26 After a Suicide | A Toolkit for Physician Residency/Fellowship Programs Appendix B: Tips for Talking about Suicide Give Accurate Information About Suicide Say Suicide is a complicated behavior. It is not caused by a single event. Research is very clear that in most cases, underlying mental health conditions like depression, substance abuse, bipolar disorder, PTSD, or psychosis (and often comorbid occurrence of more than one) were present and active leading up to a suicide. Mental health conditions affect brain functioning, impacting cognition, problem solving, and the way people feel. Having a mental health problem is actually very common and is nothing to be ashamed of, and help is available. Talking about suicide in a calm, straightforward manner does not put ideas into residents’ minds. “The cause of [NAME]’s death was suicide. Suicide most often occurs when several life and health factors converge leading to overwhelming mental and/or physical pain, anguish, and hopelessness.” “There are treatments to help people with mental health struggles who are at risk for suicide or having suicidal thoughts.” “Since 90 percent of people who die by suicide have a mental health condition at the time of their death, it is likely that [NAME] suffered from a mental health problem that affected [HIS/HER] feelings, thoughts, and ability to think clearly and solve problems in a better way.” “Mental health problems are not something to be ashamed of ­ — they are a type of health issue like any other kind, and there are very good treatments to help manage them and alleviate the distress.” Address Blaming and Scapegoating Say It is common to try to answer the question “why?” after a suicide death. Sometimes this turns into blaming others for the death. “The reasons that someone dies by suicide are not simple, and are related to mental anguish that gets in the way of the person thinking clearly. Blaming others — or blaming the person who died — does not acknowledge the reality that the person was battling a kind of intense suffering that is difficult for many of us to relate to during normal health.” Checklist continued on next page >