Workplace exposure to suicide among Australian mental health workers: A mixed‐methods study

Abstract

Workplace exposure to suicide attempts and deaths has been widely recognized as an occupational hazard for mental health and social care workers, including mental health nurses. Research consistently demonstrates the adverse impact on professionals. This paper explores the results of an online survey examining suicide exposure and impact. Of the 3010 Australian adult participants who identified exposure to suicide attempts and/or deaths in a larger study, 130 indicated that the most impactful suicide attempt and/or death exposure was that of a client or service user. While distress levels were relatively low among participants with workplace exposure, the qualitative content from 53 participants provides illumination into this experience. Themes that emerged in the qualitative responses include impact on the professional, organization response, and lack of adequate resources and supports to prevent suicide. Previous research has examined the impact of suicide exposure among professionals specifically, but this is the first known study of participants in a community sample who identified the most impactful suicide attempt or death exposure they had experienced was that of a client in a mental health setting. Workplace exposure among mental health workers is common and can have both deleterious and positive effects. Bereavement focused outcomes, where the loss of an attachment relationship is the focus, does not capture the full range of experiences in workplace exposure. Systemic issues in mental health care contribute to further distress among exposed workers, and this requires additional investigation and response.

Profiling Suicide Exposure Risk Factors for Psychological Distress: An Empirical Test of the Proposed Continuum of Survivorship Model

“…While the Continuum model proposes first responders as individuals who may fit in the categories of suicide exposed or suicide affected given their lack of closeness to the person who died, our results suggest another conceptualization of this experience, where closeness to the decedent is minimal yet the impact of the exposure is significant and life disrupting. We note that our findings align with emerging qualitative research with these groups (16), where the absence of closeness with simultaneous impact suggests that an attachment theory-based model does not adequately explain all responses to exposure to suicide death.…”

“…Yet, when examining the breadth of exposure to suicide, many people are exposed, and significantly impacted from that exposure, beyond those grieving a loss. A clear example of this is those who are occupationally exposed to suicide, including health care professionals (16) and first 1 Survivors of suicide is commonly used in North America to refer to those who have been bereaved by suicide. responders such as firefighters (17), ambulance staff (18), and law enforcement officers (19).…”

“…Yet, when examining the breadth of exposure to suicide, many people are exposed, and significantly impacted from that exposure, beyond those grieving a loss. A clear example of this is those who are occupationally exposed to suicide, including health care professionals ( 16 ) and first responders such as firefighters ( 17 ), ambulance staff ( 18 ), and law enforcement officers ( 19 ). Additionally, community members who find the deceased when a suicide occurs in public, referred to as zero responders, may not ever have known the person prior to their death, yet still experience impact resulting from the exposure ( 20 ).…”

Suicide exposure experience screener for use in therapeutic settings: A validation report

“…Third, some of the datasets asked specifically about one suicide death (e.g., SANE Survey participants were reporting specifically on a person they had cared for prior to their death), while the other surveys asked people how many suicide deaths they had experienced, and then, these two SEES items were asked specifically about the “most impactful” or “death that affected you the most.” How cumulative exposure to suicide is experienced in relation to closeness and impact is not yet known, nor is whether divergence across these two items may be present in this scenario which was not found in the datasets used in the present study that focussed only on one death. However, there is evidence that those with cumulative impact are at greater risk of suicide, including in occupational settings where exposure to suicide is more common such as members of the national guard (Bryan et al, 2017), first responders (Kimbrel et al, 2016), and health workers (Sanford et al, 2020), and thus, this should be a priority for further examination. Fourth, the relationship of these two SEES items specifically in those experiencing problematic or prolonged bereavement has not been assessed, as our datasets are primarily drawn from community members volunteering to complete an online survey.…”

Establishing a Guide for Developing Organizational Support in Healthcare Following a Critical or Sentinel Event

“…There are multiple organizational strategies showing potential to ease the distress for health professionals such as debriefing, mentoring, and psychological first aid (Liukka et al, 2020; Seys et al, 2013). The strategies are often limited in their accessibility and quality of delivery (Buhlmann et al, 2021; Kable & Spigelman, 2018; Pezaro et al, 2017; Sanford et al, 2021), as well as their responsiveness to the uniqueness of specific healthcare situations. There are examples of initiatives to address these limitations but there does not appear to be a model of support that provides a consistent guide for organizations (Buhlmann et al, 2021; Sanford et al, 2021).…”