Beyond the threat of malpractice suits, losing a patient to suicide can be one of the most profoundly disturbing experiences of psychiatrists' professional careers. Yet, there is sparse literature on the occurrence and scant attention given to it in residency training programs (Gitlin, 1999).
Psychiatrists' reactions to their patients' suicides often include numbness, shock, disbelief, grief, shame, guilt, anger, isolation, intrusive thoughts, avoidance behaviors, doubts about one's professional competency, fears of litigation and concerns about retribution from the psychiatric community (Gitlin, 1999; Hendin et al., 2000).
To educate clinicians about suicide and its prevention and to support them through the stressful impact of a patient's suicide, the American Association of Suicidology's Clinician Survivor Task Force provides a series of resources at <www.suicidology.org>. After accessing the section "Resources for Clinicians Who Have Lost a Patient to Suicide," readers will find basic information about suicide; an open letter to therapist survivors; personal accounts by therapist survivors, including a psychiatrist; a bibliography of journal articles, book chapters and letters on such issues as surviving the suicide of a patient, surviving the suicide of a colleague, and surviving the suicide of a family member or friend; and a list of clinicians to call or contact for help in the event of a patient's suicide.
In the basic information section, the task force points out that interns, residents and other novice clinicians have been found to experience higher rates of suicide among their clients than more seasoned clinicians, and, unfortunately, few training institutions or graduate programs prepare students for this possible traumatic loss (Bongar, 1991)--AK