Pathological identification as a cause of suicide on an inpatient unit

After the suicide of a patient, staff on an inpatient ward anxiously take increased suicide precautions, including special attention to patients known to be associated with the victim. However, in identifying other patients at risk, they may overlook those who have formed pathological identifications with the victim as the result of a history of similar past experience, especially that of a suicidal or abandoning parent, and of the often unrecognized intimacy that occurs between patients during a brief hospitalization. Pathological identifications involved in a suicide, a subsequent suicide attempt, and suicidal preoccupation are illustrated by the case histories of three patients treated on an inpatient ward at the same time.