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Alawad MS, Alammari MA, Almanea MM, Alhumaid RS, Alkhalifah AS, Alosaimi FD. Coping strategies of psychiatrists and psychiatry trainees following patient suicide and suicide attempt: A national cross-sectional study in Saudi Arabia. PLoS One 2024; 19:e0300004. [PMID: 38451986 PMCID: PMC10919647 DOI: 10.1371/journal.pone.0300004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 02/19/2024] [Indexed: 03/09/2024] Open
Abstract
A patient's suicide or suicide attempt is a challenging experience for psychiatrists. This study aimed to explore the common coping strategies and habits developed by psychiatrists/trainees following such incidents. A self-administered questionnaire was distributed among participants in Saudi Arabia. The study enrolled 178 participants, of whom 38.8% experienced a patient's suicide, 12.9% experienced a patient's severe suicide attempt, and 48.3% did not encounter any suicidal events. The most frequently utilized sources of support were colleagues (48.9%), team discussions (41.3%), and supervisors (29.3%). Only 21.4% received formal education in coping with a patient's suicide. Approximately 94.9% reported a lack of support systems within their institution. The study highlighted the coping strategies most commonly employed by psychiatrists/trainees and revealed that the majority of participants reported no changes in their daily habits. The findings underscore the need for a structured support system and formal educational resources to address the existing deficit. Mental health organizations must take action to ensure adequate resources for healthcare providers.
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Affiliation(s)
| | | | - Mohannad M. Almanea
- Pediatric Residency Program, Maternity and Children Hospital, Buraydah, Saudi Arabia
| | | | | | - Fahad D. Alosaimi
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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McCarthy B. Supporting trainees when a patient dies by suicide. Ir J Psychol Med 2023; 40:524-526. [PMID: 33745464 DOI: 10.1017/ipm.2021.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- B McCarthy
- St Vincent's Hospital Fairview, Convent Avenue, Ballybough, Dublin 3, Ireland
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Berardelli I, Aguglia A, Cassioli E, Bersani FS, Longo L, Luciano M, Minichino A, Santambrogio J, Solmi M, Rossi R, Ribolsi M, Gattoni E, Monteleone AM. Suicide-Related Knowledge among Italian Early Career Psychiatrists and Trainees: Results from a Cross-Sectional Survey. Brain Sci 2022; 12:brainsci12121619. [PMID: 36552079 PMCID: PMC9776389 DOI: 10.3390/brainsci12121619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/10/2022] [Accepted: 11/19/2022] [Indexed: 11/29/2022] Open
Abstract
The training of mental health professionals is an important component of suicide-prevention programs. A cross-sectional survey was conducted in different Italian regions to evaluate knowledge of, and attitudes toward, suicide as well as the experience of a patient's suicide or a suicide attempt in early career psychiatrists (ECPs) and trainees (N = 338). The Suicide Knowledge and Skills Questionnaire and the Impact of a Patient's Suicide on Professional and Personal Lives scale were administered. Furthermore, symptoms of intrusion, avoidance, and arousal were examined through the Impact of Event Scale in ECPs and trainees who had experienced the suicide of a patient or a suicide attempt. Participants with training were more confident in the clinical management of suicide-risk patients. The group with experience of a patient's suicide reported more suicide skills except for support and supervision. Finally, the participants who reported a patient's suicide presented a more conservative patient selection, difficulties in relationships, loss of self-esteem, dreams linked to suicide, intrusive thoughts of suicide, guilt, and anger. Our results show that knowledge of, and attitudes toward, suicide are essential in the management of suicide-risk patients.
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Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035, 00189 Rome, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, 16132 Genoa, Italy
- Correspondence: ; Tel.: +39-010-1353-7665
| | - Emanuele Cassioli
- Psychiatry Unit, Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - Francesco Saverio Bersani
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- Psychiatry and Clinical Psychopharmacology University Unit, Department of Mental Health, Azienda Sanitaria Locale (ASL) Latina, 04100 Latina, Italy
| | - Luisa Longo
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21201, USA
| | - Mario Luciano
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80138 Naples, Italy
| | - Amedeo Minichino
- Department of Psychiatry, University of Oxford, Oxford OX1 2JD, UK
| | - Jacopo Santambrogio
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON K1Z 7K4, Canada
- Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program, University of Ottawa, Ottawa, ON K1Z 7K4, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, 10117 Berlin, Germany
| | - Rodolfo Rossi
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Michele Ribolsi
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine, University Campus Bio-Medico of Rome, 00128 Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy
| | - Eleonora Gattoni
- Psychiatry Ward, Maggiore della Carità University Hospital, 28100 Novara, Italy
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Prevalence of trauma- and stress-related symptoms in psychiatrists and trainees following patient suicide in the United States. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1283-1288. [PMID: 33415406 DOI: 10.1007/s00127-020-02023-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Global studies show patient suicides among psychiatrists, including trainees, range from 33 to 80%. To our knowledge, there is no such data in the United States following a single study in 1988 regarding psychiatrists' or resident trainees' emotional response to patient suicide. The objective of our study was to assess the stress- and trauma-related symptoms following patient suicide in practicing psychiatrists and trainees. METHODS Data were collected by sending an online version of the survey to randomly selected psychiatrists and residency programs throughout the United States. Program directors were requested to share the questionnaires with their residents and fellows in training. Participants' stress was assessed by the impact of event scale-revised version (IES-R). RESULTS Our study shows 324 (63.6%) of the participants experienced patient suicide, which included 292 psychiatrists (76.1%) and 31 trainees (27.2%). Among the respondents, 3.8% of the psychiatrists and 9.7% of the trainees had clinically significant stress- and trauma-related disorders. CONCLUSION The presence of higher levels of emotional exhaustion and depression than medical or surgical colleagues depicts the need for training programs, formal and informal support, workshops, or curricular changes to address this almost inevitable issue in a psychiatrist's career.
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McCutcheon S, Hyman J. Increasing Resident Support Following Patient Suicide: Assessing Resident Perceptions of a Longitudinal, Multimodal Patient Suicide Curriculum. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2021; 45:288-291. [PMID: 33655455 PMCID: PMC7924018 DOI: 10.1007/s40596-021-01425-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 02/18/2021] [Indexed: 05/24/2023]
Abstract
OBJECTIVE Patient suicide is a common experience in psychiatry residency, and its effects on trainees can be profound. There are currently no ACGME Common Program Requirements for education about patient suicide, and a need exists for evidence-based curricula to prepare residents for this difficult outcome. METHODS A comprehensive patient suicide curriculum was developed utilizing multiple modes of delivering content, including a training designed to foster built-in support among peers in the healthcare workplace. The content was delivered at intervals over the course of the 2019-2020 academic year for 43 psychiatry residents at The Ohio State University Wexner Medical Center. Pre- and post-curriculum surveys were obtained to assess the resident experience of the new curriculum. RESULTS Twenty-seven residents completed the pre-curriculum survey and 25 completed the post-curriculum survey. Results demonstrated statistically significant improvements in ratings of preparedness to deal with the loss of a patient by suicide, preparedness to support a co-resident who has experienced the death of a patient by suicide, program-level support for residents, understanding systems-level and quality processes, and knowledge of what steps to take if finding out a patient has completed suicide. CONCLUSIONS A multimodal approach incorporating understanding emotional reactions, provision of support, delineation of procedural issues, and education regarding quality and risk management considerations was effective at improving resident preparedness to cope following a patient suicide.
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Affiliation(s)
- Samar McCutcheon
- The Ohio State University College of Medicine, Columbus, OH, USA.
| | - Julie Hyman
- The Ohio State University College of Medicine, Columbus, OH, USA
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Henry J, Ramages M, Cheung G. The development of patient suicide post-vention guidelines for psychiatry trainees and supervisors. Australas Psychiatry 2020; 28:589-594. [PMID: 32510980 DOI: 10.1177/1039856220930687] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Patient suicide is one of the most stressful events for psychiatrists and psychiatry trainees. However, there is often a lack of consistent guidance and support available to clinicians, including post-vention. The aim of this paper is to describe the development of a resource that could support psychiatry trainees following patient suicide. METHODS Following a literature review, we adapted two US patient suicide post-vention guidelines to reflect local processes and support systems available by consulting a number of key stakeholders in the training programme and district health boards. RESULTS The first part of the post-vention guidelines included procedural processes such as the serious incident review process and reporting to coroner's office. The second part included a checklist for trainee, supervisor, local training facilitator and director of training according to the following time frame: first 24 hours, first 1-2 weeks and following months. CONCLUSIONS Post-vention guidelines and teaching about patient suicide and its effects could improve the training experience of psychiatry trainees and facilitate the development of resilience as they progress through training.
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Affiliation(s)
- Jessica Henry
- Auckland Regional Psychiatric Training Program, Royal Australian and New Zealand College of Psychiatrists, New Zealand
| | - Meagan Ramages
- Mental Health Services for Older Adults, Waitemata DHB, New Zealand
| | - Gary Cheung
- Department of Psychological Medicine, School of Medicine, the University of Auckland, New Zealand
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Abstract
BACKGROUND/AIM Patient suicide is an adversity that can be considered an "occupational hazard." It has been identified as one of the most stressful adverse events during psychiatric training. The aim of this study was to systematically review the literature assessing the impact of patient suicide on trainees. METHODS We conducted a systematic review on the MEDLINE, Science Direct, Scopus, and Web of Science databases. Studies that reported prevalence of patient suicide, quantitative or qualitative assessment of psychological and professional impacts, coping strategies, and support or educational and postvention programs were deemed eligible for inclusion. RESULTS Of the 1994 articles identified, 22 were included. The literature on the topic was scarce, and the quality of the studies was moderate. No article dealt with nonpsychiatric residents. During their training, 46.4% of psychiatric trainees encountered at least one patient suicide. The traumatic impact was significantly more intense in trainees compared to senior physicians. A negative impact on their professional practice was reported by 17% to 39% of trainees. Formal institutional support for the affected trainees was described as having major shortcomings, and informal support from peers and families was reported as the most helpful response. However, 52% of impacted trainees considered encountering patient suicide a useful and beneficial experience. CONCLUSION The frequent posttraumatic symptoms and the negative professional consequences following patient suicide are worrying phenomena that highlight the need to improve suicide prevention and postvention programs during psychiatric training. Identifying trainees with personal vulnerability factors should be a major concern during the postvention process.
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Abstract
When considering critical elements involved in suicide prevention, dialogs are often dominated by suicide assessment, management, and intervention themes. Proactive consideration on what to do if a patient dies by suicide is often overlooked, which can be especially detrimental to our practice and those we serve. In this article, we extend the philosophy of the therapeutic risk management model to consider ways in which we can take good care of the extended community of suicide loss survivors, including providers. We begin by briefly describing the widespread impact of suicide loss and the lack of suicide postvention education and awareness. Given the increased likelihood that providers will be touched by suicide loss, we then provide recommendations and resources to assist the provider in developing and/or enhancing suicide postvention practices.
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Coverdale J, Balon R, Beresin EV, Brenner AM, Louie AK, Guerrero APS, Roberts LW. What Are Some Stressful Adversities in Psychiatry Residency Training, and How Should They Be Managed Professionally? ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2019; 43:145-150. [PMID: 30697662 DOI: 10.1007/s40596-019-01026-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 01/18/2019] [Indexed: 06/09/2023]
Affiliation(s)
| | | | | | - Adam M Brenner
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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Brenner AM, Balon R, Guerrero APS, Beresin EV, Coverdale JH, Louie AK, Roberts LW. Training as a Psychiatrist When Having a Psychiatric Illness. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2018; 42:592-597. [PMID: 30105576 DOI: 10.1007/s40596-018-0963-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 07/24/2018] [Indexed: 05/28/2023]
Affiliation(s)
- Adam M Brenner
- University of Texas Southwestern Medical Center, Dallas, TX, USA.
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Abstract
Evidence-based suggestions for developing an effective clinician-client relationship built upon trust and honesty will be shared, as well as a review of relevant scope of practice issues for audiologists. Audiologists need to be prepared if a patient threatens self-harm. Many patients do not spontaneously report their suicidal thoughts and intentions to their care providers, so we need to be alert to warning signs. Information about the strongest predictors of suicide, how to ask about suicidal intentions, and how to assess the risk of suicide will be presented. Although it is our responsibility to recognize suicidal tendencies and have a plan for preventive intervention, it is not our responsibility to conduct a suicide evaluation. Tips for collecting critical information to be provided to qualified professionals will be shared, as well as additional information about how and to whom to disclose this information. A list of suicide warning signs will be reviewed as well as some additional suggestions for how to react when a patient discloses his or her suicidal intent. A review of available resources (for both the patient and the clinician) will be provided, along with instructions for how and when it is appropriate to access them.
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Affiliation(s)
- Lori Zitelli
- Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Otolaryngology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Catherine V Palmer
- Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Otolaryngology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Becker K, Manthey T, Kaess M, Brockmann E, Zimmermann F, Plener PL. Postvention bei Suizid: Was man als Kinder- und Jugendpsychiater und -therapeut wissen sollte. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2017; 45:475-482. [DOI: 10.1024/1422-4917/a000512] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung. Postvention bezeichnet das notwendige Maßnahmenpaket für alle durch eine Suizidhandlung Betroffenen nach einem Suizid. Patientensuizide in kinder- und jugendpsychiatrischen Kliniken sind selten, stellen aber eine sehr hohe Belastung für Angehörige, Mitpatienten und Klinikmitarbeiter dar. Neben dem Management der akuten Krisensituation mit klaren Kommunikationsregeln, dem angemessenen Umgang mit Suizidhinterbliebenen und der Verhinderung von Folgesuiziden bei Mitpatienten sollten verfügbare Handlungsempfehlungen der Kliniken zum Umgang bei Patientensuizid auch das Prozedere zur Hilfe psychischer Belastungen bei Ärzten, Therapeuten und weiteren Klinikmitarbeitern umfassen. Des Weiteren sollte Postvention aufgrund seiner Bedeutung ein fester Bestandteil in der Aus- und Weiterbildung kinderpsychiatrisch tätiger Therapeuten werden.
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Affiliation(s)
- Katja Becker
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Marburg und Philipps-Universität Marburg
| | - Thomas Manthey
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Marburg und Philipps-Universität Marburg
| | - Michael Kaess
- Klinik für Kinder- und Jugendpsychiatrie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg
| | | | - Frank Zimmermann
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Klinikum Aschaffenburg-Alzenau, Aschaffenburg
- Nationales Suizidpräventionsprogramm für Deutschland (NaSPro), AG Kinder und Jugendliche
| | - Paul L. Plener
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Zentralinstitut für Seelische Gesundheit, Mannheim
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