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Suicide by patients: questionnaire study of its effect on consultant psychiatrists
D A Alexander1, S Klein, N M Gray
1Department of Mental Health, Medical School, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD. d.a.alexander@abdn.ac.uk
Objective:
To identify the effect of patients' suicide on consultant psychiatrists in Scotland.
Design:
Confidential coded postal questionnaire survey.
Participants:
Of 315 eligible consultant psychiatrists, 247 (78%) contributed.
Setting:
Scotland.
Main Outcome Measures:
Experience of patient suicide; the features and impact of "most distressing" suicide and what helped them to deal with it.
Results:
167 (68%) consultants had had a patient commit suicide under their care. Fifty four (33%) reported being affected personally in terms of low mood, poor sleep, or irritability. Changes in professional practice were described by 69 (42%) of the psychiatrists-for example, a more structured approach to the management of patients at risk and increased use of mental health legislation. Twenty four (15%) doctors considered taking early retirement because of a patient's suicide. Colleagues and family or friends were the best sources of help, and team and critical incident reviews were also useful.
Conclusions:
Suicide by patients has a substantial emotional and professional effect on consultant psychiatrists. Support from colleagues is helpful, and professional reviews provide opportunities for learning and improved management of suicide and its aftermath.
