The experience of patient suicide among Irish psychiatrists

Cryan, E.; Kelly, Paul; McCaffrey, Brian

doi:10.1192/pb.19.1.4

Cited by 38 publications

(47 citation statements)

References 7 publications

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“…Parmi les proches affectés se trouvent les professionnels de la santé qui la traitaient avant qu'elle ne meure. La recherche indique que le suicide d'un patient est un événement fréquent dans la pratique clinique des professionnels en santé mentale : 22 % à 39 % des psychologues (Chemtob et al, 1989 ;Trimble et al, 2000) et 51 % à 82 % des psychiatres (Chemtob et al, 1989 ;Cryan et al, 1995) ont rapporté avoir vécu cet événement dans l'exercice de leur profession. Aucune donnée empirique n'existe en ce qui concerne le nombre d'infirmiers(ères) en psychiatrie affectés (Collins, 2003).…”

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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“…The principle of equivalence of care states that prisoners are entitled to the same standard of healthcare as they would have were they not in prison. [2][3][4] Those prisoners who have mental disorders of a nature or degree such that their needs can only be appropriately met by in-patient treatment are meant to be transferred from prison to hospital for treatment. 5 Prison in-reach teams take referrals from a wide range of sources and generally support a high volume of prisoners with stable mental illnesses.…”

Section: Limitations Of the Studymentioning

confidence: 99%

“…2 Despite it potentially being one of the most distressing events in a psychiatrist's career, the number of studies in the literature is relatively small and there has been only one Irish study to date. 3 The studies conducted thus far have all identified patient suicide as a cause of considerable distress, yet it is an event for which training leaves psychiatrists underprepared. We conducted a nationwide study of all consultant adult psychiatrists in Ireland to establish the impact on their personal and professional life.…”

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confidence: 99%

Impact of patient suicide on consultant psychiatrists in Ireland

2010

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Suicide of a patient is a very distressing event for a consultant psychiatrist and can adversely affect both their personal and professional life. Consultant psychiatrists have been shown to have higher levels of work-related exhaustion than their medical and surgical colleagues and patient suicide potentially contributes to this.1 A review of studies from the USA, Canada and the UK suggests that 50-70% of consultant psychiatrists will experience the suicide of a patient at some point in their career.2 Despite it potentially being one of the most distressing events in a psychiatrist's career, the number of studies in the literature is relatively small and there has been only one Irish study to date.3 The studies conducted thus far have all identified patient suicide as a cause of considerable distress, yet it is an event for which training leaves psychiatrists underprepared. We conducted a nationwide study of all consultant adult psychiatrists in Ireland to establish the impact on their personal and professional life. MethodWe sent a confidential postal questionnaire to 292 consultant psychiatrists in Ireland (not including child and adolescent psychiatrists), identified through records held by the Irish Medical Council and the Irish Medical Directory (www.imd.ie) that were cross-checked with each individual hospital. To maintain confidentiality and thus optimise our response rate, the questionnaires were not coded or numbered in any way and were sent with a noncoded, stamped, addressed return envelope. However, each participant was assigned a number and was sent a corresponding numbered envelope and asked to post this simultaneously with their questionnaire, to aid identification of non-responders. Non-responders were contacted again by post after 10 weeks and after a further 8 weeks they were contacted by email if available.We examined each consultant's most recent experience of patient suicide as well as the suicide they perceived to be most distressing. We did not specify that the deaths had to have been recorded as suicides in the coroner's court, instead leaving the choice of case to each individual's judgement.The questionnaire (available from the author on request) was divided into three sections: the first gathered basic demographic data; this was followed by a section relating to the consultant's most recent experience of patient suicide, the individual patient's characteristics, the effect the suicide had on the consultant, both personally and professionally, and what coping strategies they used in its aftermath. The final section of the questionnaire asked the psychiatrists to provide that same information regarding the suicide they had found to be most distressing during their consultant career. Consultants had the opportunity to provide additional information in free-text boxes. Results Study sampleA total of 292 questionnaires were sent. We received 182 responses, of which 4 were excluded owing to incomplete information; this gave us a response rate of 61%. The Aims and method To study the effects...

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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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The experience of patient suicide among Irish psychiatrists

Cited by 38 publications

References 7 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

Impact of patient suicide on consultant psychiatrists in Ireland

The Clarke Institute Experience with Completed Suicide: 1966 to 1997

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