Nelson Pauline A, Cordingley Lis, Kapur Navneet, Chew-Graham Carolyn A, Shaw Jenny, Smith Shirley, McGale Barry, McDonnell Sharon
Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, The University of Manchester, Manchester, United Kingdom.
Division of Musculoskeletal & Dermatological Sciences, Manchester Biomedical Research Centre, The University of Manchester, Manchester, United Kingdom.
Front Psychol. 2020 Apr 21;11:722. doi: 10.3389/fpsyg.2020.00722. eCollection 2020.
Exposure to suicide is a known risk factor for suicide. Ambulance staff are exposed to work-related stressors including attending suicides, which may elevate their risk for mental health problems/suicide. Little is known about ambulance staff's perspectives on how they experience these events and whether they feel equipped to respond to bereaved families at the scene of death. This study explores the perspectives of ambulance staff about responding to deaths by suicide.
A convenience sample of ambulance staff recruited from one ambulance service in England. In-depth, qualitative, semi-structured face-to-face interviews conducted with nine ambulance staff (six male, three female) to explore experiences of responding to suicide. Data analyzed using thematic analysis.
Participants reported the experience of job-related strain including exposure to the suicide/suicidal ideation of colleagues; they described suppressing their distress despite significant emotional impact. All participants had been personally bereaved by suicide and responding to suicide was a common part of their job. They were often the first professionals at the scene, and undertook varied and often conflicting roles: negotiating with patients in crisis; informing individuals of the death of a loved one; preserving the body/potential crime scene; dealing with the intense emotional reactions of bereaved individuals. Participants reported long-term, salient memories of these events; however, there was a reported lack of acknowledgment in the workplace that suicides may be traumatic and no guidance for staff on how to cope. Opportunities to debrief were reportedly rare, and there was reluctance to access work-based liaison services. Training in how to respond to individuals bereaved by suicide was also lacking.
The study is the first to reveal the complex challenges faced by ambulance staff in responding to suicide without adequate training and support. It demonstrates the potential impact that responding to suicide can have personally and professionally on staff, and emphasizes the need for employers to support staff wellbeing in better ways. Training and postvention support could enable better coping among staff, more effective support for bereaved individuals and reduce the risk of death by suicide both in those bereaved by suicide and in ambulance staff.
接触自杀事件是已知的自杀风险因素。救护车工作人员面临与工作相关的压力源，包括参与自杀救援工作，这可能会增加他们出现心理健康问题/自杀的风险。对于救护车工作人员如何体验这些事件，以及他们是否觉得自己有能力在死亡现场应对死者家属，我们了解甚少。本研究探讨了救护车工作人员对应对自杀死亡事件的看法。
从英国一家救护车服务机构招募了一个方便样本的救护车工作人员。对九名救护车工作人员（六名男性，三名女性）进行了深入的定性半结构化面对面访谈，以探讨应对自杀事件的经历。采用主题分析法对数据进行分析。
参与者报告了与工作相关的压力经历，包括接触同事的自杀行为/自杀意念；他们描述了尽管受到重大情感影响，但仍压抑自己的痛苦。所有参与者都曾因自杀而痛失亲人，应对自杀是他们工作的常见部分。他们通常是现场的首批专业人员，承担着各种不同且常常相互冲突的角色：与处于危机中的患者谈判；告知亲人死亡的消息；保护尸体/潜在犯罪现场；应对死者家属强烈的情绪反应。参与者报告了对这些事件的长期、深刻记忆；然而，据报告工作场所并未认识到自杀事件可能具有创伤性，也没有为工作人员提供如何应对的指导。据报道，进行汇报的机会很少，而且工作人员不愿使用基于工作场所的联络服务。也缺乏如何应对自杀身亡者家属的培训。
该研究首次揭示了救护车工作人员在没有充分培训和支持的情况下应对自杀事件所面临的复杂挑战。它展示了应对自杀事件对工作人员个人和职业方面可能产生的潜在影响，并强调雇主需要以更好的方式支持员工的福祉。培训和事后干预支持可以使工作人员更好地应对，为死者家属提供更有效的支持，并降低自杀身亡者及其家属以及救护车工作人员的自杀死亡风险。
