Am J Psychiatry 161:1442-1446, August 2004
© 2004 American Psychiatric Association
Factors Contributing to Therapists’ Distress After the Suicide of a Patient
Herbert Hendin, M.D.,
Ann Pollinger Haas, Ph.D.,
John T. Maltsberger, M.D.,
Katalin Szanto, M.D., and
Heather Rabinowicz, B.S.
OBJECTIVE: Factors contributing to therapists’ severe distress after the suicide of a patient were investigated. METHOD: Therapists for 34 patients who died by suicide completed a semistructured questionnaire about their reactions, wrote case narratives, and participated in a workshop. RESULTS: Thirteen of the 34 therapists were severely distressed. Four factors were identified as sources of severe distress: failure to hospitalize an imminently suicidal patient who then died, a treatment decision the therapist felt contributed to the suicide, negative reactions from the therapist’s institution, and fear of a lawsuit by the patient’s relatives. Although one emotion was sometimes dominant in the therapist’s response to the suicide, severely distressed therapists, compared to others, reported a significantly larger number of intense emotional states. CONCLUSIONS: Over one-third of therapists who experienced a patient’s suicide were found to suffer severe distress, pointing to the need for further study of the long-term effects of patient suicide on professional practice.
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