Patient suicide leads to relatively low average PTSD symptom levels among psychotherapists, but a subset experience clinically significant PTSD, with prominent feelings of grief, shock, horror, and fear when assessing future suicidal patients.
Key Findings
Results
A subset of psychotherapists reported clinically significant symptoms of post-traumatic stress disorder following patient suicide, despite overall relatively low group-level PTSD scores.
The study used an online survey with an administered PTSD scale to measure symptom levels
Overall PTSD symptom levels were described as 'relatively low' at the group level
A distinct subset of participants exceeded the threshold for clinically significant PTSD symptoms
The sample was drawn from practicing and trainee psychotherapists in Germany
Results
Psychotherapists experienced particularly intense feelings of grief, shock, and horror following a patient suicide.
These emotional responses were identified as playing 'a prominent role' in the aftermath of patient suicide
The study used a mixed methods approach to capture these emotional effects
Both short-term and long-term emotional effects of patient suicide were examined
These findings were derived from an online survey methodology
Results
Patient suicide leads to psychotherapists experiencing fear when subsequently assessing suicidal patients.
This fear response was identified as a specific consequence of having experienced a patient suicide
The finding has implications for clinical practice, particularly during suicide risk assessments with future patients
This effect was captured through the study's mixed methods approach
The study examined both practicing and trainee psychotherapists
Results
Several factors were identified as potentially influencing the extent of psychological impact following patient suicide.
Identified factors include the patient-therapist relationship, lack of support, perception of suicide as violent, and the unpredictability of the suicide
These factors were noted as continuing to require further exploration
The study noted that lack of support was among the modulating factors, suggesting postvention support may be relevant
These factors were identified through the mixed methods approach used in the study
Methods
The study examined the temporal development of perceived distress following patient suicide to inform postvention strategies.
Both short- and long-term emotional effects of patient suicide were assessed
A mixed methods approach was employed to capture temporal dynamics of distress
The study was conducted as an online survey in a German sample of psychotherapists
The findings were intended to 'derive corresponding implications for postvention'
Background
A great number of psychotherapists and psychiatrists experience at least one patient suicide during their career.
This observation formed part of the rationale for the study
The study built upon previous research findings concerning the impact of patient suicide on mental health
Both practicing and trainee psychotherapists were included in the sample
The study was situated within a German clinical context
What This Means
This research suggests that losing a patient to suicide is a significant and fairly common occupational experience for psychotherapists, and it can have meaningful psychological consequences. Using an online survey with standardized mental health measures, researchers found that while most therapists who had experienced a patient suicide reported relatively low average levels of post-traumatic stress symptoms as a group, a meaningful subgroup showed symptom levels serious enough to be considered clinically significant PTSD. Beyond PTSD, strong feelings of grief, shock, and horror were reported as common and prominent emotional reactions.
The study also found that experiencing a patient suicide can affect how therapists approach their future clinical work — specifically, therapists reported feeling fear when later assessing other patients for suicide risk. This has practical implications because fear during risk assessment could potentially influence clinical decision-making. Several factors appeared to shape how strongly therapists were affected, including how close the therapeutic relationship was, whether the therapist had adequate support after the event, whether the suicide was perceived as violent, and whether it came as a surprise.
This research matters because it highlights that psychotherapists are a professional group who may be vulnerable to significant psychological distress following a patient's death by suicide, and that formal support systems — sometimes called 'postvention' — may be needed to help them cope. The findings suggest that factors like peer support and the circumstances surrounding the suicide are important to consider when designing support programs for mental health professionals after such events.
Siebert A, Schnell T, Lehmann J, Nübling R. (2026). The impact of patients suicide on the mental health of psychotherapists.. Scientific reports. https://doi.org/10.1038/s41598-026-67919-7