How do GPs deal with parents bereaved by suicide? A qualitative study.

The problem

Suicide prevention is an NHS priority in England, but the needs of those bereaved by suicide have not been addressed, despite being identified by the National Suicide Prevention Strategy as a group at high-risk of morbidity. Little is known about how GPs support parents bereaved by suicide, how they deal with such interactions or their support needs.

The approach

This study explores the experiences of GPs dealing with parents bereaved by suicide, and their perceptions of their own needs.Ethical approval was obtained from NRES-NW. Parents whose adult children had died by suicide in North of England, between 2010 and 2011, were recruited via the coroner, posters, newspaper articles and self-help groups. Parents agreed to give the name of their GP, who was subsequently invited by the research team to be interviewed. 13 GPs agreed. Semi-structured interviews were conducted by SMc in the GP’s own practice, and lasted from 13 to 80 minutes. The topic guide explored dealing with the specific suicide as well as suicide and bereavement in general. All interviews were recorded with consent. Data were analysed thematically using constant comparison techniques, with all authors agreeing final themes.

Findings

GPs described managing patients with mental health problems as ‘part and parcel’ of primary care, but seemed to feel less confident to talk about about suicide. GPs disclosed an unpreparedness to face parents bereaved by suicide, often due to poor communication about the circumstances of the death to the practice. Some GPs described guilt surrounding the suicide, and admitted to struggling to initiate contact with the parent. GPs talked of their duty to care for the bereaved patients, but described the difficulties they encountered in supporting them, particularly in the absence of other services. GPs reported being emotionally affected by suicide and described a lack of support or supervision, relying on informal networks and self-constructed coping mechanisms for support.

Consequences

GPs need to feel confident dealing with parents bereaved by suicide. This may be achievable through educational and training initiatives, as well as improved communication from specialist care, police or coroners, and services available to refer parents to. General practice can be isolating; practitioners require more formal support and supervision, particularly around significant events such as suicide. Results from this qualitative study has informed the development of suicide bereavement training for primary care clinicians.

Credits

• Carolyn Chew-Graham, University of Manchester, Manchester, UK
• Emily Foggin
• Lis Cordingley
• Nav Kapur
• Jenny Shaw
• Sharon McDonnell