Effects of patient deaths by suicide on clinicians working in mental health: A survey

Abstract

In the UK, at least a quarter of suicides occurs in patients whilst under the care of mental health services. This study investigated the effects of such deaths on non-medical mental health clinicians. An online survey was conducted within a single NHS mental health Trust to elicit both quantitative and qualitative responses from staff across a range of professions. The survey focused on personal and professional impacts and available support. Participants reported significant negative emotional and professional effects that were long-lasting for some. These included mental health difficulties, loss of confidence regarding clinical responsibilities, and actual or contemplated career change. However, there was also some evidence of positive effects and professional growth. Support from colleagues and line managers is clearly important following deaths of patients by suicide. Clinicians' experiences of the support they had received in the workplace were polarized, suggesting that there is no single nor ideal approach that will meet everyone's needs. Participants made recommendations for the types of support that may be helpful. Most commonly, clinicians desired opportunities for focused reflection and support and help with the formal processes following the death. Sensitivity around how clinicians are notified about the death was highlighted as being particularly important. Conclusions are drawn as to how training institutions and employers can help staff to be better prepared for the potential occurrence of patient suicides and the formal processes that follow, with a view to mitigating risks of more serious harm to staff and hence indirectly to patients, and potential loss of highly trained clinicians to the workforce.

Tackling the erosion of compassion in acute mental health services

“…In the 2021 NHS staff survey, 44% of mental health nurses and 50% of clinical psychologists reported feeling emotionally exhausted always or often,23 which is in line with the prevalence across mental health staff across the world 24. These problems are especially acute in inpatient settings, where staff are often exposed to intense negative emotions1718 and may experience vicarious trauma 25…”

Patient deaths by suicide significantly affect clinicians

“…The authors of the work, ‘Effects of patient deaths by suicide on clinicians working in mental health: A survey’ conducted an online cross-sectional survey of clinicians working in the field of mental health, excluding doctors, from one large the National Health Service (NHS) mental health Trust in England 3. The survey focused on personal and professional impacts of patient suicide and available support for clinicians.…”

“…According to the WHO, about 800 000 individuals die by suicide every year globally 1. Suicidal individuals usually have psychiatric disorders and are treated by medical professionals working in mental health 2 3. Clinicians working with psychiatric patients are frequently significantly traumatised by a patient’s death by suicide 3 4.…”

“…Suicidal individuals usually have psychiatric disorders and are treated by medical professionals working in mental health 2 3. Clinicians working with psychiatric patients are frequently significantly traumatised by a patient’s death by suicide 3 4. They often feel guilty, shocked, angry and anxious.…”

“…They often feel guilty, shocked, angry and anxious. In addition, these clinicians may be additionally traumatised by investigations and accusations that they are responsible for a patient’s death 3 4…”