Title: Attenuating Anxieties: Mental Health Nurses' Responses to Suicidal Behaviour: A Grounded Theory Study

Background: Both nationally and internationally suicide and suicidal behaviour are major public health issues and concern. Suicide risk is also a problem for people experiencing mental health problems and accessing mental... [ view full abstract ]

Background: Both nationally and internationally suicide and suicidal behaviour are major public health issues and concern. Suicide risk is also a problem for people experiencing mental health problems and accessing mental health facilities in Ireland. Mental health nurses are at the frontline of service provision to this client group and have an important role in suicide prevention. However, limited research exists that explores mental health nurses’ practices in this complex area of mental health care.

Aim: The aim of this study was to develop a grounded theory that explained how mental health nurses within a mental health service in the Republic of Ireland, respond to clients who present with suicidal behaviour.

Methodology: This study was informed by the principles of Grounded Theory as described by Glaser. Data was collected from thirty-three mental health nurses through interviews, and analysed using the concurrent processes of constant comparative analysis, theoretical sampling, theoretical sensitivity and memo writing. Ethical approval in line with the Helsinki agreement was granted by the University ethics committee and the local research ethics committee of the service where the study was conducted.

Findings: Findings indicated the participants’ main concern about caring for suicidal clients related to their feelings of professional and personal vulnerability and the need to protect clients and themselves. The participants dealt with these concerns through a process conceptualized as ‘Attenuating Anxieties’, which had five subcategories: ‘learning the discourse of anxiety’, ‘cultivating anxieties’, ‘managing anxieties’ ‘safeguarding against anxieties’ and ‘containing anxieties’.

Conclusions & Implications: Mental health nurses require continuous training and support to enable them to acquire the knowledge and competencies to engage with suicide risk assessment and management in a recovery-orientated manner. In addition, organizations should establish and promote a culture of openness wherein suicide is anticipated as a possible outcome even with excellent standards of care and staff are supported and encouraged to discuss and reflect on their anxieties while ‘taking therapeutic risk’ when working with suicidal clients.