How can we support staff after the death by suicide of a colleague?

Acknowledge the emotional impact

Gail Kinman, professor of occupational health psychology, Birkbeck Business School, says, “The sudden death of a colleague can be shocking, distressing, and destabilising. For a death by suicide, emotional responses can be intense, with wide ranging consequences. ‘Suicide postvention’ refers to the measures an organisation takes to offer sensitive and effective support following a death by suicide.

“Although suicide is rare, healthcare professionals are at greater risk. I was commissioned by the Louise Tebboth Foundation and the Society of Occupational Medicine to develop a postvention toolkit to support people working in primary care following a colleague’s suicide. The findings revealed the challenges staff encounter and the enduring impact on individuals and organisations. Although every situation is unique, the toolkit outlines key actions across four stages: the first day, first week, first month, and long term.1

“On the first day, acknowledging the emotional impact of the death is crucial, as is the need to support colleagues and manage their distress. At this stage, providing accurate information is important. Managers play a vital role in assessing staffing needs and encouraging those in distress to take time off. The need for managers to receive as well as provide support was strongly emphasised.

“In the week following the death, providing opportunities for mutual support is essential, as people may struggle with intense emotions and blame themselves or others. Clear and frequent communication with all colleagues is vital and decisions should be made about how to inform patients. A memorial, such as placing a book of condolence and flowers in reception, can offer comfort to staff and patients.

“During the first month, it’s important to be vigilant for signs of continuing distress. The impact of a colleague’s suicide can manifest itself behaviourally, emotionally, and physically, so practices should be alert for signs of difficulty such as absenteeism, problem drinking, or working long hours. Awareness of individual vulnerability factors, such as stress, limited support networks, or prior experiences of bereavement by suicide, is also important. Healthcare professionals often struggle to extend the same compassion to themselves as they do to their patients, but self-care should be encouraged for all.”

Postvention support is vital

Anya Gopfert, public health specialty registrar and honorary clinical lecturer, says, “I cannot emphasise enough how important it is for all workplaces, not only the NHS, to have postvention support in place to protect the health and wellbeing of colleagues. The event of a colleague’s suicide can be shocking and have devastating consequences for family, friends, and colleagues. Postvention support must form a component of any NHS workplace’s staff wellbeing offer.

“I speak from personal experience, having experienced suicide at work and outside. I wish that my workplace had had effective postvention policies and support in place. While I support all efforts focused on the prevention of suicide, there will be still be situations where postvention support is needed. By introducing effective and evidence based postvention, NHS workplaces can ensure that they respond in a compassionate manner, promoting recovery and minimising further harm.

“NHS organisations need to think about adopting postvention guidance and policies before the event of a suicide so they can respond quickly, if necessary. The importance of providing immediate support for patient facing staff cannot be underestimated. We know that keeping staff well keeps patients well.

“Workplaces must also carefully consider who to provide postvention support to, paying particular attention to rotating staff or those who may have known the colleague well but for whatever reason are not a member of the directly affected team.”

Grief is not linear

Sohrab Panday, mental health clinical lead, Derbyshire Integrated Care Board, and suicide prevention trainer, says, “Each month three doctors and four nurses die from suicide in the UK.2 The suicide of a colleague is shocking and many questions will go through people’s minds. How could this happen? Did we miss the signs? What do we do now?

“Shock, guilt, sadness, anger, anxiety, and blame are normal reactions. No two people will react the same way.

“Suicide is a taboo subject, yet we know that talking about it in a compassionate, responsible way will break the stigma cycle and reduce the risk of further suicides. Suicide is complicated and not caused by a single factor. Avoid any temptation to judge or blame yourself or anyone else.

“Exercise self-compassion. If you feel distressed, reach out to someone you trust and can confide in. I recommend all NHS staff make a personal safety plan setting out what to do in the event of having distressing or suicidal thoughts.3

“The classic stages of grief are not linear and can be delayed. If you are struggling, seek professional help. NHS Practitioner Health offer a confidential free service4 and Doctors in Distress provide programmes and group discussions.5 You are a human being first and a healthcare professional second. It is okay to need rest, time off, counselling, or practical support.

“The sense of loss to the workplace will be immense and some staff will feel less able to cope than others. Awareness and a compassionate non-judgmental approach are needed by all. Ask colleagues how they are—don’t assume how another person is feeling. The people who are the most affected may be those you least expect. It’s easy to be hesitant but be gently persistent.

“Leadership and management will have challenges. There are postvention guidelines on how organisations can react after a suicide of a staff member.6

“Set up a team meeting to share the news officially so there is no misinformation. At this meeting the offer of practical and emotional support should be communicated. Ongoing pastoral and information updates will be needed—it’s a long and bumpy road.

“Be prepared for patients to ask questions and express their grief. Agree on a statement for staff to share. Any media inquiries should be referred to management.

“Bereavement by suicide can lead to complex grief and an increased risk of further suicide. Postvention is specialist counselling for grief from suicide, as well as suicide prevention. It should be offered to anyone who feels distressed—family, friends, and staff.

“General practices can seek support from the Royal College of General Practitioners,7 the local medical committee,8 and their integrated care board. Once the acute grief lessens, the practice team should be offered suicide awareness, prevention, and postvention training.9

“The wellbeing of our workforce must be our top priority.”