Stress reactions after a patient suicide and their relations to the profile of mental health professionals.

Alida Gulfi,Dolores Angela Castelli Dransart,Elisabeth M. Gutjahr,Jean-Luc Heeb

doi:10.1186/s12888-015-0655-y

Alida Gulfi, Dolores Angela Castelli Dransart + Show 2 more

Open Access

https://doi.org/10.1186/s12888-015-0655-y

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Abstract

BackgroundPatient suicide is a professional hazard for mental health professionals and an event likely to trigger stress reactions among them.This study aimed to identify typical profiles of professionals after a patient suicide to address the severity of stress reactions and its discriminant variables.MethodsMental health professionals (N = 666) working in institutional settings or private practice in the French-speaking part of Switzerland filled out a self-administered questionnaire including the IES-R (Impact of Event Scale-Revised). Profiles were identified by cluster analysis.ResultsThe interplay of variables pertaining to the relationship to the patient, exposure to suicide, support and training contributed to explaining the severity of stress reactions after a patient suicide. Five profiles of professionals were identified. Low-impacted professionals (55.8 % of the sample) were characterised either by high support and anticipation (anticipators with support), emotional distance to the patient (distant professionals) or no contact with the patient at the time of death (no more contact with patient professionals). Emotional closeness to, and responsibility for the patient were typical of moderately-impacted professionals (36.6 %, concerned professionals), while highly-impacted professionals felt emotionally close to the patient and lacked support although more than half of them sought it (7.7 %, unsupported professionals).ConclusionsDifferences in the professionals’ profiles relate prominently to the interplay between risk and protective factors. Professionals who were appropriately supported, i.e., according to their risk profile, were able to cope with the event. Taking into account the profiles of professionals and the severity of stress reactions may enable the screening of those professionals most in need of support. Those most impacted sought out help more frequently. However, only a minority of them were offered sufficient support. Institutional or vocational bodies should take measures to ensure that professionals seeking help find it easily and promptly.The combination of training and support seems to be crucial for mitigating risk factors since the three low impacted subgroups had received the most training and support.

Highlights

Patient suicide is a professional hazard for mental health professionals and an event likely to trigger stress reactions among them
Findings on the severity of stress reactions are heterogeneous: some studies found that a minority (7–14 %) of respondents reported symptoms above the cut off scores used in the literature (>19 for IES and ≥ 25 for IES-R [1, 6, 7]), while others found markedly higher percentages (49–53 % [2, 3, 8])
This paper aims (i) to check whether typical profiles can be identified to classify professionals into distinct subgroups when considering the predictors of stress reactions evidenced in the literature, (ii) to examine how these typical profiles relate to the severity of stress reactions after a patient suicide; (iii) to evidence the variables that most discriminate the typical profiles in order to identify prevention and postvention measures

Summary

Introduction

Patient suicide is a professional hazard for mental health professionals and an event likely to trigger stress reactions among them. This study aimed to identify typical profiles of professionals after a patient suicide to address the severity of stress reactions and its discriminant variables. Some studies have investigated predictors of severity for stress reactions, findings pertaining to patients or professionals' characteristics have been inconsistent [6]. This paper aims (i) to check whether typical profiles can be identified to classify professionals into distinct subgroups when considering the predictors of stress reactions evidenced in the literature, (ii) to examine how these typical profiles relate to the severity of stress reactions after a patient suicide; (iii) to evidence the variables that most discriminate the typical profiles in order to identify prevention and postvention measures

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