Exposure to suicides was found to be distressing for mental health professionals (MHPs) during a scoping review, published in PLoS One.
Researchers at the University of Otago in New Zealand searched publication databases for studies that focused on the impact of suicide on MHPs. A total of 25 studies, with an average quality of qualitative research score of 7.5 out of 10, were included.
The studies assessed the well-being of psychiatrists and psychologists (n=11), all MHPs (n=7), first responders (n=5), nurses (n=1), and counselors and social workers (n=1).
Suicide exposures ranged from 32% to 46.6%; MHPs were exposed to an average of 4 suicides over their career. Professional practice changes were increased awareness of suicide risk, reduction in professional confidence, increased referrals, and fear of negative publicity or litigation. On a personal level, the MHPs described feelings of sadness, guilt, self-doubt, shock, grief, and anger.
MHPs who were women, were younger than 50 years of age, and had either less than 5 years of professional experience, or 11 to 20 years, were more likely to change their professional practice, such as becoming hypervigilant to suicide risk cues, and more likely to have negative personal impacts.
Studies that focused on only psychiatrists and psychologists reported exposure to at least 1 suicide at a rate of 31.5% to 92%. One study found that more practicing men had patient suicides than women, but the researchers involved were unable to explain this discrepancy. Women indicated they felt a higher sense of responsibility than men when their patient died by suicide and that they experienced a more pronounced emotional response. After a suicide, clinicians were more likely to use suicidality assessment tools.
For the study of only counselors and social workers, most (82.7%) had some professional experience with suicide attempts or completed suicides. A third of these professionals (34.3%) considered a career change and 15% considered retiring early as a reaction to the suicide.
This review may have been limited by including only those studies published within the last 10 years.
The review authors concluded MHPs experienced adverse mental health outcomes after exposure to suicides in the workplace. The reaction to suicide may have a gender-specific bias, in which women MHPs reported more psychological and professional impacts.
Lopes de Lyra R, McKenzie SK, Every-Palmer S, Jenkin G. Occupational exposure to suicide: A review of research on the experiences of mental health professionals and first responders. PLoS One. Published online April 30, 2021. doi:10.1371/journal.pone.0251038