Cope With Patient Suicide

Having a patient die by suicide is one of the most difficult events to deal with during a psychiatrist’s career. This information is intended to provide you with support, to help you learn from the experience of patient suicide, and to grow as a psychiatrist and as a person. It was initially developed by Columbia University psychiatry residents who had patients who died by suicide and was revised by several faculty members who have also had experience with patient suicide and wanted to help residents through the process.

Common Reactions

Initial Reactions

  • Shock

  • Disbelief

  • Denial

  • Depersonalization

Second-phase Reactions

  • Grief

  • Shame

  • Guilt

  • Fear of blame

  • Anger

  • Relief

  • Finding of omens and subsequent behavioral changes

  • Conflicting feelings of specialness

How to Cope

  • Take a day off of work at some point after the event to reflect and process your emotions

  • Allow yourself to experience your full range of emotions and reactions as valid

  • Talk to people about the experience and your reactions.

    • Co-residents (process group)

    • Chief residents

    • Training directors

    • Attending supervisors involved in case

    • Attending supervisors NOT involved in case

    • Prior attending supervisors NOT involved in case

    • Therapist

    • Family and friends (in an unidentified manner)

  • Be mindful of self-care and your own wellness

  • Read literature on suicide risk assessment

  • Read literature on dealing with the death of a patient (see article by Gitlin)

  • Consider giving a case conference on the topic

  • Consider participating in the annual APA workshop on dealing with patient suicide during residency

  • Consider writing a paper about your experience