19 After a Suicide | A Toolkit for Physician Residency/Fellowship Programs • In choosing a location, it is best that the memorial service not be held in regular meeting rooms; doing so could inextricably connect the space to the death, making it difficult for residents and faculty to return there for regular learning • The location should not be the place of death • It is also best if services are held outside of regular hours; involving family and the resident’s close friends in planning the memorial can be helpful • It is important to provide an opportunity for residents to be heard; it will be valuable to remind all who will be talking at the funeral the importance of emphasizing the connection between suicide and underlying mental health issues, and not romanticizing the death in any way • When announcing the memorial be sure to include details regarding what to expect and policies for attending funerals, arranging coverage for clinical assignments, and other relevant details • Counselors and mental health professionals should attend the memorial and be available to provide support • Attendees should be requested, if at all possible, to turn off their phones and pagers as a sign of respect to their deceased colleague; being able to truly focus for this brief span of time means a great deal to those most intimately affected by the loss Sometimes there is a desire to establish a permanent memorial (e.g., planting a tree, installing a bench or plaque, establishing a scholarship). Although such memorials may not increase risk of contagion they can be upsetting reminders to bereaved residents and faculty. Careful consideration should be given to whether a permanent memorial is warranted, and this should only be done if this is protocol for other resident deaths. If possible, permanent memorials should be located away from common areas of work and learning. It is also important to remember that once a permanent memorial is set up, it establishes a precedent that can be difficult to sustain over time. Other approaches for memorialization include: • Holding a day of community service or creating an institutional-based community service program in honor of the deceased • Putting together a team to participate in an awareness or fundraising event sponsored by one of the national mental health or suicide prevention organizations (e.g., outofthedarkness.org), or holding a local fundraising event to support a local crisis hotline or other suicide prevention program • Sponsoring a mental health awareness day • Purchasing books on mental health for the local library • Working with the administration to develop and implement a curriculum focused on effective problem- solving or other pro-mental health activities such as mindfulness • Volunteering at a community crisis hotline • Raising funds to help the family defray their funeral expenses • Making a book available in a common space for several weeks in which residents and faculty can write messages to the family, share memories of the deceased, or offer condolences; the book can then be presented to the family on behalf of the community