- Patient suicide exerts a heavier, qualitatively distinct impact on clinicians, with greater moderate and severe psychological and practice disruption than non-suicidal deaths.
- Blame strongly shapes responses: suicides prompt defensive practices, while non-suicidal deaths provoke internal questioning; clinicians view most suicides as low-predictability.
- Systems should acknowledge predictability limits, improve post-event support, and re-evaluate zero-suicide policies framed as unachievable in secondary care.
BJPsych Open. 2026 Jul 6;12(4):e178. doi: 10.1192/bjo.2026.12032.
ABSTRACT
BACKGROUND: Although all patient deaths affect clinicians, it remains unclear how the impact of suicides differs from other deaths. Is the trauma of losing a patient by suicide qualitatively distinct, or are the emotional, professional and organisational consequences of suicidal and non-suicidal deaths more similar than assumed?
AIMS: To investigate the impact of patient suicide compared with other patient deaths on clinicians’ psychological well-being, clinical practice and career. To explore clinicians’ perspectives on how current support systems do, or do not, meet their needs.
METHOD: A mixed-methods approach was used. An online survey with two subsets of questions (one for suicidal and one for non-suicidal patient deaths) was circulated to clinicians across South London and Maudsley NHS Foundation Trust.
RESULTS: A total of 122 responses were collected: two-thirds of respondents had experienced a patient suicide, with 53% reporting moderate and 12% reporting severe impact versus 36.6% reporting moderate and 4.2% severe for non-suicidal deaths. Non-suicidal death was associated with significantly lower impact (odds ratio 0.14, 95% CI [0.05, 0.41], p < 0.001) and less disruption to clinical practice. Blame emerged as a key factor shaping clinicians’ responses: 98% of respondents rated suicide as <60% predictable in secondary care, and 69% rated the ‘zero-suicide’ policy as unachievable.
CONCLUSIONS: Patient suicide has a heavier impact on clinicians, qualitatively distinct from other patient deaths. Blame shapes defensive responses in suicides, and internal questioning in non-suicidal deaths. The low-risk paradox and perceived unachievability of zero-suicide policies call for re-evaluation. Acknowledging predictability limits and clinicians’ support needs can help systems navigate the complex impact of patient suicides.
PMID:42405425 | DOI:10.1192/bjo.2026.12032
Share Evidence Blueprint
Save to Google Notes
Search Google Scholar
Save as PDF
⭐ My Revision List
