Impact of Client Suicide on Psychologists in Australia

Abstract

Objective: This research aimed to assess the frequency and impact of client suicides on psychologists in Australia. Method: Participants were 178 psychologists who completed an online self-report questionnaire concerning the frequency of occurrence and impact of client suicide. Results: Fifty six (31.5%) participants reported one or more client suicides. Psychologists with more years of experience reported more client suicides. Participants who had experienced a client suicide reported a range of emotional, cognitive and behavioural reactions as well as professional impacts. Ratings of responsibility, preventability and predictability of a client suicide were associated with emotional and/or professional impacts. Beneficial coping responses included talking to supervisors and colleagues, recognising the psychologist is not responsible and having increased acceptance of a client suicide. Conclusions: The findings have important implications for training, workplace practices and research.

The impact on mental health practitioners of the death of a patient by suicide: A systematic review

“…The experience of losing a patient to suicide resulted in some practitioners being more accepting of suicide as a possibility (Kleespies et al, 1990; Linke et al, 2002) or having an increased awareness of the limits of their professional ability to prevent suicide (Goldstein & Buongiorno, 1984; Gulfi et al, 2010; Ting et al, 2006). Other studies detected increased acceptance of suicide itself (Finlayson & Graetz Simmonds, 2016) or feelings of understanding or acceptance of suicide as an option (Rothes, Scheerder, Van Audenhove, & Henriques, 2013; Ting et al, 2006).…”

“…Although the methodologies in the quantitative studies were heterogeneous, making comparisons difficult, 13 studies (total n = 717) utilized the Impact of Event Scale (IES or IES‐R, Horowitz, Wilner, & Alvarez, 1979; Weiss & Marmar, 1996) and reported that between 12% and 53% of their samples recorded clinically significant scores in the time immediately following the suicide (see Table 2). Of the other quantitative and mixed‐method studies, Finlayson and Graetz Simmonds (2016) included 12 items in their study questionnaire to capture intensity of emotions and reported that sadness was rated most highly, followed by shock, helplessness, anger, and pain. Gulfi, Castelli Dransart, Heeb, and Gutjahr (2010) used nine items from an adapted Long‐term Emotional Impact Scale and reported low to moderate impact overall, with increased sensitivity to signs of risk and increased anxiety when working with suicidal patients being the highest rated items.…”

“…Fourteen studies described changes that relate to risk assessment. Heightened awareness of risk was frequently cited (Alexander et al, 2000; Bowers et al, 2006; Draper, Kolves, De Leo, & Snowdon, 2014; Kelleher & Campbell, 2011; Landers et al, 2010; Murphy et al, 2019), as was attentiveness to risk assessment (Bowers et al, 2006; Pilkinton & Etkin, 2003) and increased attentiveness/focus on suicide cues (Chemtob et al, 1988; Cryan et al, 1995; Finlayson & Graetz Simmonds, 2016; Gulfi et al, 2010; McAdams & Foster, 2000; Trimble, Jackson, & Harvey, 2000).…”

“…There were also a number of examples where more cautious management of those at potential risk of suicide was reported following the loss of a client to suicide: increased caution (Draper et al, 2014; Finlayson & Graetz Simmonds, 2016; Grad, Zavasnik, & Groleger, 1997), excessive vigilance (Wang, Ding, Hu, Zhang, & Huang, 2016), more frequent risk assessments (Murphy et al, 2019), more referrals to psychiatry (Draper et al, 2014; Halligan & Corcoran, 2001), more antidepressant prescribing (Halligan & Corcoran, 2001; Kelleher & Campbell, 2011), and an increase in the number of patients assessed as being at risk for suicide (Kleespies et al, 1990). Increased use of hospital admission or use of mental health legislation to detain those thought to be at risk (Alexander et al, 2000; Cryan et al, 1995; Gulfi et al, 2010; Kelleher & Campbell, 2011; Landers et al, 2010; McAdams & Foster, 2000; Menninger, 1991; Pilkinton & Etkin, 2003; Trimble et al, 2000) was also frequently reported.…”

“…Nine studies detected more conservative record keeping (Chemtob et al, 1988; Finlayson & Graetz Simmonds, 2016; McAdams & Foster, 2000; Trimble et al, 2000) or more detailed record keeping, (Cryan et al, 1995; Halligan & Corcoran, 2001; Kelleher & Campbell, 2011; Linke, Wojciak, & Day, 2002; Menninger, 1991). Greater attention to legal aspects was also regularly reported upon (Chemtob et al, 1988; Courtenay & Stephens, 2001; Cryan et al, 1995; Gulfi et al, 2010; McAdams & Foster, 2000; Pilkinton & Etkin, 2003; Trimble et al, 2000).…”