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

Abstract

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.

Stress reactions after a patient suicide and their relations to the profile of mental health professionals

“…Subgroup variations in the total score of the IES-R are in part related to the predictors of stress reactions after a patient suicide and to the profession [ 6 , 9 , 10 ]. Mean scores of the IES-R were higher for emotional closeness to the patient (M = 15.8; no closeness M = 10.3), insufficient support received (M = 17.6; sufficient support M = 11.6) and nurses (M = 14.4) as well as educators (M = 14.1; psychiatrists M = 12.0, social workers M = 11.3, psychologists M = 10.7).…”

“…Some studies have investigated predictors of severity for stress reactions, however findings pertaining to patients or professionals' characteristics have been inconsistent [ 6 ]. The length and intensity of the relationship with the patient proved to be significant, i.e., professionals who felt closer to, or were in a therapeutic relationship with the patient for longer reported higher levels of stress [ 6 , 9 , 10 ]. Support was identified as a protective factor [ 10 ].…”

“…The length and intensity of the relationship with the patient proved to be significant, i.e., professionals who felt closer to, or were in a therapeutic relationship with the patient for longer reported higher levels of stress [ 6 , 9 , 10 ]. Support was identified as a protective factor [ 10 ]. Results concerning vocations were inconsistent among studies using the IES and the IES-R [ 6 , 9 , 10 ].…”

“…Support was identified as a protective factor [ 10 ]. Results concerning vocations were inconsistent among studies using the IES and the IES-R [ 6 , 9 , 10 ]. To our knowledge, no study so far has purposely investigated subgroups of professionals likely to be more vulnerable to stress reactions by taking into account the potential interaction of various variables.…”

Post-traumatic symptoms in the staff of a mental health inpatient unit after the suicide of a patient: a case report in Chile

“…It has been seen that the suicide of a patient generates changes in health care workers both at their work and personal life. Significant among psychiatrists are feelings of professional failure, questions about their expertise, concerns about legal repercussions and changes in their professional practice (Campbell & Fahy, 2002;Grad & Michel, 2005;Grad, Zavasnik & Groleger, 1997;Hendin, Lipschitz, Maltsberger, Haas & Wynecoop, 2000;Henry, Séguin & Drouin, 2008;Horn, 1994). However, it has been shown that to the extent that physicians acquire greater professional experience, the guilt, low self-esteem and social withdrawal experienced after the suicide of a patient decreases (Chemtob et al, 1988).…”