Open Letter to Clinicians www.ZeroAttempts.org Open Letter to Counselors, Clinicians and Professional Healthcare Providers originated by the American Association of Suicidology ZERO ATTEMPTS One Million & Counting when IN CRISIS cALL 800-273-8255 or text "sos" to 741741 Dear Dr. Layton: This brief letter has two purposes 1) to address an issue about which many of us in the healing arts are not fully aware, and for which very few are fully prepared, and 2) to offer assistance to clinicians who may lose a client to suicide. As a standing committee of the American Association, the Clinicians as Survivors of Client Suicide wish to offer the following facts: Many beginning clinicians are unaware that suicide is a leading cause of premature death for many of the emotionally distressed people they have been trained to serve. (1) Over 90% of all completed American suicides are by persons with an Axis I disorder. (2) Fully one in six psychiatric patients who die by suicide die in active treatment with a healthcare provider. (3) Approximately 50% of those who die by suicide in America will have seen a mental health provider at some time in their life. (4) Interns, residents and other novice clinicians have been found to experience higher rates of suicide among their clients than more seasoned clinicians. (5) Suicide malpractice is the leading cause of legal action against all behavioral healthcare providers, regardless of discipline. (6) Experiencing the loss of a client by suicide can be psychologically traumatic for the provider, and may even become a career-ending event. Unfortunately, few training institutions or graduate programs prepare students for this possible traumatic loss. (7) In summary, the odds that you will lose a client to suicide at some time during your career may be slim, but they are not zero. Based on our collective experience as clinicians and researchers, we wish to offer you the following suggestions to assist you both now and in the future should someone in your care die by suicide: If you are new to the helping profession and have not yet had training in suicide risk assessment and risk management, we encourage you to seek out such training and provide yourself with the best knowledge base you can find. In the event a consumer of your service dies by suicide while in your care, you will at least be comforted by the fact that you had received relevant training in assessing and managing consumers at risk for suicide. If you are still in training (student, intern, resident, etc.), we encourage you to seek out a professor or instructor and request specific training in suicide risk assessment and management. We strongly encourage you to routinely inquire about suicide with every consumer of your service so that you that you can immediately assess any suicide potential that may be present. We strongly encourage you to seek supervision and/or consultation when you are serving someone known to be at risk for suicide. In the event of a bad outcome, you will be comforted by the fact that more than one professional was participating in the treatment plan. In the event that you may have already lost one or more clients to suicide, we invite you to join us at our web page where we provide a variety of materials that may be of help: resources, connections to others, information, support and help. The loss of a client to suicide is something we all wish to avoid. However, preventing all suicides is simply not possible. Still, we believe that through training, education and research, we can help create a therapeutic "climate of safety" for suicidal persons. Therefore, we wish to encourage you and all clinical providers to learn as much as possible about suicide, its etiology, the psychological and medical conditions that enhance risk, and about how those interventions and therapeutic endeavors that reduce risk and enhance protective factors. We also believe that by sharing our experiences we can not only learn how to better prevent suicide among those we serve, but we may also learn important lessons for our own survival as clinicians. Resources (1) World Health Organization, 1999. (2) Multiple studies summarized by Morscicki, Eve K. 1999, in The Harvard Medical School Guide to Suicide Assessment and Intervention, Doug Jacobs, Editor. (3) Bongar, Bruce, 1991, The Suicidal Patient, Clinical and Legal Standards of Care, Washington, DC: American Psychological Association. (4) U.S. Department of Health and Human Services, 1999, Mental Health, a Report of the Surgeon General. (5) Bongar, Bruce, 1991, The Suicidal Patient, Clinical and Legal Standards of Care, Washington, DC: American Psychological Association. (6) Thomas G. Gutheil 1999, in The Harvard Medical School Guide to Suicide Assessment and Intervention, Doug Jacobs, Editor. (7) Bongar, Bruce, 1991, The Suicidal Patient, Clinical and Legal Standards of Care, Washington, DC: American Psychological Association. Source: pages.iu.edu/~jmcintos/basicinfo.htm Yours in service,     Gordon Clay Chair, Suicide Awareness and Prevention Council of Curry County ©2017-2023, www.ZeroAttempts.org/ccspc/clinicians-ltr.html or https://bit.ly/3dpWj1r