Suicide Attempt Survivors' Perceptions of Inpatient Psychiatric Care

Research Aims: The internal struggles of suicide attempt survivors may be unimaginable for providers without lived experience, which can impede their ability to best support their patients. For suicide attempt survivors who are psychiatrically hospitalized following their attempt, their inpatient psychiatric treatment must be in an environment that feels safe and emotionally supportive to begin the healing process. This is particularly important as 5-11% of individuals who have attempted suicide and who have been psychiatrically hospitalized eventually die by suicide. Providers that survivors encounter immediately after an attempt play an important role in their recovery. Therefore, the goal of this study was to understand patients’ prior experiences with inpatient psychiatric care following a suicide attempt in order to identify strengths and weaknesses of current practices and elicit suggestions for improvements in inpatient psychiatric care.

Methods: Nine in-depth, semi-structured interviews were conducted with individuals who spent a minimum of 72 hours on a psychiatric unit following a suicide attempt (M_age=42). The sample was predominantly female (78%), White (78%), and heterosexual (33%). The interviews elicited information on the participants’ experiences in medical and/or psychiatric care within the first 24 hours of their attempt, the effects of attitudes of inpatient psychiatric staff, and survivors’ confidence in recovery and post-inpatient treatment. The interviews also asked suicide attempt survivors to give advice to providers working in psychiatric units regarding how they can provide the best quality care to their patients and how to enhance education curricula to deliver optimal training for psychiatric care providers.

Results: Salient themes with respect to inpatient care included the negative impact of stigma in the psychiatric unit among healthcare workers, and the importance of empathy and flexibility in attending to a patient’s unique needs, and validation, in the form of treating patients as “people” and equals to any medical patient. Participants said that they were more likely to seek care again when they felt supported by and connected to staff on the unit, and would not seek a higher level of care in the future if they had negative experiences.

Conclusions: Results indicated that suicide attempt survivors were positively affected by their experiences in inpatient psychiatric units when their providers practiced empathy, active listening, and helpfulness in discharge planning. Patients with positive experiences reported they were more likely to seek help in the future if they were feeling suicidal. However, suicide attempt survivors who felt invalidated, dehumanized, and stigmatized by the unit staff said they would be less likely to seek help (through inpatient care or other forms of care) if they were suicidal in the future. These findings suggest the importance of a provider’s commitment to empathic interactions and providing emotional support to ensure continuity of care. Training for psychiatric care providers should emphasize developing and practicing empathy, providing individualistic patient-centered care, confronting stigma around mental illness, and treating mental health with the same sensitivity as any other medical diagnosis.