Program Helps Psychiatrists Cope With Patient's Suicide

Herbert Hendin, M.D., CEO and medical director of the not-for-profit Suicide Prevention International (SPI) in New York City, has prepared a Web-based program to help APA members deal with the loss of a patient to suicide.

The program consists of a short audiovisual presentation on the subject by Hendin, who explains that many psychiatrists are not prepared for a patient's suicide. They experience shock, guilt, shame, self-reproach, and other negative emotions, just as do family members and friends of the patient. In addition, they may experience an emotion that family members and friends usually do not—betrayal—as well as fear of a lawsuit by family members or friends of the patient. They may have dreams of inadequacy or punishment. They may be angry or anxious about dealing with other patients. They may avoid taking certain patients who present a risk of suicide. Some even consider abandoning psychiatry altogether, Hendin noted.

Toward the end of the audiovisual presentation, Hendin encourages psychiatrists who have lost a patient to suicide to sign up for a“ live” small-group teleconference designed to help them deal with their loss. Such teleconferences will be organized by SPI, and “six psychiatric experts in the area will alternate facilitating the conference calls,” Hendin explained during an interview.

“This APA Web-based program was created in response to the APA Assembly's request for more support to residents and psychiatrists who have experienced the suicide of a patient,” Deborah Hales, M.D., APA's director of the Division of Education, told Psychiatric News.

Indeed, Hendin appears to be well suited to provide that support since he has worked in the field of suicide during most of his professional career and since he and his colleagues have been holding, for 15 years now, workshops to help therapists who have lost a patient to suicide. They have written extensively about their work, most notably in an article in the August 2004 American Journal of Psychiatry titled “Factors Contributing to Therapists' Distress After the Suicide of a Patient.” Six of Hendin's books and 50 of his professional articles have dealt with suicide.

“The psychiatrists who have participated in one of our workshops over the years have indicated that it was a highly valuable experience, not only because it helped them deal with their distress, but because they learned from it,” Hendin reported. “One young psychiatrist who had reacted to the loss with strong doubts about his ability to function as a psychiatrist instead went on to a distinguished career as a suicide researcher. He credited his participation in the program with helping him turn what had been a traumatic experience into a constructive one.”

An advantage of the workshops, Hendin noted, is that it gives psychiatrists an opportunity to discuss their traumatic experience outside of their own institutions, where they can feel comfortable and not threatened. “We are not in a position to have any influence on their careers,” he pointed out.

Hendin will be inviting some of the psychiatrists who participate in the teleconferences to SPI's office in New York City to further discuss their cases in such a workshop. Travel and hotel costs as well as an honorarium will be provided. He stated that participation is especially beneficial to psychiatry residents since “young doctors are particularly sensitive to the loss of a patient to suicide.”

The Web-based audiovisual presentation for APA members who have lost a patient to suicide can be accessed at<www.spiorg.org/flash/copingwithlossofpatient.html>. To participate in a “live” teleconference on the subject, click on the link on the presentation's last slide, which will take you to the application form on APA's Web site. Complete the application form, print it out, and mail it to Suicide Prevention International, 1045 Park Avenue, New York, N.Y. 10028. Further information is available via e-mail at [email protected].▪