Helping Psychiatry Residents Cope with Patient Suicide



Every clinical specialty has its own high risk patient challenges that threaten to undermine their trainees’ professional identity, evolving sense of competence. In psychiatric training, it is patient suicide, an all-too frequently encountered consequence of severe mental illness that may leave the treating resident perplexed, guilt-ridden, and uncertain of their suitability for the profession. This study evaluates a patient suicide training program aimed at educating residents about patient suicide, common reactions, and steps to attenuate emotional distress while facilitating learning.


The intervention was selected aspects of a patient suicide educational program, “Collateral Damages,”—video vignettes, focused discussions, and a patient-based learning exercise. Pre- and post-survey results were compared to assess both knowledge and attitudes resulting from this educational program. Eight psychiatry residency training programs participated in the study, and 167 of a possible 240 trainees (response rate = 69.58 %) completed pre- and post-surveys.


Knowledge of issues related to patient suicide increased after the program. Participants reported increased awareness of the common feelings physicians and trainees often experience after a patient suicide, of recommended “next” steps, available support systems, required documentation, and the role played by risk management.


This patient suicide educational program increased awareness of issues related to patient suicide and shows promise as a useful and long overdue educational program in residency training. It will be useful to learn whether this program enhances patient care or coping with actual patient suicide. Similar programs might be useful for other specialties.

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The authors would like to thank Cynthia L. Arfken, Ph.D. for her invaluable assistance with statistical analysis, Glen Gabbard, M.D., Emily Gray, M.D., Nicholas Hatzis, M.D., Nicole Lanouette, M.D., James Lomax, M.D., and Paul Puri, M.D. for courageously providing their personal narratives on Collateral Damages and the John A Majda, MD Foundation for its support of the production and dissemination of Collateral Damages.


Dr. Seritan is the PI of a student wellness grant from the Substance Abuse and Mental Health Services Administration (SAMHSA). The other authors have no disclosures.

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Correspondence to Deepak Prabhakar.

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Prabhakar, D., Balon, R., Anzia, J.M. et al. Helping Psychiatry Residents Cope with Patient Suicide. Acad Psychiatry 38, 593–597 (2014).

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  • Patient suicide
  • Psychiatry residents
  • Curriculum