27 After a Suicide | A Toolkit for Physician Residency/Fellowship Programs Do Not Focus on the Method or Graphic Details Say Talking in graphic detail about the method can create images that are upsetting and can increase the risk of imitative behavior by vulnerable individuals. If asked, it is okay to give basic facts about the method, but don’t give graphic details or talk at length about it. The focus should not be on how someone killed themselves but rather on how to cope with feelings of sadness, loss, anger, etc. “It is tragic that he died by hanging. Let’s talk about how [NAME] death has affected you and ways for you to handle it.” “How can we figure out the best ways to deal with our loss and grief?” Address Anger Say Accept expressions of anger at the deceased and explain that these feelings are normal. “It is not uncommon to feel angry. These feelings are normal and it doesn’t mean that you didn’t care about [NAME]. You can be angry at someone’s behavior and still care deeply about that person.” Address Feelings of Responsibility Say Reassure those who feel responsible or think they could have done something to save the deceased. Many physicians have exceedingly high expectations of themselves, and along with medical training, they may feel that they should have detected signs of suicide risk. The reality is that many cloak their internal distress (to their detriment) so that it can be challenging for even the closest people in their lives to observe the change in their mental state. This highlights the importance of asking and caring when you notice even subtle changes in others’ usual way of behaving and approaching problems. “[NAME] was a colleague, a friend, and not your patient. No one has the ability to predict imminent suicide. We do know that talk saves lives. If your gut instinct tells you something is different about a fellow resident’s behavior, just engage in a conversation with them, and if you are concerned encourage them to seek help and consider letting [NAME OF APPROPRIATE LOCAL PERSON] know.” “This death is not your fault. This is an outcome we all would have wanted to prevent, and no one action, conversation or interaction is what caused this.” “We can’t always predict someone else’s behavior. Especially when many of us are able to hide distress.” Checklist continued on next page >