Patient suicide has a profound effect on health care professionals, and institutions that train or employ them should develop best practices for suicide education, prevention, and post-suicide intervention, according to a report in Psychiatric Services in Advance.
A literature review revealed that more than half of all health care professionals and nearly three-quarters of all psychiatrists have experienced the suicide of a patient; just under half of all psychiatric trainees have experienced the suicide of a patient.
“Patient suicide is common and occurs across the spectrum of health care professionals at all career stages, including training,” wrote lead author Madison Jupina, D.O., of MetroHealth Hospital, Cleveland, and colleagues. “The impacts of patient suicide can be serious, and it appears that certain groups of professionals may be more vulnerable to adverse outcomes, including individuals in training and those who are more isolated within systems of care.”
The authors conducted a systematic literature review in October 2021 and August 2022 using keywords related to patient suicide to capture articles on the prevalence of patient suicide and its impact on health care professionals. In total, 66 articles met the inclusion criteria. Of these, 41 studies from 15 countries reported the prevalence of patient suicide experienced by health care professionals; the sample sizes of health care professionals in these studies ranged from 5 to 1,391.
The following are significant findings from the review:
- An average of 51% of health care professionals across the studies experienced a patient suicide, and an average of 73% of psychiatrists across the studies experienced a suicide; among psychiatric trainees, the average was 48%.
- Eleven articles reported that health care professionals developed increased self-doubt or decreased self-confidence after a patient suicide. Eight articles reported that they considered a career change, and two reported that they made a career change. Six articles examined the practice of taking time off after a patient suicide and found that only 0% to 10% of health care professionals did so.
- Fifty articles reported on the professional impact of patient suicide on health care professionals, and 33 articles noted a change in practice. Changes in practice included an increased tendency to hospitalize suicidal patients; they also become more cautious, used more consultations, avoided or no longer treated suicidal patients, and recorded more details in patient charts.
The literature review highlighted the usefulness of informal institutional supports after a patient suicide. “Time off should be actively encouraged to allow health care professionals to grieve and to utilize informal supports, such as family and friends,” Jupina and colleagues wrote. “Because informal support offered by colleagues was rated as very helpful and highly desirable, it would be beneficial to consider providing allotted time during the workday for peer-led grief or process groups, and facilitator training could be provided for these groups.”
For related information, see the Psychiatric News article “Preventing Suicide Begins With Regular Assessments.”
(Image: Getty Images/iStock/KatarzynaBialasiewicz)
