Impact of patient suicide on psychiatric trainees

Abstract

Aims and MethodA survey of 89 psychiatric trainees in a regional rotational training scheme was carried out to investigate the impact immediately after a patient's suicide and at the time of the study. Main outcome measures used were the Impact of Events Scale and a rating scale of the impact on personal and professional life.ResultsTwenty-three trainees out of 53 who returned questionnaires reported at least one suicide. Initial reactions included shock, self-blame, guilt, grief and fear of negligence. Impact on personal and professional life was moderately severe. Over half of the trainees were ‘clinically stressed’ in the immediate aftermath, with no statistically significant reduction overtime.Clinical ImplicationsThe impact of a patient suicide can be profound. It can be experienced as a stressful event but can also lead to positive changes in clinical practice. Greater availability of training and support as well as further research in this area are recommended.

When a patient dies by suicide: incidence, implications and coping strategies

“…Fifteen per cent of consultants considered taking early retirement as a result of patient suicide. Yousaf et al (2002) found that 52% of the psychiatric trainees in their study who had experienced patient suicide had signs of clinical stress in the aftermath of the event and 29% remained clinically stressed despite the passage of time. Courtenay & Stephens (2001) found that 51% of their psychiatric trainees reported a moderate emotional impact after a patient suicide and 24% reported a severe emotional impact.…”

“…Courtenay & Stephens (2001) found that 51% of their psychiatric trainees reported a moderate emotional impact after a patient suicide and 24% reported a severe emotional impact. Chemtob et al (1988), Gitlin (1999), Alexander et al (2000), Dewar et al (2000), Courtenay & Stephens (2001), Yousaf et al (2002) Dewar et al (2000) likewise reported significant effects on psychiatric trainees following patient suicide: 31% reported an adverse effect on their personal lives and 39% an adverse effect on their work. In addition, 9% considered a change of career in the aftermath of patient suicide.…”

“…Of the 203 who responded, 54% reported experiencing at least one patient suicide; of this group, 39% had experienced more than one, and the total number of suicides experienced ranged from one to seven. Yousaf et al (2002) contacted 89 psychiatric trainees in the UK and found that 43% of the 53 respondents had already experienced one or more patient suicides.…”

“…This initiative was informed by a literature review that clearly indicated, as outlined above, that: (a) the most valued support following patient suicide comes from contacts with consultants and other team members, as well as family and friends; and (b) many psychiatrists identify a need for training programmes and formal systems of support to complement informal support in addressing the issues raised by patient suicide (Chemtob et al, 1988;Gitlin, 1999;Dewar et al, 2000;Courtenay & Stephens, 2001;Yousaf et al, 2002).…”

“…In the first instance, it is important to note that some degree of grieving is appropriate following the death of a patient; it is the prolonged negative effects on the personal and professional lives of psychiatrists that need to be addressed. Most studies on this topic identify a need for training programmes and formal systems of sup port in order to address the issues raised by patient suicide (Chemtob et al, 1988;Gitlin, 1999;Dewar et al, 2000;Courtenay & Stephens, 2001;Yousaf et al, 2002). In their study of psychiatric trainees, Dewar et al (2000) reported that 28% of respondents had received some training in relation to patient suicide and most of these found it helpful in the long run.…”