Borderline Personality Disorder

How Patient Suicide Affects Psychiatrists

An estimated 80 percent of borderline patients attempt suicide, with an average of three attempts per person According to most statistics, about 10 percent succeed, making BPD one of the most lethal existing psychiatric illnesses.

How Patient Suicide Affects Psychiatrists

Mental-health practitioners whose clients kill themselves can face stigma from their colleagues, lawsuits, and a toll on their own psyches—making them less likely to take on suicidal patients who need their help.

SULOME ANDERSONJAN 20 2015, 7:10 AM ET

It’s hard to listen to a psychiatrist who sounds so broken. I expect a mental-health provider to seem healthy, detached. But even over the phone, the weariness in Dr. Brown’s voice is palpable.

“This is what we do when people die,” he says. “Even if they die an expected death, it seems to be human nature to go back over [it]. What should I have said that I didn’t, or shouldn’t have said that I did? Could I have done more or did I do too much? This seems to be a part of the grieving process. I think it’s especially intense in a situation where you have direct responsibility for helping the person get better.”

Brown lost a patient to suicide last year. She was a long-term client of his, the mother of a large, loving family. Right after a session with him, she went home and killed herself. Two months later, Brown’s son did the same thing.

He doesn’t want to talk about his son. It’s still too immediate and painful. But he does tell me how he felt after his patient died. “I went to the funeral,” he says quietly. “I stood for the entire service … it was completely packed with people just standing and so I was thinking, as I was listening to this service, that I was the only person in that room who had that particular relationship with that woman. Everybody else knew her in some different way. They were friends, they were family, they were relatives, maybe they knew her in the congregation and I was the only one who had been working with her, seeing her the day before, trying to prevent this. I felt unique and not in a very flattering way.”

Suicide is the third leading cause of death for young adults, and the 10th leading cause of death for the general population. The doctors I spoke with about this gave me different statistics on the number of mental-health professionals whose patients commit suicide. One says 51 percent of psychiatrists; another tells me it’s as high as 80 percent of all people who work in the mental-health field—including psychologists, social workers, etc. But the stigma of suicide is so strong that it’s often an issue left unspoken, even by doctors. Many psychiatrists refuse to treat chronically suicidal patients, not only because of the stigma that surrounds it even in their profession, but because suicide is the number-one cause of lawsuits brought against mental-health treatment providers.

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