Psychiatrists' reactions to a patient's suicide - narrative review.

Abstract

Introduction: The suicide of a patient can have a profound impact on the emotional state and professional practice of clinicians. The aim of the study was to: (1) determine the prevalence of the psychiatrists' experience of patient suicide; (2) compare doctors' responses to the patient's death conditioned by various causes; (3) identify the impact of patient suicide on the emotional state and professional practice of psychiatrists; (4) identify possible interventions and mental support for doctors.

Material and methods: A comprehensive review of literature in Polish and English was conducted, sourcing from PubMed and Google Scholar with keywords: "patient suicide", "psychiatrists' reactions" and "mental support" databases from 1983 to 7 March 2024. A total of 56 publications, including 41 original research papers and 15 review articles, were analysed using the SANRA scale to ensure the quality of the review.

Results: Between 38.8% and 91.5% of psychiatrists experienced patient suicide in their practice, which involved the following consequences: (1) a change in emotional state (the appearance of sadness, fear, disbelief, anger, grief, shame; less often stress reaction and the syndrome of post-traumatic stress disorder); (2) impact on professional practice (doubt in one's competence, fear of professional responsibility or criticism, increased number of consultations, excessive compliance with safety measures, too frequent hospitalisations of patients). Adequate mental support, including especially from more experienced colleagues and loved ones, significantly reduced the negative reactions of doctors.

Conclusions: It is important to recognise the problem of the enormous emotional burden of a patient suicide death on psychiatrists and the impact on their professional practice, as well as building among them an efficient training and mental support system.