Croft Alison, Lascelles Karen, Brand Fiona, Carbonnier Anne, Gibbons Rachel, Wolfart Gislene, Hawton Keith
Department of Continuing Education, University of Oxford, Oxford, UK.
Oxford Cognitive Therapy Centre, Oxford Health NHS Foundation Trust, Oxford, UK.
Int J Ment Health Nurs. 2023 Feb;32(1):245-276. doi: 10.1111/inm.13080. Epub 2022 Oct 26.
In the UK, at least a quarter of suicides occurs in patients whilst under the care of mental health services. This study investigated the effects of such deaths on non-medical mental health clinicians. An online survey was conducted within a single NHS mental health Trust to elicit both quantitative and qualitative responses from staff across a range of professions. The survey focused on personal and professional impacts and available support. Participants reported significant negative emotional and professional effects that were long-lasting for some. These included mental health difficulties, loss of confidence regarding clinical responsibilities, and actual or contemplated career change. However, there was also some evidence of positive effects and professional growth. Support from colleagues and line managers is clearly important following deaths of patients by suicide. Clinicians' experiences of the support they had received in the workplace were polarized, suggesting that there is no single nor ideal approach that will meet everyone's needs. Participants made recommendations for the types of support that may be helpful. Most commonly, clinicians desired opportunities for focused reflection and support and help with the formal processes following the death. Sensitivity around how clinicians are notified about the death was highlighted as being particularly important. Conclusions are drawn as to how training institutions and employers can help staff to be better prepared for the potential occurrence of patient suicides and the formal processes that follow, with a view to mitigating risks of more serious harm to staff and hence indirectly to patients, and potential loss of highly trained clinicians to the workforce.
在英国,至少四分之一的自杀事件发生在接受心理健康服务护理的患者身上。本研究调查了此类死亡事件对非医学心理健康临床医生的影响。在一家国民保健服务(NHS)心理健康信托机构内进行了一项在线调查,以获取不同职业工作人员的定量和定性反馈。该调查聚焦于个人和职业影响以及可得的支持。参与者报告了显著的负面情绪和职业影响,其中一些影响持续时间较长。这些影响包括心理健康问题、对临床职责的信心丧失,以及实际的或考虑中的职业转变。然而,也有一些积极影响和职业成长的证据。患者自杀死亡后,同事和直属经理的支持显然很重要。临床医生对在工作场所获得的支持的体验两极分化,这表明没有一种单一的或理想的方法能满足每个人的需求。参与者对可能有帮助的支持类型提出了建议。最常见的是,临床医生希望有集中反思和支持的机会,以及在患者死亡后的正式流程方面得到帮助。强调在通知临床医生患者死亡的方式上保持敏感性尤为重要。得出了关于培训机构和雇主如何帮助员工更好地应对患者自杀潜在事件及其后续正式流程的结论,以期降低对员工造成更严重伤害的风险,从而间接降低对患者的风险,并防止训练有素的临床医生从劳动力队伍中流失。