The Impact of Patient Suicide on the Professional Reactions and Practices of Mental Health Caregivers and Social Workers

Abstract

Beyond the emotional and professional impact, patient suicide may have also a formative influence, encouraging professionals to review and improve their working practices. Recommendations to help mental health and social professionals who have experienced a patient suicide are discussed.

Psychiatrists’ Emotional Reactions to Patient Suicidal Behavior

“…5,31 A recent study on the impact of patient suicide on mental health professionals showed that effects on emotional and cognitive areas and on clinical practice diminish over time. 13 The temporal-emotional pattern described above overlaps with the typical grief process following a loss, which is initially characterized by psychological pain, guilt, anger, and feelings of betrayal; and then subsequently by frustration and helplessness; and finally by reassurance. This means that patient suicidal behavior, be it attempted or completed, is an emotionally significant event for the therapist as it is for the relatives of the patient.…”

“…13 It has been reported that, following a completed suicide, many psychiatrists experience significant concerns about patients with a history of suicidal behavior; some may even refuse to treat other suicidal patients, and most are significantly concerned that another patient may become suicidal. 11,12 This is not consistent with the results of our study; rather, we found that the attempted suicide did not affect the psychiatrists' professional attitude at all in 66% of the cases.…”

“…This is partly consistent with the findings of Gulfi et al that mental health professionals are less likely to change their professional practice after the suicide of a patient with a history of previous suicide attempts than after the suicide of a patient after a first attempt. 13 About two thirds of the therapists who were interviewed sought to discuss their patient's attempted suicide with someone; they most often talked with colleagues and more rarely with relatives and/or friends. This suggests that even the attempted suicide of a patient is accompanied by a significant need to share emotions and confer with others who can understand due to direct experience.…”

“…For example, it has been shown that mental health professionals are less likely to change their practice after the suicide of a patient who had a history of previous suicide attempts than after the suicide of a patient after a first attempt. 13 It is plausible that similarity of gender and age between the psychiatrist and the patient and the quality of the therapeutic relationship also have an influence. These factors are known to affect outcomes in psychotherapy, 14 and Dembo et al observed that young adult clients whose therapists were of a similar age experienced less distress and social isolation after treatment.…”

“Will you treat me? I'm suicidal!” The effect of patient gender, suicidal severity, and therapist characteristics on the therapist's likelihood to treat a hypothetical suicidal patient

“…One in five of those who die by suicide had some contact with mental health services in the month prior to their death (Stene‐Larsen & Reneflot, ). Most mental health professionals encounter suicidal behaviour during their career (Hendin, Haas, Maltsberger, Szanto, & Rabinowicz, ), and some even experience a patient's suicide (Gulfi, Dransart, Heeb, & Gutjahr, ). Different methods of therapy, such as cognitive–behavioural therapy, problem‐solving therapy, and interpersonal psychotherapy, have been proved to be effective in treating suicide and reducing suicidal behaviour, ideation, and suicide attempts.…”