Department of Psychiatry, Institute of Medical Science, University of Toronto, Toronto, Canada.
Psychiatr Q. 2015 Dec;86(4):449-57. doi: 10.1007/s11126-015-9346-6.
While there is a large literature on the impact of patient suicide on care providers and on family members, and a small literature on the impact of hospital suicide on inpatients and on surviving members of a therapy group, nothing has been written about the effect of a suicide on patients in a community mental health facility. This paper discusses the potential for ripple effects and the need for extra care and surveillance when a patient commits suicide in an outpatient program for the seriously mentally ill. The paper draws on related literature (suicide in groups, hospitals, schools, and college campuses) and, using examples from a clinic for women with psychosis, makes recommendations for psychiatric intervention post suicide. After the trauma of suicide, staff needs protected time to inform and support survivors, taking special care with those seen as most vulnerable. Following a trauma such as suicide, patients tend to stay near a source of comfort, and may require extra staff time. Survivors need to make sense of what happened and to honor the dead. This brings privacy concerns to the fore, as well as staff ambivalence about the respect due to a person who should be remembered, but should not serve as a role model to fellow patients who are susceptible to contagion effects. The review that follows a suicide can lead to closure for staff and patients and to the development of a protocol to follow should similar incidents recur.
虽然有大量文献探讨了患者自杀对护理人员和家属的影响，也有少量文献探讨了医院自杀对住院患者和治疗小组幸存成员的影响，但对于社区心理健康机构的患者自杀的影响却没有任何研究。本文讨论了在门诊严重精神疾病患者计划中患者自杀可能产生的连锁反应，以及需要额外的护理和监测。本文借鉴了相关文献（团体、医院、学校和大学校园自杀），并从精神病诊所的例子出发，为自杀后的精神干预提出了建议。在自杀的创伤之后，工作人员需要有时间来通知和支持幸存者，并特别关注那些被认为最脆弱的人。在经历了自杀等创伤之后，患者往往会留在一个舒适的地方，可能需要额外的工作人员时间。幸存者需要理解发生的事情，并向死者表示敬意。这就引发了隐私问题，以及工作人员对应该被记住但不应成为易受感染影响的其他患者榜样的人的尊重的矛盾心理。对自杀事件的审查可以让工作人员和患者得到解脱，并制定一个在类似事件再次发生时遵循的协议。
