Background: Suicide attempts can lead to life-threatening conditions that require intensive care. In such situations, patients often experience existential fear when cared for in highly technological and unfamiliar environments such as the intensive care unit. The circumstances surrounding the suicide attempt, together with their critical condition, may further influence their ability to cope and shape their experience of care. Understanding these experiences is important to ensure that the therapeutic relationship supports the recovery process. Interprofessional collaboration and communication are essential for coordinated, recovery-oriented care.
Aim: To map the existing evidence on how patients, family members and healthcare personnel experience care in intensive care units following a suicide attempt, to identify key themes, knowledge gaps and implications for clinical practice and future research.
Study Design: This scoping review was conducted using the Arksey and O'Malley methodology and the PRISMA-ScR list. Six databases were systematically searched using predefined keywords. All English-language studies addressing the review aim were included.
Results: The search yielded 1107 articles. After screening, 13 were assessed in full, and five met the inclusion criteria. These studies, published between 1985 and 2011, comprised four surveys and one qualitative interview study. Findings indicate that patients felt misunderstood, families lacked information and support, and personnel experienced emotional strain. Attitudes varied widely, and healthcare personnel expressed a need for further education and reflective practice in suicide care.
Conclusions: Only five relevant studies were identified, all published between 1985 and 2011, with just one including patient or family perspectives. This limited and dated research highlights a clear gap in research on intensive care following suicide attempts and precludes firm conclusions about care experience. With these constraints, the findings tentatively suggest the importance of compassionate, holistic and collaborative approaches to care, as well as the potential value of personnel's support and training and policies that attend to the mental health needs of suicidal patients and their families.
Relevance to Clinical Practice: The findings may suggest the potential relevance of a holistic approach to caring for patients after a suicide in ICU practice, where physical, psychological, social and emotional aspects of care are considered in supporting recovery and well-being.
Impact Statements
What is known about the topic
○Suicide is a prevalent global health issue, and many individuals who attempt suicide require advanced, life-saving treatment in the ICU.
○Patients admitted after a suicide attempt often experience severe psychological distress and therefore require empathetic and supportive interactions from healthcare professionals.
○The highly technological and intensive environment of the ICU can pose additional challenges for these patients, influencing their emotional state and overall experience of care.
What this paper adds
○This study underscores the marked scarcity of research and limited development of expertise in this area, highlighting an urgent need for further investigation and targeted educational initiatives.
○This study provides an initial glimpse into the vulnerability experienced by patients, family members and healthcare personnel in the context of ICU care following a suicide attempt.
○This study suggests that gaps in knowledge and uncertainty among healthcare personnel may be associated with countertransference reactions, potentially influencing how care is experienced and delivered.