Occupational exposure to suicide: A review of research on the experiences of mental health professionals and first responders

Renan Lopes de Lyra; Sarah K. McKenzie; Susanna Every-Palmer; Gabrielle Jenkin

doi:10.1371/journal.pone.0251038

Peer Review History

Original SubmissionNovember 25, 2020
6 Mar 2021 Decision Letter - Vedat Sar, Editor PONE-D-20-36231 Suicide exposure through work: a scoping review of research on mental health professionals and first responders PLOS ONE Dear Dr. Lopes De Lyra, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by the deadline. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: N/A Reviewer #2: I Don't Know ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: This is an interesting and important review of the literature on mental health and first responder exposure to suicide and the impact on them. The conclusions are supported by the review and are compelling. There were no statistics done but they do comment on the methodology of the studies they review. The biggest issue is the wordiness and size of "table 1. Literature review summaries." Point form rather than sentence form would be more appropriate. A few minor points. Page 5, line 4, please define "high emotional labor". Page 7 line 1 and 2 are not necessary about why the spreadsheet was turned into a table. Page 8, first sentence, 15+5+6 does not equal 25. Page 14, 6th column under Erlich et al, the authors forgot to replace "commit" suicide with "died by" suicide. Page 21, first sentence is confusing about why the analysis wasn't broken down by professional category and whether it was this paper's authors or the authors of the papers they reviewed who did this. It would make sense if it read " The MHPs group includes psychologists, psychiatrists, social workers and nurses." Page 22, last paragraph needs clean up of the text citations. Page 23, line 6, 7 and 8. What evidence do the authors have that male professionals are less inclined to report emotional reactions? If there is no proof, this clause of the sentence should be more tentative. Page 25 , last line, "attending suicide scenes have a particular PTSD impact". The verb should be has. Furthermore, I think this is a very important point and should be re-iterated in the conclusion. Page 26, line 14 & 15, "All the papers that assessed suicide exposure used web-surveys." I was surprised to find out that most of the methodology of the reviewed studies was web surveys, in the discussion. Perhaps there should be a column in the table 1 for methodological design. A quick count revealed that 17/25 studies were web based. Is this true? This also merits some discussion of the shortcomings of web based surveys. Page 27, last paragraph, I really like the conclusion that "suicide researchers may not pay enough attention to suicide risk among health professionals, assuming that, as they are trained to give support in these situations, they might be better equipped to manage their emotions." Page 28, line 17 should read "usage of the scale can lead to an inflated result of professionals being clinically distressed." Page 30, last line. should read "might be reduced". Reviewer #2: I have a few suggestions to make about clarity of phrasing: The term "suicide exposure" isconvenient but not as telling as "exposure to suicide" I don't understand the meaning of "scoping" review Consider writing in the title "...review of research on the experience of mental health professionals and first responders" Was it possible to know differences in the nature of the relationship with the client among mental health professionals, e.g., case manager, prescriber, psychotherapist, etc. It should be important to include. I find important the "insight" in the Discussion about lack of theory in "framing" the research. I suggest saying more about what "framing" means and what hose twotheories say. ****** 6. 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Revision 1
1 Apr 2021 Author Response Thank you very much for your favorable assessment of our manuscript and for reading it so carefully and making such constructive recommendations. All recommendation were accepted and included on the text. We feel the recommendations have greatly improved the quality and clarity of our manuscript. Journal recommendations We have corrected the style elements in line with PLOS requirements. Funding information was corrected. Competing interests was corrected. Caption for the supporting file was corrected. Reviewer one Thank you for your review and suggestions to improve our work. The biggest issue is the wordiness and size of "table 1. Literature review summaries." Point form rather than sentence form would be more appropriate. - Table 1 was revised and reworded. Page 5, line 4, please define "high emotional labor". – Emotional Labor defined. Page 7 line 1 and 2 are not necessary about why the spreadsheet was turned into a table. – Phrase removed. Page 8, first sentence, 15+5+6 does not equal 25. – We have recounted and noticed that it was one extra paper that was not included in the final version. The numbers were corrected. Page 14, 6th column under Erlich et al, the authors forgot to replace "commit" suicide with "died by" suicide. – Replaced. Page 21, first sentence is confusing about why the analysis wasn't broken down by professional category and whether it was this paper's authors or the authors of the papers they reviewed who did this. It would make sense if it read " The MHPs group includes psychologists, psychiatrists, social workers and nurses." – We have reworded the phrase in order to make sense that the authors of the cited papers have included all those professionals as a single group during analyses. Page 22, last paragraph needs cleanup of the text citations. – The last paragraph was cleaned, and the authors were excluded, only the reference number left. Page 23, line 6, 7 and 8. What evidence do the authors have that male professionals are less inclined to report emotional reactions? If there is no proof, this clause of the sentence should be more tentative. -After discussion, we decided to remove the phrase as it was not supported by the data, but a anecdotical conclusion. Page 25 , last line, "attending suicide scenes have a particular PTSD impact". The verb should be has. Furthermore, I think this is a very important point and should be re-iterated in the conclusion. -The verb was corrected and a few lines were included to the conclusion highlighting this aspect. Page 26, line 14 & 15, "All the papers that assessed suicide exposure used web-surveys." I was surprised to find out that most of the methodology of the reviewed studies was web surveys, in the discussion. Perhaps there should be a column in the table 1 for methodological design. A quick count revealed that 17/25 studies were web based. Is this true? This also merits some discussion of the shortcomings of web-based surveys. - We have counted and confirmed this number. A few lines were written to address the potential issues related to this fact, highlighting the limitations of the use. Page 28, line 17 should read "usage of the scale can lead to an inflated result of professionals being clinically distressed." -Phrase corrected. Page 30, last line. should read "might be reduced". -Corrected. Reviewer two The term "suicide exposure" is convenient but not as telling as "exposure to suicide". -We have replaced all the entries of “suicide exposure” for “exposure to suicide” on the text. I don't understand the meaning of "scoping" review Consider writing in the title "...review of research on the experience of mental health professionals and first responders" - After discussion we decided to change the tittle. Although we explain that our review fits in the description of a scoping review on the method section. Was it possible to know differences in the nature of the relationship with the client among mental health professionals, e.g., case manager, prescriber, psychotherapist, etc. It should be important to include. -We came back to the papers, but they did not describe the nature of relationship of professionals. This may be a limitation on data, and we have addressed this issue on our discussion. Thank you. I find important the "insight" in the Discussion about lack of theory in "framing" the research. I suggest saying more about what "framing" means and what those two theories say. -We have written some lines trying to describe how research that used theory framing should work, trying to link exposure to suicide and the suicide risk among professionals. Thank you for your revision. Attachments Attachment Submitted filename: Response to reviewers.docx https://doi.org/10.1371/journal.pone.0251038.r002
19 Apr 2021 Decision Letter - Vedat Sar, Editor Occupational exposure to suicide: A review of research on the experiences of mental health professionals and first responders PONE-D-20-36231R1 Dear Dr. De Lyra, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Vedat Sar, M.D. Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed Reviewer #2: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: N/A Reviewer #2: I Don't Know ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Thank you for making all the requested changes. I am glad the authors feel the reviewer comments enhanced the paper Reviewer #2: The authors have responded constructively and sufficiently to all comments and suggestions from the initial review. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No https://doi.org/10.1371/journal.pone.0251038.r003
Formally Accepted
21 Apr 2021 Acceptance Letter - Vedat Sar, Editor PONE-D-20-36231R1 Occupational exposure to suicide: A review of research on the experiences of mental health professionals and first responders Dear Dr. Lyra: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Vedat Sar Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0251038.r004

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