Improving Support of Residents After a Patient Suicide: A Residency Case Study

Mangurian, Christina; Harre, Elizabeth; Reliford, Aaron O.; Booty, Andrew; Cournos, Francine

doi:10.1176/appi.ap.33.4.278

Cited by 16 publications

(5 citation statements)

References 12 publications

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“…For example, Mangurian and colleagues reported that, when they encountered patient suicide during their own residencies, they found that emotional support and support by medical institutions were lacking [18]. …”

Section: Discussionmentioning

confidence: 99%

The impact of inpatient suicide on psychiatric nurses and their need for support

Takahashi¹,

Chida

Nakamura

et al. 2011

BMC Psychiatry

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BackgroundThe nurses working in psychiatric hospitals and wards are prone to encounter completed suicides. The research was conducted to examine post-suicide stress in nurses and the availability of suicide-related mental health care services and education.MethodsExperiences with inpatient suicide were investigated using an anonymous, self-reported questionnaire, which was, along with the Impact of Event Scale-Revised, administered to 531 psychiatric nurses.ResultsThe rate of nurses who had encountered patient suicide was 55.0%. The mean Impact of Event Scale-Revised (IES-R) score was 11.4. The proportion of respondents at a high risk (≥ 25 on the 88-point IES-R score) for post-traumatic stress disorder (PTSD) was 13.7%. However, only 15.8% of respondents indicated that they had access to post-suicide mental health care programmes. The survey also revealed a low rate of nurses who reported attending in-hospital seminars on suicide prevention or mental health care for nurses (26.4% and 12.8%, respectively).ConclusionsThese results indicated that nurses exposed to inpatient suicide suffer significant mental distress. However, the low availability of systematic post-suicide mental health care programmes for such nurses and the lack of suicide-related education initiatives and mental health care for nurses are problematic. The situation is likely related to the fact that there are no formal systems in place for identifying and evaluating the psychological effects of patient suicide in nurses and to the pressures stemming from the public perception of nurses as suppliers rather than recipients of health care.

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Section: Discussionmentioning

confidence: 99%

The impact of inpatient suicide on psychiatric nurses and their need for support

Takahashi¹,

Chida

Nakamura

et al. 2011

BMC Psychiatry

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“…In sum, the study findings inform standardization of postvention protocols among psychiatry training programs. In medicine, numerous approaches to addressing patient death have emerged such as debriefings, death rounds, quality care rounds, and crisis support teams along with postvention protocols [8,15,30,[37][38][39]. This study's evaluation of a postvention protocol suggests it may be effective at mitigating the psychological and professional ramifications of patient suicide.…”

Section: Discussionmentioning

confidence: 99%

“…The postvention protocol focused on minimizing the negative impact of patient suicide on trainees' mental health and professional identity [12]. While postvention protocols have been proposed in the literature, none has been formally evaluated among early career physicians [13][14][15][16]. The current study evaluated the postvention protocol among adult psychiatry residents who participated in the protocol from June 2018 to April 2020.…”

mentioning

confidence: 99%

Responding to a Tragedy: Evaluation of a Postvention Protocol Among Adult Psychiatry Residents

et al. 2021

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Objective In a time of “zero suicide” initiatives and rising suicide rates, resident physicians are particularly susceptible to the psychological and professional ramifications of patient suicide. An adult psychiatry residency program developed and implemented a postvention protocol to address the impact of patient suicide among resident physicians. The current study is a formal evaluation of a training program’s postvention protocol from June 2018 to April 2020. Methods Process and outcome indicators were identified to assess protocol implementation and effectiveness. Process indicators included were postvention protocol adherence. Outcome indicators were perceived helpfulness of postvention protocol–related supports, occupational and general health measures, posttraumatic growth, and posttraumatic stress symptoms following resident participation in the postvention protocol. Results Study response rate was 97% (n = 57/59) and 81% completed the entire survey (n = 48/59). Twenty percent of residents (n = 10/48) experienced patient suicide during residency. Postvention protocol adherence was between 57 and 100%. Protocol-related supports, such as speaking with attendings who had previously experienced an adverse event, were more helpful than other supports (p < 0.01). Compared to residents who had not experienced patient suicide, mean work empowerment, burnout, mental health, and quality of life scores were not significantly different from residents who participated in the postvention protocol (p > 0.05). Posttraumatic growth was positively correlated with self-determination at work (p = 0.01). Conclusions The postvention protocol was helpful to residents and potentially effective at mitigating the psychological and professional consequences of patient suicide. Study findings may inform standardization of postvention protocols among psychiatry training programs.

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“…The authors comment on training directly; clinicians should be sensitized to various cultural perspectives on suicide and trained in the ethical standards of the profession to prevent and manage suicidal behaviours. As others have argued (Coverdale, Roberts, & Louie, 2007;Fang et al, 2007), psychiatry training programmes should teach suicide care as an integral part of training and should prepare trainees for the possibility of a suicide of a patient and to learn how best to respond to the suicide of a patient (Balon, 2007;Ellis, Dickey, & Jones, 1998;Hamaoka et al, 2007;Mangurian, Harre, Reliford, Booty, & Cournos, 2009;Melton & Coverdale, 2009;Pilkinton & Etkin, 2003;Ruskin, Sakinofsky, Bagby, Dickens, & Sousa, 2004;Schwartz, Kaslow, & McDonald, 2007;Sockalingam, Flett, & Bergmans, 2010;Sudak, 2007).…”

Section: Special Groupsmentioning

confidence: 99%

Global challenges and ethics in protecting and promoting the interests of psychiatrically ill patients

Coverdale¹,

Roberts²

2010

International Review of Psychiatry

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Improving Support of Residents After a Patient Suicide: A Residency Case Study

Cited by 16 publications

References 12 publications

The impact of inpatient suicide on psychiatric nurses and their need for support

The impact of inpatient suicide on psychiatric nurses and their need for support

Responding to a Tragedy: Evaluation of a Postvention Protocol Among Adult Psychiatry Residents

Global challenges and ethics in protecting and promoting the interests of psychiatrically ill patients

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