Staff experiences and perceptions of working with in-patients who are suicidal: qualitative analysis.

Background
Suicidal behaviour is frequent in psychiatric inpatients and much staff time and resources are devoted to assessing and managing suicide risk. However, little is known about staff experiences of working with suicidal inpatients.
Aims
To investigate staff experiences of working with suicidal inpatients.
Method
Qualitative study guided by thematic analysis of semi-structured interviews with mental health staff with experience of psychiatric inpatient care.
Results
Twenty staff participated. All had encountered inpatient suicide deaths or attempts. Three key themes were identified: 1. Experiences of suicidality, 2. Conceptualizing suicidality, 3.Talking about suicide.
Conclusions
Suicidal behaviour in psychiatric wards impacts highly on staff feelings, practice and behaviour. Staff felt inadequately equipped to deal with such behaviours, with detrimental consequences for patients and themselves. Organisational support is lacking. Training and support should extend beyond risk assessment to improving staff skills in developing therapeutic interactions with suicidal inpatients.