Magazine article Clinical Psychiatry News

Brief Consults Help Suicide Survivors

Magazine article Clinical Psychiatry News

Brief Consults Help Suicide Survivors

Article excerpt

MONTREAL -- A brief forensic psychiatric intervention after a suicide can be helpful in getting survivors to figure out why their loved one took such a step, Robert I. Simon, M.D., said at the annual meeting of the American Academy of Psychiatry and the Law.

He got involved in doing such consults after a patient and then his identical twin brother committed suicide within 6 months of each other. Talking to the parents "was a miserable experience for the psychiatrist," said Dr. Simon, director of the psychiatry and law program at Georgetown University, Washington.

"They were totally shocked and bewildered. The psychiatrist felt defensive. A forensic psychiatric consultation would have been very helpful to the family and the psychiatrist," he said.

The focus of the consultation, which Dr. Simon does for other psychiatrists' patients, is to understand a family member or friend's suicide. Some treating psychiatrists refuse to speak to a patient's family at all after a suicide has occurred. "It's not a great idea to do that," he said, but an attorney may say, "'Close your records; don't talk to anybody about this,' so the family is left without any understanding of the suicide." This brief intervention, which is done by a psychiatrist who did not treat the suicide victim, is not a litigation referral service nor is it survivor aftercare. Nor do such interventions require a psychiatrist who specializes in forensics. A psychiatrist familiar with the field of suicidology can do it, although some forensic psychiatrists have an advantage because "they're good at gathering information from a variety of sources and have experience with suicide cases," he said.

Forensic psychiatrists also have experience reviewing depositions, which reveal an intimate view of the family's suffering before and after the suicide.

Psychiatrists must be aware of the typical vulnerabilities of survivors and should be familiar with group process, which some psychiatrists already know how to do. "The main object of the consultation is to foster a supportive process of communication among family members and friends in their struggle to understand the suicide, a process that continues after the consultations conclude," said Dr. Simon, who is also president-elect of AAPL.

When beginning the intervention, which is usually limited to one or two sessions, be sure to obtain specific informed consent. …

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