29 After a Suicide | A Toolkit for Physician Residency/Fellowship Programs Appendix C: Sample Scripts to be Used in Face-to-Face Communication Death Ruled a Suicide It is with great sadness that I have to tell you that one of our residents, [NAME], has died by suicide. All of us want you to know that we are here to help you in any way we can. A suicide death presents us with many questions that we may not be able to answer right away. Rumors may begin to circulate, and we ask that you not spread rumors you may hear. We’ll do our best to give you accurate information as it becomes known to us. Suicide is a very complicated act. It is usually the culmination of several health and life factors that converge in a person’s life during the same period of time, including mental health conditions such as depression, which lead to overwhelming mental and/or physical pain, anguish, and hopelessness. Sometimes these risk factors are not identified or noticed; in other cases, a person with a disorder will show obvious changes or warning signs. One thing is certain: there are treatments that can help. Suicide should never be an option. Each of us will react to [NAME]’s death in our own way, and we need to be respectful of each other. Feeling sad is a normal response to any loss. Some of you may not have known [NAME] very well and may not be as affected, while others may experience a great deal of sadness whether you knew him/her well or not. Some of you may find you’re having difficulty concentrating, and others may find that diving into your work is a good distraction. We have counselors available to help our program deal with this sad loss and to enable us to understand more about suicide. If you’d like to talk to a counselor, these are the contacts [INSERT CONTACTS HERE]. Sometimes physicians, when confronted by the death of a colleague, feel responsible. They wonder if there was “something that they missed.” First, remember, that [NAME] was a colleague, a friend, and that [NAME] was 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 caring conversation and listen to their thoughts; if you are concerned encourage them to seek help and consider letting [NAME OF APPROPRIATE LOCAL PERSON] know. This is a time to take a moment to be together, to remember [NAME] in our grief, and to support one another. Please remember that we are all here for you.