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My Patient Committed Suicide

18 May

By Jeffrey N. Younggren, PhD; Eric Harris, JD, EdD and Joseph Scroppo, JD, PhD, from Ethics & Risk Management: Expert Tips VII

Probably no area of professional practice is more upsetting and traumatic than the suicide of a patient. In addition to the fear that the psychologist will be sued and the existential questioning about what might have been done differently, the loss of a patient is like the loss of a family member and must be mourned and dealt with.

My Patient Committed SuicideIntense feelings of anxiety and grief can make it difficult to determine how to behave with regard to the family, police, the medical examiner, insurance companies and one’s colleagues.

Traditional risk management thinking was that once a suicide occurred, interaction with the survivors was too risky. After many years of experience, we find that everyone does better if the psychologist is allowed to be human and able appropriately to share feelings of caring for the patient with the family. Expressing condolences, attending the funeral and meeting with grieving family members are important for the family and the psychologist coping with the loss. They are more likely to reduce risks of lawsuits and licensing board complaints than to precipitate them.

  • When a client commits suicide, the need to process the loss is intense but it is important to remember that one’s judgment may be adversely impacted. Consultation and peer support is crucial but there is a risk that things said may be used against the psychologist if there is a lawsuit. Talking to colleagues and supervisors about your feelings is not problematic, but sharing uncertainties about what you did or might have been done to prevent the suicide should only be discussed with your therapist, your lawyer, your supervisor or your spouse. These are the only privileged relationships off-limits to a plaintiff’s attorney.
  • Access to records changes after a suicide. Individuals who have rights to the information about the deceased are dictated by law. However, sometimes rigid adherence to the law is not the best risk management strategy. If someone wants access to records of a patient who committed suicide, immediately seek legal advice from someone familiar with the demands of psychological practice.
  • The best risk management for potentially suicidal patients occurs before a suicide. Careful documentation of regular suicide risk assessments, consultation with other involved professionals and family members where appropriate is what will be looked for by lawyers on both sides.
  • It is important to remember that while one out of four psychologists loses a patient to suicide, malpractice suits are far less frequent than board complaints. Also, while a malpractice suit is very unpleasant, it is rarely career damaging in the long run.

Ethics and Risk Management: Expert Tips VII is a 3-hour online continuing education (CE/CEU) course that addresses a variety of ethics and risk management topics in psychotherapy practice in the form of 22 archived articles from The National Psychologist and is intended for psychotherapists of all specialties.

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. Professional Development Resources maintains responsibility for all programs and content. Professional Development Resources is also approved by the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the California Board of Behavioral Sciences; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board; the South Carolina Board of Professional Counselors & MFTs; and by theTexas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners.

 

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