Abstract
Objectives
Patient suicide is a tragic occurrence, and it can be a demoralizing experience for medical residents. Few studies, however, have assessed suicide management skills among these front-line healthcare professionals. This study evaluated the self-assessed competence and confidence of medical residents with regard to the management of potentially suicidal patients and assessed the correlation with the residents’ background characteristics.
Method
The authors conducted a multicenter, cross-sectional survey of 114 medical residents in Japan, using a modified version of the Suicide Intervention Response Inventory (SIRI—22), the Medical Outcomes Study 8-Item Short-Form Health Survey (SF28), and a 5-point Likert scale to assess confidence in suicide management.
Results
A majority (89.5%) of the residents rated their confidence in managing suicidal patients as Not At All Confident or Rather Not Confident, although most were close to completing their psychiatric rotation. Results on the SIRI—22 suggested intermediate competence in managing suicidal behavior, as compared with that of other healthcare professionals. Competence as indicated by the SIRI—22 score was weakly and negatively correlated with the score for self-perceived Vitality on the SF—8 scale.
Conclusion
Insufficient skills and lack of confidence in the management of suicidal patients was observed in this sample of Japanese medical residents, thus highlighting the need for improved suicide-management programs for junior medical residents in Japanese hospitals.
Similar content being viewed by others
References
Ruskin R, Sakinofsky I, Bagby RM, et al: Impact of patient suicide on psychiatrists and psychiatric trainees. Acad Psychiatry 2004; 28:104–110
Pilkinton P, Etkin M: Encountering suicide: the experience of psychiatric residents. Acad Psychiatry 2003; 27:93–99
Schwartz AC, Kaslow NJ, McDonald WM: Encountering patient suicide: a requirement of the residency program curriculum. Acad Psychiatry 2007; 31:338–339
Mann JJ, Apter A, Bertolote J, et al: Suicide prevention strategies: a systematic review. JAMA 2005; 294:2064–2074
Rihmer Z: Strategies of suicide prevention: focus on health care. J Affect Disord 1996; 39:83–91
Potter LB, Powell KE, Kachur SP: Suicide prevention from a public health perspective. Suicide Life Threat Behav 1995; 25:82–91
Rutz W, von Knorring L, Wålinder J: Frequency of suicide on Gotland after systematic postgraduate education of general practitioners. Acta Psychiatr Scand 1989; 80:151–154
Power K, Davies C, Swanson V, et al: Case-control study of GP attendance rates by suicide cases with or without a psychiatric history. Br J Gen Pract 1997; 47:211–215
Appleby L, Morriss R, Gask L, et al: An educational intervention for front-line health professionals in the assessment and management of suicidal patients (The STORM Project). Psychol Med 2000; 30:805–812
Hamaoka DA, Fullerton CS, Benedek DM, et al: Medical students’ responses to an inpatient suicide: opportunities for education and support. Acad Psychiatry 2007; 31:350–353
Høifødt TS, Talseth AG: Dealing with suicidal patients: a challenging task: a qualitative study of young physicians’ experiences. BMC Med Educ 2006; 6:44
Gaffney P, Russell V, Collins K, et al: Impact of patient suicide on front-line staff in Ireland. Death Stud 2009; 33:639–656
Balon R: Encountering patient suicide: the need for guidelines. Acad Psychiatry 2007; 31:336–337
Fang F, Kemp J, Jawandha A, et al: Encountering patient suicide: a resident’s experience. Acad Psychiatry 2007; 31:340–344
Sudak H: Encountering patient suicide: the role of survivors. Acad Psychiatry 2007; 31:333–335
Mangurian C, Harre E, Reliford A, et al: Improving support of residents after a patient suicide: a residency case study. Acad Psychiatry 2009; 33:278–281
Melton BB, Coverdale JH: What do we teach psychiatric residents about suicide? a national survey of chief residents. Acad Psychiatry 2009; 33:47–50
Sudak D, Roy A, Sudak H, et al: Deficiencies in suicide training in primary care specialties: a survey of training directors. Acad Psychiatry 2007; 31:345–349
Shiho Y, Tohru T, Shinji S, et al: Suicide in Japan: present condition and prevention measures. Crisis 2005; 26:12–19
Teo A: The current state of medical education in Japan: a system under reform. Med Educ 2007; 41:302–308
Kozu T: Medical education in Japan. Acad Med 2006; 81:1069–1075
Nomura K, Yano E, Mizushima S, et al: The shift of residents from university to non-university hospitals in Japan: a survey study. J Gen Intern Med 2008; 23:1105–1109
Kelly CM, Jorm AF, Kitchener BA, et al: Development of mental health first-aid guidelines for suicidal ideation and behaviour: a Delphi study. BMC Psychiatry 2008; 8:17
Kitchener BA, Jorm AF: Mental health first aid training: review of evaluation studies. Aust N Z J Psychiatry 2006; 40:6–8
Kato TA, Suzuki Y, Sato R, et al: Development of 2-hour suicide intervention program among medical residents: first pilot trial. Psychiatry Clin Neurosci 2010; 64:531–540
Neimeyer RA, Bonnelle K: The Suicide Intervention Response Inventory: a revision and validation. Death Stud 1997; 21:59–81
Kawashima D, Kawano K, Ito H: Development of the Japanese version of the Suicide Intervention Response Inventory (SIRI). Seishin Igaku 2010; 52:543–551 [Japanese Journal of Clinical Psychiatry]
Tokuda Y, Okubo T, Ohde S, et al: Assessing items on the SF-8 Japanese version for health-related quality of life: a psychometric analysis based on the nominal categories model of item response theory. Value Health 2009; 12:568–573
Morriss R, Gask L, Battersby L, et al: Teaching front-line health and voluntary workers to assess and manage suicidal patients. J Affect Disord 1999; 52:77–83
Simpson G, Franke B, Gillett L: Suicide prevention training outside the mental health service system: evaluation of a state-wide program in Australia for rehabilitation and disability staff in the field of traumatic brain injury. Crisis 2007; 28:35–3
Scheerder G, Reynders A, Andriessen K, et al: Suicide intervention skills and related factors in community and health professionals. Suicide Life Threat Behav 2010; 40:115–124
Palmieri G, Forghieri M, Ferrari S, et al: Suicide intervention skills in health professionals: a multidisciplinary comparison. Arch Suicide Res 2008; 12:232–237
Coverdale JH, Roberts LW, Louie AK: Encountering patient suicide: emotional responses, ethics, and implications for training programs. Acad Psychiatry 2007; 31:329–332
Prins JT, Hoekstra-Weebers JE, Gazendam-Donofrio SM, et al: Burnout and engagement among resident doctors in the Netherlands: a national study. Med Educ 2010; 44:236–247
West CP, Tan AD, Habermann TM, et al: Association of resident fatigue and distress with perceived medical errors. JAMA 2009; 302:1294–1300
Neimeyer RA, Fortner B, Melby D: Personal and professional factors and suicide intervention skills. Suicide Life Threat Behav 2001; 31:71–82
Brown MM, Range LM: Responding to suicidal calls: does trait anxiety hinder or help? Death Stud 2005; 29:207–216
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Fujisawa, D., Suzuki, Y., Kato, T.A. et al. Suicide Intervention Skills Among Japanese Medical Residents. Acad Psychiatry 37, 402–407 (2013). https://doi.org/10.1007/BF03340078
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03340078