12 After a Suicide | A Toolkit for Physician Residency/Fellowship Programs Do’s Don’ts Avoid Contagion In written communications, acknowledge the tragic loss to suicide of a member of our program (and call it a suicide if emergency contact person has given permission). But do not include the suicide method in written communications. During in-person meetings, it’s ok to mention the method of suicide, but avoid dwelling on the manner of death during in-person conversations (e.g., “___ took his life by hanging. We probably won’t ever fully know all of the factors that led to his suicide, but we recognize that there must have been overwhelming pain/struggle and we grieve his loss”). Don’t include graphic or detailed descriptions of the suicide method, location, circumstances surrounding the death Don’t highlight pictures of the location or sensationalized media accounts Even during in-person meetings, avoid providing more detail than the general method (e.g., “died by overdose, hanging, took his life using a firearm”). Going beyond this into more detail is not advisable especially in written or group settings. Don’t Glorify the Act of Suicide Talk about the person in a balanced manner. Avoid idealizing the person and only extolling virtues. Do not be afraid to include the struggles that were known, especially during conversations. Try to avoid describing the deceased resident only in terms of his/her strengths. This paints a picture of suicide being an option/solution or presents a confusing picture when the person’s apparent struggles aren’t mentioned or alluded to. Encourage Help-Seeking Always include the list of resources and the after- hours numbers that anyone can call 24/7. Include the National Suicide Prevention Lifeline at 1-800- 274-TALK (8255), and the Crisis Text Line at 741-741. Don’t portray suicide as a reasonable solution to the person’s problems. Give Accurate Information About Suicide Explain that suicide is a complicated outcome of several health and life stressors that converge at one moment in a person’s life to increase risk. Mention the fact that mental health is a real part of life, dynamic and changing like other aspects of health, that we all have common life struggles, and can support one another. Explain that along with risk factors, there are known protective factors that mitigate risk for suicide. Emphasize the institution’s stance on help seeking as a sign of strength, a way to show the most proactive mature level of professionalism. Mention the fact that there have been times when all good leaders have sought support or healthcare to the good of their personal health/wellbeing, as well as for the betterment of their professional work. Don’t portray suicide as the result of one problem, event or issue.