The impact of adolescent suicide on clinicians: a mixed-methods study

Abstract Background Clinician reactions to client suicide may include shock, grief, guilt, self-doubt, shame, anger, and fears of blame and medico-legal consequences. Clinicians will often differ in their reactions to the suicide and the type of supports required. Adolescent suicide-specific literature is limited. Aims We sought to explore clinician reactions and perceptions of support following child and adolescent suicide. Methods One hundred and fifteen staff working for a Child and Adolescent Mental Health Service were invited to complete an online survey with quantitative and qualitative components, and an in-depth semi-structured interview. Results were presented to teams for reflection and further feedback. Results Eight clinicians participated in the semi-structured interview, and 33 in the online survey. Thirteen were the primary clinician, and 21 were part of a multi-disciplinary team when a client suicided. Respondents were predominantly female, from a range of disciplines. Fifty per cent of primary clinicians found the support good to very good. The rest were neutral. However, 26% of team members found support poor to very poor. Clinicians reported questioning their clinical effectiveness and chosen vocation. Some reported a need to disconnect or withdraw to preserve motivation and empathy for the work. They received significant support from their team, and teams were very anxious for the well-being of primary clinicians. Conclusions Health services must find ways of helping staff feel that their sense of vocation is valued and nurtured. These strategies will likely include fostering team cohesiveness and mutual support and allowing opportunities to temporarily step back and recover after challenging experiences. Adolescent suicide can have a profound impact on clinicians’ appraisal of their own clinical abilities and sense of vocation. Workplace well-being interventions need to support the active measures that clinicians take to nurture their own sense of vocation. Such measures may be led by managers or occupational health services and may include healthy self-distancing from intense clinical work after critical incidents. Teams need to be reassured that the primary clinician is adequately supported post-critical incident.