Dealing with suicide on a psychiatric inpatient unit.

Suicide on an inpatient unit can cause severe trauma among patients and staff. Consequently both groups may revert to less adaptive coping styles. In general, staff's recovery is gradual and natural and may yield an opportunity for emotional growth; however, prolonged disability may also occur. The authors interviewed 23 staff members who had worked on an inpatient unit during a 16-month period when four patients committed suicide. On the basis of these interviews, the authors have developed a framework for understanding the three phases of staff reaction to suicide and guidelines for helping staff through the recovery process. They recommend that ward administrators monitor and facilitate the group process by providing protection and support during the initial phase of shock, appropriate channels and limits for the intense feelings that occur during the second phase, and constructive forums for more mature coping activities during the third phase, as staff regain their equilibrium.