Impact of death by suicide of patients on Thai psychiatrists.

The objective of this study was to identify the impact of a patient's suicide on psychiatrists in Thailand. A confidential coded postal questionnaire survey was sent to 320 eligible psychiatrists; with a response rate of 52.18%). The results showed that 94 (56.28%) of responding psychiatrists had a patient die by suicide, consistent with high rates found in similar large-scale studies in the United States and United Kingdom. Less than half (41.5%) of patients had been diagnosed with schizophrenia, 33% had a depressive disorder, and the others had a wide array of diagnoses. More than 50% of psychiatrists reported personally experiencing sadness, depression, hopelessness, and guilt; 74.5% reported professional reactions, most frequently a review of their practice (93.4% reported being more aggressive in assessment of suicidality). Respondents were diverse in their postvention; 90% of Thai psychiatrists reported that working through with colleagues was most helpful. Family and friends helped. A majority (72.4%) of psychiatrists prayed or did "merit" for the dead patient; 86.8% found it helpful. This finding suggests that cultural sensitivity may be needed to understand the impact of suicide on psychiatrists but also to its response.