The experience and impact of patient's suicide on psychiatrists in Malaysia

Patient suicide is one of the most distressing clinical events a psychiatrist can encounter, yet research in lower-middle-income countries remains limited. The main objectives of this study were to examine the emotional and professional impact of patient suicide on psychiatrists in Malaysia and to identify their support needs following such events.

A cross-sectional survey was conducted among psychiatrists working in government, university, and private healthcare settings across Malaysia. Participants completed an online questionnaire exploring experiences of patient suicide, emotional responses, effects on clinical practice, and perceptions of the availability and usefulness of support after the incidents.

A total of 120 psychiatrists participated, of whom 79% had experienced at least one patient who died by suicide, with 53.7% reporting that the most impactful event occurred within the first five years of practice. Most respondents reported moderate to high emotional impact, with a median rating of 7 out of 10. Over half of psychiatrists (56.8%) experienced a detrimental effect on clinical confidence, while 55.8% reported increased vigilance in suicide risk assessment and documentation. Female psychiatrists reported significantly higher perceived responsibility for the patient's death than male psychiatrists at the time of the event (p = 0.01). Despite substantial distress, 95.7% of psychiatrists did not take any time off work, and only 16.8% accessed external support. More than half (53.7%) reported being unfamiliar with procedures following a patient suicide. Supportive leadership, peer support, and clear organisational processes were perceived as beneficial, whereas blame and a lack of structured support were regarded as unhelpful.

Patient suicide is a common and emotionally challenging experience for psychiatrists in Malaysia, especially during the early stages of their careers. The findings reveal gaps in postvention support and highlight the need for structured, proactive frameworks to support clinician wellbeing and function after a patient's suicide.