Psychiatrists' experiences of patient suicide loss: perspectives from residency and supervision

Patient suicide is a common adverse event during psychiatric residency. This study aimed to understand psychiatry residents' experiences of patient suicide from the perspectives of psychiatrists who experienced this loss as a resident and/or as a psychiatrist supervising residents, and to assess which interventions may help residents feel supported after such tragedies.

This is a secondary qualitative analysis based on a previous study in which psychiatrists who experienced a patient's death by suicide were interviewed about their experiences. Of the 18 participants interviewed, 13 participants had experienced the death of a patient by suicide during residency and/or had experience supervising residents in the context of this loss. Direct transcriptions from these 13 interviews were analyzed using constructivist grounded theory.

Participants' experiences of patient suicide during training were influenced by the practice setting, patient-related factors, learners' personal circumstances, and the supervisor-trainee relationship. Participants described feeling supported by supervisors from a practical perspective, such as offering a modified workload. Emotional, professional, and existential supports were identified as helpful, though their provision varied depending on the supervisory dynamic. There were differences between resident and supervisor responses to patient suicide, which may be due to residents' fear of negative evaluations and lack of formal training for supervisors.

The experience of a patient's death by suicide during residency is diverse and multifactorial. Encouraging connection within the supervisory relationship is critical for both residents and supervisors in coping with the loss and effectively supporting trainees.