psychiatric disorders
Suicidal Behavior
Impact of Suicide
Any suicidal act has a marked emotional effect on all involved. Losing someone to suicide is a particularly painful and complex type of loss. Suicide-related grief differs from other types of loss because of unanswered questions surrounding why someone died by suicide and because many people have limited knowledge about suicide. In an effort to make sense of the inexplicable and shocking event, people frequently launch an intense search for information and generate a series of hypotheses about why the suicide occurred. This can lead to guilt, blame, and anger directed at themselves and others for not having prevented the suicide, and also anger at the loved one who died. This natural part of suicide grief is generally extremely intense in the initial few months, and often lessens in intensity in the second year and beyond. Many individuals are affected by each suicide death, including family members, friends, colleagues and others ( Impact of suicide references ). An international meta-analysis of population-based suicide loss studies found 4.3% of community members had experienced another’s suicide in the past year, and 21.8% during their lifetime. In the United States, even higher rates of exposure were found ( The physician can provide valuable assistance to patients who are suicide bereaved. For clinicians who lose a patient to suicide, the experience can be far more distressing than other clinically related deaths. It is often similar to the traumatic and profoundly distressing experience of the death of a clinician's family member rather than to the loss of a patient. In one study, half of psychiatrists who lost a patient to suicide had scores on the Impact of an Event Scale comparable to those of a clinical population who had experienced the death of a parent ( Impact of suicide references ). The loss experience for health professionals often has both personal and professional ramifications, which can include anguish, feelings of guilt, self-doubt, complicated grief, and even thoughts of leaving the profession. There are resources available to clinicians for support through several organizations (American Foundation for Suicide Prevention, American Association of Suicidology, Jed Foundation; Suicide Prevention Resource Center [ 1.Berman AL: Estimating the population of survivors of suicide: Seeking an evidence base.Suicide Life Threat Behav41(1):110-116, 2011. doi:10.1111/j.1943-278X.2010.00009.x 2.Andriessen K, Rahman B, Draper B, et al: Prevalence of exposure to suicide: A meta-analysis of population-based studies.J Psychiatr Res88:113-120, 2017. doi: 10.1016/j.jpsychires.2017.01.017 3.Feigelman W, Cerel J, McIntosh JL, et al: Suicide exposures and bereavement among American adults: Evidence from the 2016 General Social Survey.J Affect Disord227:1-6, 2018. doi: 10.1016/j.jad.2017.09.056 4.Hendin H, Lipschitz A, Maltsberger JT, et al: Therapists' reactions to patients' suicides.Am J Psychiatry157(12):2022-2027, 2000. doi: 10.1176/appi.ajp.157.12.2022 5.Sung JC: Sample agency practices for responding to client suicide. Forefront: Innovations in Suicide Prevention. 2016. Accessed June 5, 2023. 6.Lerner U, Brooks K, McNeil DE, et al: Coping with a patient’s suicide: A curriculum for psychiatry residency training programs.Acad Psychiatry, 36(1):29-33. 2012. doi: 10.1176/appi.ap.10010006 