Plenary 2: When a Physician Attempts Suicide: Challenges for the C-L Psychiatrist [Michael Myers, MD, DLFAPA]

Speaker: Michael Myers, MD, DLFAPA

There are unique issues to consider when asked to consult on a physician who has attempted suicide. Some of these are: an interior sense of diminishment and naked vulnerability in the physician-patient; ambivalence about the need for psychiatric assessment; mistrust of (and hostility toward) the well-intentioned consulting psychiatrist; shame and guilt about "failing" and not dying; denying, lying about, and minimizing the magnitude of one’s suicidality; constricted ability (depending upon the underlying psychiatric illness and other suicidal drivers) to accurately and authentically engage in the consultation; classic transference and countertransference dynamics when one physician treats another. I will offer suggestions and make recommendations but most important, invite questions and engage in a dialogue with attendees about this most critical, and often lifesaving, role of the C-L psychiatrist.

Because the consultation-liaison psychiatrist is often the first mental health professional that a physician-patient sees in the hospital, it is essential that best practices are applied. This is not only humanistic, but medical legally sound. An unknown number of lawsuits are launched each year by families of physicians who died by suicide shortly after being discharged from a hospital setting.