The Second Victim Phenomenon: a Perspective on Professional Grief and Postvention after a patient's suicide across European healthcare settings

The second victim phenomenon refers to the psychological trauma and distress experienced by healthcare professionals following an adverse event involving a patient. The literature recognises second victims as a significant matter, but it lacks a complete review or perspective investigating the second victim phenomenon specifically in the context of exposure to suicide and from a European-specific perspective. This study aims to address this gap by assessing the prevalence and impact of exposure to a patient's suicide among European healthcare professionals and evaluating the available intervention systems for second victims to determine their adequacy and effectiveness on the target population. This was assessed through a qualitative perspective on a selection of recent epidemiological and empirical literature, focusing on the professional grief of European clinicians following a patient’s suicide and on the evaluation of existing institutional and individual intervention systems. The study was conducted utilising the resources available on PubMed and Google Scholar. The keywords employed included "second victim," "suicide," "healthcare," and "European setting." Findings indicate that healthcare professionals are likely to experience the loss of a patient due to suicide, with Italian research specifically showing a prevalence of 37% among clinicians. Furthermore, studies highlight the intensity of psychological symptoms and consequences experienced. Many clinicians across Europe reported feelings of extreme misery and guilt, with a high correlation found regarding turnover intentions. While some variations exist in the manifestation of professional grief across different European populations, a consistent finding is the concerning dissatisfaction among clinicians with existing interventions, which primarily focus on institutional management and support systems. Professionals primarily expressed disappointment regarding the insufficient support from their superiors as well as the lack of requested peer assistance. A notable disregard for individual coping strategies intended for second victims suffering the loss of a patient was also reported. An integrated approach combining institutional support, peer support networks, and individual coping strategies appears to be a promising solution for supporting the target population. Future research should implement and evaluate this proposal, further evolving the understanding of the domain.