A Colleague’s Suicide

To the Editor: How does one cope with the suicide of a colleague? It has become common knowledge that the risk of suicide among physicians in general (1), and those who work in the mental health system in particular, is high. After many years of concern about the subject, in 1973 a research team was formed under the auspices of the American Psychiatric Association (2).

Despite the many analyses and taxonomies of at-risk personalities, the suicide of a colleague reopens with great personal pain the question of why someone whose job it is to save people would commit suicide (3). Beyond the pain and the consternation that fellow workers undergo when hearing the bitter news, the need to continue functioning and to handle the situation raises pressing questions regarding the treatment of the colleague’s patients and what they should be told.

Can the patients cope with the knowledge that their therapist committed suicide—that the same person who helped them cope with excruciating mental illnesses, with their own suicidal thoughts and attempts, decided to throw in the towel and kill himself? On the other hand, is there any justification for hiding the truth from them? Does consideration for their mental health justify telling an untruth, which creates distance between the patient, who does not know, and the therapist, who knows?

There is also the question of whether it is possible to hide information from a segment of the population of a dynamic psychiatric ward. If the information unintentionally becomes known, lack of trust and distance between the therapists and their patients is likely to result.

The staff copes with such questions while dealing with their personal grief as well. Questions arise as to how sensitive they were to their colleague’s distress and whether they could have done anything to prevent what happened. The staff must function on several levels at once: the staff level, the patients’ level, and the level of their personal sorrow.