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

Abstract

BackgroundPatient suicide is a professional hazard for mental health professionals and an event likely to trigger stress reactions among them.This study aimed to identify typical profiles of professionals after a patient suicide to address the severity of stress reactions and its discriminant variables.MethodsMental health professionals (N = 666) working in institutional settings or private practice in the French-speaking part of Switzerland filled out a self-administered questionnaire including the IES-R (Impact of Event Scale-Revised). Profiles were identified by cluster analysis.ResultsThe interplay of variables pertaining to the relationship to the patient, exposure to suicide, support and training contributed to explaining the severity of stress reactions after a patient suicide. Five profiles of professionals were identified. Low-impacted professionals (55.8 % of the sample) were characterised either by high support and anticipation (anticipators with support), emotional distance to the patient (distant professionals) or no contact with the patient at the time of death (no more contact with patient professionals). Emotional closeness to, and responsibility for the patient were typical of moderately-impacted professionals (36.6 %, concerned professionals), while highly-impacted professionals felt emotionally close to the patient and lacked support although more than half of them sought it (7.7 %, unsupported professionals).ConclusionsDifferences in the professionals’ profiles relate prominently to the interplay between risk and protective factors. Professionals who were appropriately supported, i.e., according to their risk profile, were able to cope with the event. Taking into account the profiles of professionals and the severity of stress reactions may enable the screening of those professionals most in need of support. Those most impacted sought out help more frequently. However, only a minority of them were offered sufficient support. Institutional or vocational bodies should take measures to ensure that professionals seeking help find it easily and promptly.The combination of training and support seems to be crucial for mitigating risk factors since the three low impacted subgroups had received the most training and support.

Addressing Suicide Risk According to Different Healthcare Professionals in Spain: A Qualitative Study

“…A patient’s suicide always has a huge impact on healthcare professionals, especially on those working in the area of mental health, affecting them both at the professional and the personal levels [ 20 ]. Indeed, it can increase awareness of the factors involved in suicide risk [ 21 ], although, on the other hand, being involved in the care of people at risk for suicide can also trigger rejection, fear, and high levels of stress [ 22 ]. In general, healthcare professionals are sufficiently educated about suicidal behavior, but still there are certain lacks and problems that hinder an effective approach to it [ 23 ].…”

The borderline between life and death

“…The finding that MHPs also experienced the suicide as a relief needs to be discussed. There are several studies that have identified stress and different emotional responses in staff (Dransart, Gulfi, & Gutjahr, 2015 often very difficult to predict and is often followed by negative emotional reactions in nurses (Bohan & Doyle, 2008), such as feeling emotionally strained or in psychological pain (Hagen et al, 2017). This indicates the need for sufficient formal support to be able to regulate emotions and feelings when caring for these patients.…”

The SUPPORT-S Protocol Study: A Postvention Program for Professionals After Patient or User Suicide

“…The negative impact of PUS is significantly associated with a closeness to the deceased, a high level of the professional-client relationship and a lack of support and training. Castelli Dransart et al (2015) notably reported that the lack of support in the aftermath was a risk factor for higher traumatic impact in the aftermath of PUS.…”

“…Postvention refers to the activities developed in the aftermath of a suicide to prevent negative health outcomes and facilitate recovery among the bereaved (Andriessen, 2009). Despite the growing evidence on the impact of PUS, the lack of institutional support in the aftermath has been widely documented (Ruskin et al, 2004;Castelli Dransart et al, 2015;Leaune et al, 2019a,b). Moreover, the literature on postvention programs dedicated to the support of health and social work professionals remains scarce.…”