The impact of drug-related death on staff who have experienced it as part of their caseload: An exploratory study

Abstract

Background: Previous research into drug-related death (DRD) has targeted specific groups such as the deceased themselves, witnesses, or families of victims. There has been no research on staff working in the substance misuse field and the impact that DRD has had on them. Method: A postal questionnaire survey was conducted across a Scottish health authority area and quantitatively measured the impact that this event had on the work, health, and social life. Results: Sixty-five staff persons were identified as having experiencing at least one DRD on their caseload. These 65 reported a range of grief-related reactions, with the majority (88%) identifying at least one reaction. The most common feelings identified were sadness (83%), guilt (40%), and anger (37%) about the death of their client. Female staff, those with access to more sources of support, those who had a larger caseload, those with greater career experience of DRD on their caseload, and those who felt close to their client all reported significantly greater prevalence of grief-related reactions. The length of time since the DRD had occurred was also associated. Conclusions: When a DRD occurs, staff involved in the care and treatment of the deceased need to be considered in the aftermath.

Reducing drug related deaths: a pre-implementation assessment of knowledge,barriers and enablers for naloxone distribution through general practice

“…The main motivating factor in one GP was the experience of a potentially avoidable patient death. This finding concurs with other evidence that experience of a DRD on the caseload of staff does cause a grief-related response [ 23 ]. Perhaps this type of experiential evidence could be used to motivate others.…”

The impact of COVID-19 on health care professionals who are exposed to drug-related deaths while supporting clients experiencing addiction

“…Similar to the current study, McAuley and Forsyth (2011) examined grief-related reactions in health care workers who work with people who use drugs. Many bereavement outcomes emerging from the 2011 study’s surveys were prevalent in the current study’s interviews.…”

“…Current bereavement literature has identified grief-related and countertransference reactions in clinicians following the death of a client ( Lakeman, 2011 ; McAuley & Forsyth, 2011 ; Yule & Levin, 2019 ). These studies highlight service providers as a vulnerable group in the aftermath of a service user death, calling for targeted support to address a high risk of complicated grief.…”

“…These deaths can be socially stigmatizing, and associated bereavement outcomes include guilt, self-blame, anxiety, and, conversely, relief ( Titlestad et al, 2019 ). Research to date has primarily focused on families, but a study by McAuley and Forsyth (2011) in Scotland examined grief-related reactions in service providers who experience drug-related deaths as part of their caseload. The authors examined emotional responses to a client’s drug death using a self-report questionnaire with 76 caretakers across social, health, and voluntary care sectors.…”

“…Clients of professionals providing addiction services face further risks to their mortality compared to other health care settings. The complicated nature of drug-related bereavement has significant implications for providers, who are placed at increased risk for prolonged grief outcomes such as self-blame, depression, and anxiety ( McAuley & Forsyth, 2011 ; Titlestad et al, 2019 ). Furthermore, a decreased sense of job control and increased demands both in and out of work can lead to a rise in occupational stress ( Jetha et al, 2017 ), which may be exacerbated by unprecedented circumstances.…”