Patient Suicide
Losing a patient is one of the most difficult things you can experience as a provider. This page is here to help you find your way forward and give you guidance for the next steps, as well as where you can find support.
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I just found out so what do I do now?
Involved and affected residents most directly impacted may:
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Have any remaining patient care or other responsibilities for that day (and the following day if you so choose) canceled with other staff covering necessary duties, remain at work to complete administrative duties, take sick leave for the remainder of the day (if approved by appropriate leadership), seek counseling available at work, and/or continue patient care.
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While residents with direct patient care are recommended to take time to process their emotions before resuming patient care, the decision to do so will be at their discretion unless they seem impaired.
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You may be offered to be put in touch with residents/fellows with similar experiences.
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If multiple residents are involved, resources may be arranged to be available at a time and date of supervisors’ choosing with time afforded for affected residents to receive supportive counseling.
2. What happens next?
Two Reviews of Care (this is initiated within a few days after the event by the President of the Medical Staff at WR)
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A staff member will be identified by the DBH to review the EMR to ensure that the national standards of care were met. This step will occur after every suicide and may occur for other events at the discretion of the Director or Department Chief.
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Involved providers will be notified via e-mail that they have the option to submit a statement about their patient care via a templated Memorandum of Significantly Involved Provider (SIP); see below for this. Provider has 14 days from date of notification (received email) to submit statement should they choose to do so. This is simply an option to allow a provider to state their thought process and patient care decisions throughout the patient/provider relationship.
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A review will be made by the residency in order to present the case via a M&M conference as an opportunity to evaluate best practices, seek lessons learned as a system, and to improve future care.
3. Take care of yourself!
You are not alone - the question is not If this event will happen in your career, but When.
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So many Psychiatrists have been in your shoes before (and will be in them after). This is not easy and may be one of the most difficult events that can happen in your professional life. That being said, please take care of your own mental health!
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Please reach out to your Supervisor, the Chiefs and the PD and also remember that some of your fellow residents have experienced this as well so keep the discussion going and talk to others you feel safe with about how you feel. There are many avenues for help and support detailed below. If you need help or just need to talk - ask!
General Informational Resources for the Resident
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Psychiatry Residency Handbook (pages 63-66) https://www.capitalpsych.org/thebook ; has complete outline/direction for entire process after a patient suicide.
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Administrative Links
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Written Memorandum of Significantly Involved Provider (SIP) template (link below), Blank SIP Notification Letter and SIP Information Sheet
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DODSER (Suicide Event Report) website https://dodser.health.mil (requires CAC certificate)
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Support Resources for the Resident
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General Resident Wellness page https://www.capitalpsych.org/wellness *Counseling and support may be received by Fleet and Family Counseling, the Chaplains Office, the Social Work Department, or supervisors/peers as appropriate and able.
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Free access to Grief and Loss Group at Michigan State University: https://health4u.msu.edu/sessions/spring-2023-msu-grief-and-loss-support-group-2023
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Faculty Mentor for patient suicide available if needed: Please contact Chief Residents to be assigned a Faculty Mentor should you feel you need more individual assistance and/or feel that a group grief session for residents should be conducted.
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Peer Support: Contact Leianne Pouliot, LCSW to be connected with a fellow WRNMMC peer that has been designated and trained for support
leianne.pouliot.civ@health.mil​
Office: 301-295-5434
Cell: 202-870-7151
This is an outline of the entire process and is directly from the NCC Psychiatry Residency Handbook (p. 63):
