48)(49). It is hypothesized that the distribution of suicide cases among attending physicians reflects both the length oftheir hospital appointment and their degree of exposure to high-risk case loads (that is, inpatients, those with schizophrenia, and those with severe affective disorders).…”

Section: Methodsmentioning

confidence: 99%

The Clarke Institute Experience with Completed Suicide: 1966 to 1997

Martin

2000

Can J Psychiatry

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Suicide as a cause ofdeath is one ofthe eventual outcomes ofmental illness, and the estimated risk ofsuicide for specific disorders is substantial, ranging from 4% to 10% for schizophrenia and up to 15% for severe affective disorders (1-6). The prevalence ofmental disorder in cases ofsuicide is 80% to 90% or higher (7-11). As a generalization, almost every substance abuse and severe mental disorder carries an increased risk of suicide (12,13). It will, therefore, inevitably be a cause of death in the caseload of every facility involved in the care of patients with serious mental illness.Not unexpectedly, then, the reported suicide rates for psychiatric caseloads are higher than those for general populations. An overview of the literature presents rates for both individual hospitals and groups ofhospitals over different time periods from the 19th century to 1985 (14). The more contemporary studies from 1950 on indicate a wide range in suicide rates. The cumulative rates for studies lasting from 3 to 21 years range from 79 to 684 per 100 000 patients treated or admitted; the rates for 5-year periods ranged from 35 to 629. The annual rates (in studies lasting 8 to 20 years) ranged from 49.6 to 208 per 100 000 patients. For schizophrenia alone, rates of 167, 411, and 456 per 100 000 patients have been reported (15)(16)(17). In several studies, these high rates are extrapolations from small numbers of actual suicide cases. Recent reports of inpatient suicide at Canadian hospitals do not cite the rates for registered patients at risk (18)(19)(20).Although inevitable and not uncommon within hospital caseloads, the occurrence of a suicide is generally very distressing to staff-often more so than a death from natural causes. To address both staffconcerns and more general quality assurance issues, many facilities conduct mandatory reviews ofall suicides in their caseloads. Such audits, including those conducted at the Clarke Institute, may address more than do traditional psychological autopsies, answering why the person died, what was the cause of death, and whether it was a suicide (21).The primary purpose of this report is to describe the experience with suicide in over 100 000 patients at a single psychiatric facility over a period ofmore than 30 years. The secondary purpose is to present an overview ofrecommendations made pursuant to audits of the documentation, management, and post-suicide response for each case. Although data on part of this caseload have been published previously (22,23), this is the first report of the entire cumulative experience with

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Dealing With Suicide on a Psychiatric Inpatient Unit

Cited by 36 publications

References 11 publications

L’impact du suicide d’un patient chez des professionnels en santé mentale

L’impact du suicide d’un patient chez des professionnels en santé mentale

The experience of patient suicide among trainees in psychiatry

The Clarke Institute Experience with Completed Suicide: 1966 to 1997

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