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The Impact of Suicide on Co-patients

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Abstract

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.

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References

  1. Wurst FM, Kunz I, Skipper G, Wolfersdorf M, Beine KH, Thon N: The therapist’s reaction to a patient’s suicide: Results of a survey and implications for health care professionals’ well-being. Crisis 32:99–105, 2011.

    Article  PubMed  Google Scholar 

  2. Wurst FM, Kunz I, Skipper G, Wolfersdorf M, Beine KH, Vogel R, Müller S, Petitjean S, Thon N: How therapists react to patient’s suicide: Findings and consequences for health care professionals’ wellbeing. General Hospital Psychiatry 35:565–570, 2013.

    Article  PubMed  Google Scholar 

  3. Scocco P, Toffol E, Pilotto E, Pertile R: Psychiatrists’ emotional reactions to patient suicidal behavior. Journal of Psychiatric Practice 18:94–108, 2012.

    Article  PubMed  Google Scholar 

  4. Castelli Dransart DA, Gutjahr E, Gulfi A: Traumatic impact on Swiss mental health professionals. Death Studies 38:315–321, 2014.

    Article  Google Scholar 

  5. Henry M, Séguin M, Drouin M-S: Les réactions des professionnels en santé mentale au décès par suicide d’un patient. [Mental health professionals’ response to the suicide of their patients] Revue Québécoise Psychology 25:241–257, 2004.

    Google Scholar 

  6. Linke S, Wojciak J, Day S: The impact of suicide on community mental health teams: Findings and recommendations. Psychiatric Bulletin 26:50–52, 2002.

    Article  Google Scholar 

  7. Bjorkenstam C, Bjorkenstam E, Hjern A, Boden R, Reutfors J: Suicide in first episode psychosis: A nationwide cohort study. Schizophrenia Research 157:1–7, 2014.

    Article  CAS  PubMed  Google Scholar 

  8. Fleischhacker WW, Kane JM, Geier J, Karayal O, Kolluri S, Eng SM, Reynolds RF, Strom BL: Completed and attempted suicides among 18,154 subjects with schizophrenia included in a large simple trial. The Journal of Clinical Psychiatry 75:e184–190, 2014.

    Article  PubMed  Google Scholar 

  9. Pedersen CG, Jensen S, Gradus J, Johnsen SP, Mainz J: Systematic suicide risk assessment for patients with schizophrenia: A national population-based study. Psychiatric Services 65:226–231, 2014.

    Article  PubMed  Google Scholar 

  10. Maple M, Cerel J, Jordan JR, McKay K: Uncovering and identifying the missing voices in suicide bereavement. Suicidology Online 5:1–12, 2014.

    Google Scholar 

  11. Seeman MV, Cohen R: A service for women with schizophrenia. Psychiatric Services 49:674–677, 1998.

  12. Cheng Q, Li H, Silenzio V, Caine ED: Suicide contagion: A systematic review of definitions and research utility. PLoS ONE 9:e108724, 2014.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Haw C, Hawton K, Niedzwiedz C, Platt S: Suicide clusters: A review of risk factors and mechanisms. Suicide and Life Threatening Behavior 43:97–108, 2013.

    Article  PubMed  Google Scholar 

  14. Goldberg RW, Rollins AL, Lehman AF: Social network correlates among people with psychiatric disabilities. Psychiatric Rehabilitation Journal 26:393–402, 2003.

    Article  Google Scholar 

  15. Harley EWY, Boardman J, Craig T. Friendship in people with schizophrenia: A survey. Social Psychiatry and Psychiatric Epidemiology 47:1291–1299, 2012.

    Article  PubMed  Google Scholar 

  16. Buelow G: A suicide in group: A case of functional realignment. International Journal of Group Psychotherapy 44:153–168, 1994.

    CAS  PubMed  Google Scholar 

  17. Kibel HD: A group member’s suicide: Treating collective trauma. International Journal of Group Psychotherapy 23:42–53, 1973.

    CAS  PubMed  Google Scholar 

  18. O’Neill SM, Kueppenbender K: Suicide in group therapy: Trauma and possibility. International Journal of Group Psychotherapy 62:587–611, 2012.

    Google Scholar 

  19. Bartels SJ: The aftermath of suicide on the psychiatric inpatient unit. General Hospital Psychiatry 9:189–197, 1987.

    Article  CAS  PubMed  Google Scholar 

  20. Bowers L, Simpson A, Eyres S, Nijman H, Hall C, Grange A, Phillips L: Serious untoward incidents and their aftermath in acute inpatient psychiatry: The Tompkins Acute Ward Study. International Journal of Mental Health Nursing 15:226–234, 2006.

    Article  PubMed  Google Scholar 

  21. Brent DA, Moritz G, Bridge J, Perper J, Canobbio R: Long-term impact of exposure to suicide: A three-year controlled follow-up. Journal of the American Academy of Child & Adolescent Psychiatry 35:646–653, 1996.

    Article  CAS  PubMed  Google Scholar 

  22. Combs H, Romm S: Psychiatric inpatient suicide: A literature review. Primary Psychiatry 14:67–74, 2007.

    Google Scholar 

  23. Levine H: Suicide and its impact on campus. New Directions for Student Services 121:63–76, 2008.

    Article  Google Scholar 

  24. Sakinofsky I: The aftermath of suicide: Managing survivors’ bereavement. The Canadian Journal of Psychiatry 52(Suppl #1):129–136, 2007.

    Google Scholar 

  25. Myin-Germeys I, van Os J: Stress-reactivity in psychosis: evidence for an affective pathway to psychosis. Clinical Psychology Review 27:409–424, 2007.

    Article  PubMed  Google Scholar 

  26. Collins NL, Feeney BC: Attachment and caregiving in adult close relationships: Normative processes and individual differences. Attachment & Human Development 15:241–245, 2013.

    Article  PubMed  Google Scholar 

  27. Park CL: Making sense of the meaning literature: An integrative review of meaning making and its effects on adjustment to stressful life events. Psychology Bulletin 136:257–301, 2010.

    Article  PubMed  Google Scholar 

  28. Carver CS: Resilience and thriving: Issues, models, and linkages. Journal of Social Issues 54:245–266, 1998.

    Article  Google Scholar 

  29. Kan C-K, Ho T-P, Dong JYS, Dunn ELW: Risk factors for suicide in the immediate post-discharge period. Social Psychiatry and Psychiatric Epidemiology 42:208–214, 2007.

    Article  PubMed  Google Scholar 

  30. Pompili M, Amador XF, Girardi P, Harkavy-Friedman J, Harrow M, Kaplan K, Krausz M, Lester D, Meltzer HY, Modestin J, Montross LP, Mortensen PB, Munk-Jørgensen P, Nielsen J, Nordentoft M, Saarinen PI, Zisook S, Wilson ST, Tatarelli R: Suicide risk in schizophrenia: learning from the past to change the future. Annals of General Psychiatry 6:10, 2007; doi:10.1186/1744-859X-6-10.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Stack S, Kposowa AJ: The association of suicide rates with individual-level suicide attitudes: A cross-national analysis. Social science quarterly 89:39–59, 2008.

    Article  Google Scholar 

  32. Ballard ED, Pao M, Horowitz L, Lee LM, Henderson DK, Rosenstein DL: Aftermath of suicide in the hospital: institutional response. Psychosomatics 49:461–469, 2008.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Kuehn BM: Preventing suicide’s ripple effects takes coordinated effort. JAMA 310:570–571, 2013.

    Article  CAS  PubMed  Google Scholar 

  34. Cotton PG, Drake RE, Whitaker A, Potter J: Dealing with suicide on a psychiatric inpatient unit. Hospital & community psychiatry 34:55–59, 1983.

    CAS  PubMed  Google Scholar 

  35. Peterson EM, Luoma JB, Dunne E: Suicide survivors’ perceptions of the treating clinician. Suicide and Life-Threatening Behavior 32:158–166, 2002.

    Article  PubMed  Google Scholar 

  36. McGann VL, Gutin N, Jordan JR: Guidelines for postvention care with survivor families after the suicide of a client. In: Jordan JR, McIntosh JL (Eds) Grief after suicide: understanding the consequences and caring for the survivors New York, Routledge, pp. 133–155, 2011.

    Google Scholar 

  37. Michael ST, Snyder CR: Getting unstuck: The roles of hope, finding meaning, and rumination in the adjustment to bereavement among college students. Death Studies 29:435–458, 2005.

    Article  PubMed  Google Scholar 

  38. Hall C: Reconstructing meaning in the wake of loss: Creating ‘meaning full’ ritual. Grief Matters: The Australian Journal of Grief and Bereavement 4:1–53, 2001.

    Google Scholar 

  39. Neimeyer RA, Burke LA, Mackay MM, van Dyke Stringer JG: Grief therapy and the reconstruction of meaning: from principles to practice. The Journal of Contemporary Psychotherapy 40:73–83, 2010.

    Article  Google Scholar 

  40. Callahan J: Effects of a school suicide postvention program— A case example. Crisis 17:108–115, 1996.

    Article  CAS  PubMed  Google Scholar 

  41. Comstock BS, McDermott M: Group therapy for patients who attempt suicide. International Journal of Group Psychotherapy 25:44–49, 1975.

    CAS  PubMed  Google Scholar 

  42. Hippie J: Group treatment of suicidal clients. Journal for Specialists in Group Work 7:245–250, 1982.

    Article  Google Scholar 

  43. Cavanagh JT, Carson AJ, Sharpe M, Lawrie SM: Psychological autopsy studies of suicide: a systematic review. Psychological Medicine 33:395–405, 2003.

    Article  CAS  PubMed  Google Scholar 

  44. Shneidman ES: Suicide, lethality, and the psychological autopsy. International Psychiatry Clinics 6:225–250, 1969.

    CAS  PubMed  Google Scholar 

  45. Dyregrov KM, Dieserud G, Hjelmeland HM, Straiton M, Rasmussen ML, Knizek BL, Leenars AA: Meaning-making through psychological autopsy interviews: the value of participating in qualitative research for those bereaved by suicide. Death Studies 35: 685–710, 2011.

    Article  PubMed  Google Scholar 

  46. Foster T: Adverse life events proximal to adult suicide: A synthesis of findings from psychological autopsy studies. Archives of Suicide Research 15:1–15, 2011.

    Article  PubMed  Google Scholar 

  47. Hendin H, Haas AP, Maltsberger JT, Koestner B, Szanto K: Problems in psychotherapy with suicidal patients. The American Journal of Psychiatry 163:67–72, 2006.

    Article  PubMed  Google Scholar 

  48. Bongar B, Greaney SA: Essential clinical and legal issues when working with the suicidal patient. Death Studies 18:529–548, 1994.

    Article  CAS  PubMed  Google Scholar 

  49. Sher L: Suicide medical malpractice: an educational overview. The International Journal of Adolescent Medicine and Health, 2014; doi:10.1515/ijamh-2015-5012.

    Google Scholar 

  50. Balon R, Coverdale JH, Beresin EV, Louie AK, Roberts LW: Improving psychiatric education related to suicide. Academic Psychiatry 38:521–524, 2014.

    Article  PubMed  Google Scholar 

  51. Cerel J, Padgett JH, Conwell Y, Read GA: A call for research: The need to better understand the impact of support groups for suicide survivors. Suicide and Life Threatening Behavior 39:269–281, 2009.

    Article  PubMed Central  PubMed  Google Scholar 

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Conflict of interest

The author has no conflicts of interest in relation to this manuscript. No funding was received for this work.

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The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. No writing assistance was utilized in the production of this manuscript.

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  1. Department of Psychiatry, Institute of Medical Science, University of Toronto, Toronto, Canada

    Mary V. Seeman MDCM

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Correspondence to Mary V. Seeman MDCM.

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Seeman, M.V. The Impact of Suicide on Co-patients. Psychiatr Q 86, 449–457 (2015). https://doi.org/10.1007/s11126-015-9346-6

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