9 After a Suicide | A Toolkit for Physician Residency/Fellowship Programs Informing the Emergency Contact Person Individuals within the training program may be the first to know a resident has been declared deceased. In such a situation the crisis response leader or a delegate (e.g., DIO or Residency Training PD) should contact the emergency contact person immediately. Every resident should have emergency contact information on file (phone numbers, email address, and names of parents, spouse/partner, or other emergency contact person). Such information should be updated yearly. In other situations the police may know first, and they will have their own protocol for managing this and notifying the next of kin. If the resident was brought to the Emergency Room, it will be the physician who declares the individual deceased who would likely make the call. In situations where another individual has disclosed the death of a resident, it is still important that the Crisis Response Team Leader or a designated individual from the institution call the emergency contact person. Prior to calling the emergency contact person it is helpful to obtain as much information as is currently available (see Get the Facts First, pg. 7) as well as information about what, if anything, has already been conveyed to the emergency contact person by others (e.g., police, emergency dept. physician). This initial call should focus on condolences and extending support. Ask what the residency training program can do to assist, and discuss the family’s preference regarding what information is provided to the faculty and fellow residents. The family may ask what happened. Sometimes it is not clear early on if the death was by suicide or if the death was accidental. Starting by asking what they have heard or what they understand about what happened may be helpful. Be careful about sticking to the known facts and avoiding any conjecture. Ask if they have thought about funeral arrangements and if residents and faculty from the program can attend. Some families wish for the funeral to be private. Although difficult, it is vital to discuss what information can be relayed to faculty and residents. If the death is determined to be a suicide and the family does not want it disclosed, the emergency contact person should be informed that it would be helpful for fellow residents to know the cause of death. It is important to tell the emergency contact person that faculty and fellow residents are deeply affected by the passing of their loved one and would benefit from honest disclosure of cause of death. Doing so enables peers, faculty and support staff to fully process and grieve the death of the resident, to learn more about suicide and its causes, and, importantly, is an important step to keeping the residents safe and avoiding more tragedy. That said, it should be kept in mind that the family may be in a state of shock immediately following the death, and may not be ready to accept suicide as the cause of death; it is advisable not to push too hard, with the understanding that acceptance may arise within 24-48 hours. End the conversation by providing information about how the emergency contact person can reach one particular contact person (typically the caller) if questions arise following the initial call. If that person is not the individual making the initial call be sure that is clearly conveyed to the emergency contact person. Also, let them know to expect a follow up phone call within a few days. Suggested topics to cover with the emergency contact person can be found on Page 10. It may be relevant to inform the family of anticipated media attention surrounding the death of their loved one. Although suicides happen all over the world every day, the death of a resident may draw unwanted media attention and the caller can help prepare the emergency contact person.