Impact of exposure to severe suicidal behaviours in patients during psychiatric training: An online French survey

Aim: Patient suicide (PS) has been identified as a frequent and stressful "occupational hazard" for mental health professionals. Studies are needed to assess the impact on psychiatric trainees of the exposure to severe patient suicidal behaviours.

Methods: Our cross-sectional study aimed to measure the prevalence of exposure to PS and severe patient suicide attempts (SPSA) in French psychiatric trainees. We also assessed the emotional, traumatic and professional impacts and perceived support in the aftermath through a 62-item online questionnaire that included the French version of the IES-R, a composite emotional score and questions about professional practice and perceived support. All French psychiatric trainees were contacted regarding participation in the study through email and social networks between November 2017 and March 2018.

Results: A total of 409 trainees participated in the survey (response rate = 16.4%). 253 trainees fully completed the questionnaire. Of the 253 trainees, 43.2% were exposed to PS and 13.8% to SPSA. The exposure mostly occurred in the early stage of the training period. Ten to 15% of exposed trainees showed a high level of traumatic and emotional impact and 8.1% exhibited clinically relevant symptoms of post-traumatic stress disorder (PTSD). We found that 21.6% received no support in the aftermath, especially after PS.

Conclusion: A large proportion of psychiatric trainees encounter severe suicidal behaviours of patients, and a substantial part of them is highly impacted. Our results thus stress the need for programmes dedicated to the prevention of the deleterious effects of the exposure to PS or SPSA in psychiatric trainees.