Suicide by patients: questionnaire study of its effect on consultant psychiatrists

Objective To identify the effect of patients' suicide on consultant psychia trists in Scotland, Design Confidential coded postal questionnaire sun ev. Participants Of 315 eligible consultant psychiatrists, 247 (78%) contribute d. Setting Scotland, Main outcome measures Experience of patient suicide; the features and impac t of "most distressing" suicide and what helped them to deal with it. Results 167 (68%) consultants had had a patient commit suicide under their care. Fifty four (33%) reported being affected personally in terms of low m ood, poor sleep, or irritability. Changes in professional practice were des cribed by 69 (42%) of the psychiatrists-for example, a more structured appr oach to the management of patients at risk and increased use of mental heal th legislation, Twenty four (15%) doctors considered taking early retiremen t because of a patient's suicide. Colleagues and family or friends were the best sources of help, and team and critical incident reviews were also use ful. Conclusions Suicide by patients has a substantial emotional and professiona l effect on consultant psychiatrists. Support from colleagues is helpful, a nd professional reviews provide opportunities for learning and improved man agement of suicide and its aftermath.