Clinician attitudes toward the suicide attempter

The clinical and sociodemographic characteristics and dispositional outcome of 248 suicide attempters were studied in a general hospital emergency room. A mood adjective checklist was completed by evaluating psychiatric residents and three orthogonal factor analytically derived mood clusters were related to sociodemographic, clinical, and dispositional variables. Residents expressed warmth toward patients having low suicide risk and limited overall psychopathology. They felt anxious toward patients with high suicidal risk and significant psychopathology. Angry feelings were reported toward patients with high suicidal risk in the absence of recent precipitating events. Residents reported warmth toward patients admitted to private or mental health center vs. state hospital facilities and tended to devote more time to their clinical assessment of these patients. Feelings of anxiety and anger characterized the responses to state hospital admissions who were only briefly assessed. The findings have implications for the organization of clinical services and the training of mental health professionals. Supervision needs to be directed to the recognition and modification of therapist emotional attitudes as well as to the understanding of patient psychopathology. Clinician feelings can then be effectively utilized to "capture" a high risk, high drop-out population into effective follow-up care.