Patient Suicide in Institutions: Emotional Responses and Traumatic Impact on Swiss Mental Health Professionals

Abstract

The reactions of professionals after a patient suicide are still a subject of controversy in academic literature. This article reports on retrospective data about the aftermath experienced by mental health professionals working in institutional settings in Switzerland. Findings indicate that both self-rated emotional responses and traumatic impact were low for the majority of the 258 professionals surveyed. Variables that mediated the impact included the support received and the characteristics of the professional-patient relationship. No significant differences were found with regard to gender and profession.

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

“…The three subgroups, anticipators with support , distant professionals and no more contact with patient professionals accounted for more than half (55.8 %) of the sample and had low stress reactions, while the concerned professionals subgroup presented a moderate impact (36.6 %) and the unsupported professionals subgroup (7.7 %) a high impact. These findings might explain previous results reporting contrasting proportions of respondents with high scores on the IES (or the IES-R) [ 1 – 3 , 6 – 8 ]. Indeed, presuming that these various subgroups are to be found in other studies and contexts, the proportion of professionals with higher scores on the IES (or the IES-R) could vary in accordance with the size of the various subgroups.…”

“…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).…”

“…Stress reactions or traumatic symptoms following a patient suicide have been examined in a number (14) of studies between 1988 and 2014 using the Impact of Event Scale [ 4 ] or the Impact of Event Scale-Revised [ 5 ]. Findings on the severity of stress reactions are heterogeneous: some studies found that a minority (7–14 %) of respondents reported symptoms above the cut off scores used in the literature (>19 for IES and ≥ 25 for IES-R [ 1 , 6 , 7 ]), while others found markedly higher percentages (49–53 % [ 2 , 3 , 8 ]).…”

“…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 ].…”

“…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.…”