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Ein Suizid in der Klinik – am Ort des maximalen Schutzes für den Betroffenen und der Entlastung von Angehörigen – ist besonders belastend für alle Beteiligten. Diese Arbeitshilfe stellt das aktuelle Wissen über Suizid im Krankenhaus oder anderen psychosozialen Einrichtungen dar und macht praxiserprobte Vorschläge, wie Begleitung und Unterstützung aussehen können. Suizidnachbesprechungen etablieren Wenn ein Suizid an dem Ort geschieht, der als Ort des Schutzes für den Betroffenen und als Entlastung von Verantwortung für die Angehörigen gedacht war, dann bleibt von einem solchen Ereignis niemand unberührt. Die Autoren haben deshalb die Suizidnachbesprechung als festen Bestandteil der Nachbearbeitung von Suizidereignissen in ihrer Klinik etabliert. Dabei geht es nicht um Kontrolle oder Schuldzuweisung, sondern um ein unmittelbares Lernen aus der Situation, um eine angemessene Würdigung des Geschehenen und um die Fürsorge für die Mitarbeiterinnen und Mitarbeiter, die Angehörigen oder andere Beteiligte. Neben einer knappen Zusammenfassung zum Wissen über den Suizid allgemein und im psychiatrischen Krankenhaus im Besonderen wird ein Konzept zum Umgang mit dem Krankenhaussuizid vorgestellt. Mit seinen transparenten Informationsregeln, festen Routinen und klaren Abläufen kann es auf viele psychosoziale Einrichtungen übertragen werden.

Background: Vocational rehabilitation aims to improve work performance. Few studies have examined the course of work performance during vocational rehabilitation. It remains unclear whether all subjects profit equally from rehabilitation programs regarding improvement of work performance. Aims: The purpose of this study is to examine the course of work performance in order to differentiate between responder groups and to distinguish between those groups regarding sociodemographic status, psychiatric diagnosis, level of individual satisfaction and vocational rehabilitation success. Methods: Work performance of N = 125 subjects with severe mental disorders was rated on intake to the rehabilitation program and six months later with the German version of the Work Personality Profile (WPP). A cluster analysis was conducted to identify different responder groups. Results: Groups with poor, moderate, improving and superior work performance were identified. These groups differed in educational level, psychiatric diagnosis, individual satisfaction and rehabilitation outcome. Conclusion: Not all subjects profit equally from vocational rehabilitation in terms of improvement of work performance. Unfavorable courses of work skills were shown for participants with schizophrenia and low education. Low individual satisfaction with performance is related to consistently low or moderate performance. Group differences predicted reintegration success. Future research should focus on different responder groups and their identification in early stages of the rehabilitation process to ensure appropriate assistance, particularly for subjects with poorer performance.

Background: In recent years it could be shown that psychosocial working conditions and mental health of employees are closely correlated. One well-established instrument to measure psychosocial stress at work is the COPSOQ (Copenhagen Psychosocial Questionnaire, German Standard Version). It is an 84 item self-rating instrument addressing several domains of psychosocial working conditions and is generally used for risk assessments in companies. Aims: To examine associations between COPSOQ ratings with clinical features and symptoms of employees who currently suffer from an episode of a mental illness requiring inpatient treatment. Method: For 265 inpatients with mental disorders who participated in a cluster randomized trial (RETURN-study) COPSOQ-data were available as part of the baseline data acquisition. These data were compared with the German COPSOQ validation sample of the Freiburg research center for occupational sciences (FFAW; approximately 250,000 participants). For subdomains of the COPSOQ that showed major and significant differences between the two samples regression analyses were done to predict COPSOQ scores within the RETURN-sample. Results: Psychiatric inpatients did not assess their working conditions significantly different compared to the population based FFAW sample. However, with regard to the effects of working conditions (general health, burnout, presenteeism, and intention to leave the job) there were major differences between the two samples with the clinical sample expressing more negative views. In the RETURN sample these were predicted by a greater expression of depressive symptoms. Conclusions: The linkage between work and mental wellbeing is complex. Mental illness is not necessarily a result of poor working conditions, while good working conditions may not in every case prevent symptoms of bad health, even if such associations exist.