Demand for Suicide Prevention Increases

New findings underscore earlier survey data that indicate Americans are ready and willing to talk about mental health—in particular suicide—and they are feeling more empathetic during this time of uncertainty, isolation, economic stress, and concern about physical health.^1,2 A Harris Poll online survey of 2072 US adults took place from July 22-24, 2020, and makes the case for suicide prevention as a national priority, especially in light of the turmoil, disruption, and uncertainty of the COVID-19 pandemic.

The American Foundation for Suicide Prevention (AFSP), National Action Alliance for Suicide Prevention (Action Alliance), the Suicide Prevention Resource Center (SPRC), and Education Development Center (EDC), teamed up to assess where we are in the national conversation about suicide. Overwhelming respondents in the online survey deemed mental health as important:

• 81% think suicide prevention should be a nationwide priority.
• 93% believe suicide is preventable.
• 66% are concerned for friends and family members with psychiatric issues and are open to talking about suicide with them.
• 78% believe both mental and physical health are essential for quality living.

Given that September is Suicide Prevention Awareness Month, the findings are even more timely. In a press release, Jerry Reed, PhD, senior vice president for practice leadership at EDC, said, "This data shows us that Americans see these issues as critically important and that they want to play a role in addressing them. We must take bold steps now to support those who are struggling and to emerge a stronger country."

In the event a patient dies by suicide

According to Christine Moutier, MD, Chief Medical Officer of AFSP, “Research shows approximately half of psychiatrists and approximately 20% of other mental health professionals experience the loss of one or more patients to suicide over the course of their career.” A range of emotions flood all individuals associated with the patient, but clinicians especially may experience feelings of guilt, grief, anger, or shame.

“This loss experience can be far more distressing than one might anticipate,” said Moutier. “For example, in one study, half of psychiatrists who lost a patient to suicide had scores on the Impact of an Event Scale comparable to a clinical population after the death of a parent."³

Moutier added, “Psychiatry residents are even more likely to experience the suicide of a patient related to the structure of training with trainees often caring for the most severely and chronically ill patient populations. The loss experience for health professionals also has the challenge of including both personal and professional levels of ramifications.”

Steps for clinician support

Self-care and outside support are especially important after the loss of a patient to suicide. Psychiatrists can take intentional steps to process the many emotions and grief so that they continue in the healthiest way possible in the event one of their patients dies by suicide, as follows:

• Immediately after a death by suicide and in the ensuing weeks, seek support as needed. This can take the form of debriefing, therapy, peer support, etc.
• Take steps to practice basic self-care, eg, sleep, exercise, adequate nutrition, and time for reflection.
• Participate in institutional processes such as case review, sentinel event, meeting with risk management, and root cause analyses.
• Offer to meet with the deceased patient’s family. According to Moutier, “This meeting has a clear purpose and parameters—to listen and provide support and empathy for the family, answer questions without violating patient confidentiality, and to offer sincere condolences.
• Know that you are not alone in this experience.

Additionally, Moutier said, “Ask your organizational leaders about educational programs and resources that make health care professional mental health a priority. These resources can help break the culture of silence around clinician mental health as well as barriers physicians can face from accessing mental health care, including concerns about licensure and hospital privileging.”

References

1. National Survey Shows Majority of Americans Would Take Action to Prevent Suicide. The Harris Poll. Accessed September 16, 2020. https://theharrispoll.com/national-survey-shows-majority-of-americans-would-take-action-to-prevent-suicide

2. COVID-19 Reinforces A Renewed Call to Make Suicide Prevention a National Priority (press release). September 1, 2020. Accessed September 16, 2020. https://www.prnewswire.com/news-releases/covid-19-reinforces-a-renewed-call-to-make-suicide-prevention-a-national-priority-301121593.html

3. Chemtob CM, Hamada RS, Bauer G, et al. Patients' suicides: frequency and impact on psychiatrists. 1988;145(2):224-228.