Working with suicidal people : an exploration of the meaning of front-line, non-mental-health professionals

• Main Author: Richards, Barbara
• Published: University of Reading 2011
• Subjects: 362.28
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.553150

This study investigated the psychological impact on professionals in the non-mental- health sectors, of working with suicidal people. It sought to provide a deeper understanding of the meaning that such professionals attribute to their experiences of this kind. Four professional groups were included: Police Officers, Ambulance personnel, Intensive Care Nurses and Medical Practitioners. Questionnaire results provided a contextual overview, to which was added the rich descriptions of lived experience that emerged from narrative interviews. This is the first time that personal, in-depth accounts about their experience of the task have been collected from front-line staff working with suicidal people. A purposive sample of 34 interviewees was selected from the 103 questionnaires returned. One person from each profession was interviewed a second time. An analysis based upon the hermeneutic circle ensured that the process was iterative and the interpretation of phenomena holistic. Psychoanalytic theory was used to provide a framework within which this complex area of experience could be explored and represented. Professionals were found to be affected by experiences with suicidal people according to the core aspects of their own internal world. Negative staff attitudes were understood to arise out of feelings evoked in such work, such as fear and inadequacy, which may conflict with the professional's sense of identity. A spectrum of detachment defences was noted and a dynamic relationship between individual and group defences was revealed. Models were developed to illustrate the nature of the defensive system and categories of features which were found to make suicidal incidents salient and pernicious for the professionals concerned. As a result of the findings it is recommended that specific training and ongoing clinical supervision be provided for non-mentaI-health professionals, to equip them to understand service users who self-harm and also the psychological impact of this work upon themselves and upon their colleagues.