When a patient dies by suicide: incidence, implications and
                        coping strategies

Foley, Sharon; Kelly, Brendan D.

doi:10.1192/apt.bp.106.002501

Cited by 35 publications

(30 citation statements)

References 11 publications

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“…International studies have shown that patient suicide is a relatively common experience for consultant psychiatrists, with 50-70% experiencing it at least once. 2 We found the effect on both the personal and professional life of the consultants to be consistent with or greater than previous studies, with up to 97% reporting some disturbance in their personal life. 2,6 Informal support from colleagues was identified by the majority of respondents as the most effective support, which is again reflective of other studies.…”

Section: Discussionsupporting

confidence: 89%

“…2 We found the effect on both the personal and professional life of the consultants to be consistent with or greater than previous studies, with up to 97% reporting some disturbance in their personal life. 2,6 Informal support from colleagues was identified by the majority of respondents as the most effective support, which is again reflective of other studies. 6,7 However, the number seeking formal and independent reviews suggests that, although many receive psychological support from family and friends, consultants would also welcome an objective review from a professional view point.…”

Section: Discussionsupporting

confidence: 89%

“…The principle of equivalence of care states that prisoners are entitled to the same standard of healthcare as they would have were they not in prison. [2][3][4] Those prisoners who have mental disorders of a nature or degree such that their needs can only be appropriately met by in-patient treatment are meant to be transferred from prison to hospital for treatment. 5 Prison in-reach teams take referrals from a wide range of sources and generally support a high volume of prisoners with stable mental illnesses.…”

Section: Limitations Of the Studymentioning

confidence: 99%

“…2 Despite it potentially being one of the most distressing events in a psychiatrist's career, the number of studies in the literature is relatively small and there has been only one Irish study to date. 3 The studies conducted thus far have all identified patient suicide as a cause of considerable distress, yet it is an event for which training leaves psychiatrists underprepared.…”

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confidence: 99%

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Impact of patient suicide on consultant psychiatrists in Ireland

2010

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Suicide of a patient is a very distressing event for a consultant psychiatrist and can adversely affect both their personal and professional life. Consultant psychiatrists have been shown to have higher levels of work-related exhaustion than their medical and surgical colleagues and patient suicide potentially contributes to this.1 A review of studies from the USA, Canada and the UK suggests that 50-70% of consultant psychiatrists will experience the suicide of a patient at some point in their career.2 Despite it potentially being one of the most distressing events in a psychiatrist's career, the number of studies in the literature is relatively small and there has been only one Irish study to date.3 The studies conducted thus far have all identified patient suicide as a cause of considerable distress, yet it is an event for which training leaves psychiatrists underprepared. We conducted a nationwide study of all consultant adult psychiatrists in Ireland to establish the impact on their personal and professional life. MethodWe sent a confidential postal questionnaire to 292 consultant psychiatrists in Ireland (not including child and adolescent psychiatrists), identified through records held by the Irish Medical Council and the Irish Medical Directory (www.imd.ie) that were cross-checked with each individual hospital. To maintain confidentiality and thus optimise our response rate, the questionnaires were not coded or numbered in any way and were sent with a noncoded, stamped, addressed return envelope. However, each participant was assigned a number and was sent a corresponding numbered envelope and asked to post this simultaneously with their questionnaire, to aid identification of non-responders. Non-responders were contacted again by post after 10 weeks and after a further 8 weeks they were contacted by email if available.We examined each consultant's most recent experience of patient suicide as well as the suicide they perceived to be most distressing. We did not specify that the deaths had to have been recorded as suicides in the coroner's court, instead leaving the choice of case to each individual's judgement.The questionnaire (available from the author on request) was divided into three sections: the first gathered basic demographic data; this was followed by a section relating to the consultant's most recent experience of patient suicide, the individual patient's characteristics, the effect the suicide had on the consultant, both personally and professionally, and what coping strategies they used in its aftermath. The final section of the questionnaire asked the psychiatrists to provide that same information regarding the suicide they had found to be most distressing during their consultant career. Consultants had the opportunity to provide additional information in free-text boxes. Results Study sampleA total of 292 questionnaires were sent. We received 182 responses, of which 4 were excluded owing to incomplete information; this gave us a response rate of 61%. The Aims and method To study the effects...

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 89%

Section: Limitations Of the Studymentioning

confidence: 99%

mentioning

confidence: 99%

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Impact of patient suicide on consultant psychiatrists in Ireland

2010

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“…Pieta House (www.pieta.ie) offers support, both for those bereaved and those who are feeling suicidal. Patient suicide also affects psychiatrists and other health care staff and can be a substantial source of stress (Foley & Kelly, 2007).…”

Section: Interventions At the Level Of The Individualmentioning

confidence: 99%

Are we finally making progress with suicide and self-harm? An overview of the history, epidemiology and evidence for prevention

Kelly

2017

Ir. j. psychol. Med.

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Ireland’s suicide rate is falling, but suicide and self-harm remain substantial societal problems. It is not possible to predict suicide at the level of the individual but good primary care, good mental health care and good social care all likely reduce risk. In terms of targeted interventions, public health measures, such as paracetamol pack size regulations, have the best evidence base to support them. Despite increased public and professional discussion, much remains to be done to provide effective, coordinated support to those at risk of suicide and those bereaved. In 2016, there were up to 300 different groups providing support. Clearly, a coordinated, effective and compassionate approach is needed, linking community and state resources meaningfully with each other. Approaches rooted outside of core mental health services will be vital: addressing alcohol problems and other addictions, reducing homelessness, reforming the criminal justice system and improving social care.

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The impact of suicide prevention on experienced Irish clinicians

Moore

Donohue

2016

Couns and Psychother Res

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Background Emerging research coming from the person‐centred and psychodynamic traditions in the past 15 years has examined the traumatic dimension of suicidal behaviour on clinicians. However, there is limited empirical literature on the impact of suicidality on Irish psychotherapists. In Ireland, it is estimated that 500 citizens die by suicide each year, while approximately 11,000 accident and emergency admissions are the consequence of suicide attempts. Aim This elicits the question, how does suicide prevention impact Irish mental health professionals who work solely with these vulnerable populations? Method In this article, the process of interpretative phenomenological analysis (IPA) was applied to the narratives of seven experienced therapists. Findings The Irish Poet W.B. Yeats coined the famous refrain ‘All changed, changed utterly, a terrible beauty is born’ in his poem ‘Easter 1916’ (as cited in Martin, ). This quote aptly encapsulates the reality of seven experienced Irish psychotherapists who work exclusively in the field of suicide prevention. Three salient superordinate themes emerged: (1) Overworking; (2) All changed, changed utterly/identity disruption; (3) A terrible beauty is born/A spiritual practice. Discussion Clinicians were ‘changed, changed utterly’ with identity disruption evident in their self, bodies, intimate relationships and professional identity. ‘A terrible beauty was born’ was demonstrated in the overarching theme of the restorative nature of client engagement in the life of the therapist. This was particularly evident in humanistic practitioners, who were acutely aware of their own sublimation of melancholia. Conclusion Most striking across all seven transcripts was the mix of the corrosive nature of suicide prevention on the self of the therapist, combined with unparalleled opportunities for personal growth and spiritual reformulation.

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When a patient dies by suicide: incidence, implications and coping strategies

Cited by 35 publications

References 11 publications

Impact of patient suicide on consultant psychiatrists in Ireland

Impact of patient suicide on consultant psychiatrists in Ireland

Are we finally making progress with suicide and self-harm? An overview of the history, epidemiology and evidence for prevention

The impact of suicide prevention on experienced Irish clinicians

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