The impact of service user death on staff working within addiction services

Research focusing on deaths due to addiction tends to explore the deceased themselves, their families, or those who have witnessed an overdose. However, limited research exploring the impact of bereavement on staff working in addiction services exists. This study explored how staff working within addiction services experience service user death.

An interpretative phenomenological analysis (IPA) approach was used in this study. Ten members of staff working in an Alcohol and Drug Recovery Service (ADRS) in Scotland who had experienced the death of a service user were recruited. Data were collected via semi-structured, in-depth, one-to-one interviews.

Three group experiential themes (GETs) were identified: 1) Traumatic events; 2) The emotional aftermath; 3) Abandoned by the system. These GETs explored factors that further compounded service user death, aspects of how staff processed their grief, and factors relating to management and the wider system within the contextual framework of bereavement.

Staff in addiction services experience complex grief responses following the death of a service user, such as sadness, guilt, and anger. These responses are compounded by factors such as stigmatised deaths and disenfranchised grief, along with expectations of professional endurance. Their grief responses are further influenced by expectations from a wider service context, and the moral injury that staff can experience at work, leading staff to question their practice and decision-making. Staff appeared to rely on colleague support in the absence of other workplace support, within a service culture of 'silence' about these bereavements. This study offers recommendations for support for staff members in these settings, such as the inclusion of bereavement in models of supervision, and the introduction of supportive peer groups and reflective practice within teams. These changes could lead to an open environment of talking about death and emphasise the importance of staff well-being in an empathetic and trauma-informed framework. Finally, management could foster wider awareness of the impact of bereavement within addiction service systems to enhance support.