Encountering Suicide: The Experience of Psychiatric Residents

Abstract

Objective: The authors sought to determine how often psychiatric residents encountered completed suicide, how it affected them, and what supports were available and most useful to them. Methods: Psychiatric residents completed questionnaires about their encounters with completed suicide during residency. Questionnaire items asked about the resident’s relationship to the deceased, the impact of the suicide on the resident, what supports were available and useful to residents, and whether residents had received education about suicide. Postgraduate education directors were similarly surveyed about their programs. Results: Of 197 respondents, 61.4% had encountered one or more completed suicides during their residency. Of the suicides, 61% were by patients and 16.5% by a colleague, friend, or relative; 22.3% of the residents had encountered both. The most common context was suicide by a patient the resident had seen on call or in consultation; next was suicide by a fellow physician. The greatest impact on residents was on their emotional health, followed by how they assess patients and their medicolegal view of psychiatry. Friends and fellow residents were identified as significant supports. Residents were reluctant to use employee assistance programs, citing confidentiality and insurance issues. Only one-third of residents received education on the impact of suicide on trainees. Postgraduate education directors’ responses closely reflected those of residents. Only one-third of postgraduate education directors reported having a policy in place in the event of suicide. Conclusions: Suicide is a commonly encountered, stressful event for trainees. Additional supports, education, and policies should be implemented to address this issue.