The impact of Patient Suicide on Psychiatric Trainees and Early Career Psychiatrists: a qualitative analysis of feelings and unmet needs from an Italian survey

The experience of patient suicide (PS) represents a challenging event that most psychiatrists may deal with during their careers. We conducted a qualitative study to evaluate the emotional impact and reactions to PS, in a small sample of psychiatric trainees and early career psychiatrists (n=15) in one university hospital in Italy. Psychiatric trainees and early career psychiatrists working at the Clinical Psychiatry Unit of Polytechnic University of Marche (Ancona, Italy) were surveyed to assess emotional impact of PS, influence on future work, perceived support, and how the PS experience should be managed. An online survey was conducted, and a qualitative approach (thematic analysis) was used to analyse the data. Fifteen professionals completed the survey. Sadness (47%) and shock (33%) were the most reported emotions, along with feelings of guilt, impotence and inadequacy, disappointment, frustration, and anger. PS seemed to have a strong influence on clinical activity, increasing attention towards the patient and commitment, although the impression of being of limited help to the patient was commonly reported. Albeit valuing the opportunity to share their emotional experience with peers, the respondents highlighted the lack of professional support and the relevant need to implement discussion and interventions to deal with PS. Overall, our findings support the importance of addressing the strong emotional effect of PS on psychiatric trainees and early career psychiatrists as well as the necessity for more structured support strategies in the aftermath of PS. Larger investigations on this topic are warranted.