When depression becomes terminal: the impact of patient suicide during residency

Patient suicide often results in profound personal and professional crises for the treating clinicians. Residency training in psychiatry represents a critical time for experiencing the death of patients by suicide. While residents often treat some of the most acutely ill, high-risk patients, during a uniquely vulnerable phase of professional development, many training programs do not have formalized procedures in place for aiding residents in the event of patient suicide. The working through of a suicide offers an opportunity for personal and professional growth. This paper examines this issue from the perspective of a resident-in-training who experienced the suicide of a long-term outpatient. Issues explored include personal and professional reactions to the patient's death as well as a discussion of the organizational response to the event.