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Why We Need to Enhance Suicide Postvention: Evaluating a Survey of Psychiatrists’ Behaviors after the Suicide of a Patient

Erlich, Matthew D. MD*†; Rolin, Stephanie A. MD, MPH*‡§; Dixon, Lisa B. MD, MPH*†∥; Adler, David A. MD¶**; Oslin, David W. MD††‡‡; Levine, Bruce MD§§∥∥; Berlant, Jeffrey L. MD, PhD¶¶***; Goldman, Beth MD, MPH; Koh, Steve MD, MPH, MBA†††; First, Michael B. MD*‡‡‡; Pabbati, Chaitanya MD§§§∥∥∥; Siris, Samuel G. MD¶¶¶

Journal of Nervous & Mental Disease: July 2017 - Volume 205 - Issue 7 - p 507–511
doi: 10.1097/NMD.0000000000000682
Original Articles

Abstract: Suicide prevention efforts are increasing to enhance capabilities and better understand risk factors and etiologies. Postvention, or how clinicians manage the postsuicide aftermath, strengthens suicide prevention, destigmatizes the tragedy, operationalizes the confusing aftermath, and promotes caregiver recovery. However, studies regarding its efficacy are minimal. The Psychopathology Committee of the Group for the Advancement for Psychiatry surveyed a convenience sample of psychiatrists to better understand postvention activities. Ninety psychiatrists completed the survey; they were predominantly men (72%) with an average of 24.6 years of experience (SD, 16.7 years). Most had contact with the patient's family within 6 months of the suicide, and most psychiatrists sought some form of support. Few psychiatrists used a suicide postvention procedure or toolkit (9%). No psychiatrists stopped clinical practice after a patient suicide, although 10% stopped accepting patients they deemed at risk of suicide. Postvention efforts, therefore, should be improved to better address survivor care.

*New York State Psychiatric Institute; †Division of Behavioral Health Services and Policy Research, Department of Psychiatry, Columbia University Medical Center; ‡Department of Psychiatry, Columbia University; §New York–Presbyterian Hospital; ∥Center for Practice Innovations, New York State Psychiatric Institute, New York, New York; ¶Department of Psychiatry, Tufts University School of Medicine; **Department of Psychiatry, Tufts Medical Center, Boston, Massachusetts; ††Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia; ‡‡Department of Psychiatry, CPL Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania; §§Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York; ∥∥James J. Peters VA Medical Center (OOMH), Bronx, New York; ¶¶Optum Idaho, Meridian; ***Canyon Manor Mental Health Rehabilitation Center, Novato; †††Department of Psychiatry, University of California, San Diego, California; ‡‡‡Division of Clinical Phenomenology, Department of Psychiatry, Columbia University Medical Center, New York, New York; §§§Mental Health Intensive Case Management Program, University of California San Diego School of Medicine, La Jolla; ∥∥∥Department of Psychiatry, VA San Diego Healthcare System, San Diego, California; and ¶¶¶Research Division, Hofstra Northwell School of Medicine, Zucker Hillside Hospital, Glen Oaks, New York.

Beth Goldman is unaffiliated with an institution.

Send reprint requests to Matthew D. Erlich, MD, Psychopathology Committee of the Group for Advancement of Psychiatry (GAP), 295 Central Park West, Office 1, New York, NY 10024. E-mail: mde33@columbia.edu.

The authors are members of the Committee on Psychopathology of the Group for the Advancement of Psychiatry, a think tank composed of psychiatrists. Dr Rolin is a guest of the Committee and affiliated with Columbia University Medical Center/New York State Psychiatric Institute.

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