Do we need suicide enquires?

Suicide is a tragic event not only for the patient’s family but also for the healthcare professionals who are caring for him.

After fajr prayers, the young man next to me shook my hand and whispered, “Do you remember me”. I paused for a second or two before saying his name, his face let up with a smile as he nodded “Correct”. He was one of my patients who was diagnosed with schizophrenia during his first year at the university which led him to eventually leave as he could not cope with studying and living on his own in a big city.

I recognised him although he stopped coming to my clinic for over two years. He told me that he is now seeing a psychiatrist at a different clinic. I asked how he ended up in this masjid as I recalled he lived outside Muscat, and he told me he was visiting a friend in the area. We said goodbye and wished each other a nice day. A few weeks later I learned from a nurse who comes from the same village and knew his family that he was found hanging from the ceiling of his bedroom. The news came as a shock to me, he was in his early thirties. I kept thinking what could we have done to prevent this suicide ?

Suicide is a tragic event not only for the patient’s family but also for the healthcare professionals who are caring for him. It is not uncommon that doctors and nurses who lose patients to suicide experience variety of negative emotions such as anger, anxiety and depression as some tend to blame themselves and doubt their abilities to detect people with suicidal tendencies and provide the necessary support. The anger is often directed towards one self but sometimes to the person who committed suicide as if saying “why did you do this to us?" While anxiety can manifest in developing unnecessary fear that more patients will commit suicide and therefore need to stay in hospitals to prevent that, even when the risk is low.

In some countries a coroner's inquiry conducted by the legal system takes place to find out more about the person who committed suicide, how was he or she and where did the act of suicide took place and how they died. If the patient was seen by a psychiatrist before the court will request a medical detailed report and may call the doctors for a hearing before a judge.

Although the main idea is to learn from the event and prevent it from happening again some doctors feel that are being blamed for the suicide even if they followed guidelines. If the inquiry showed there was a negligence from the doctor side a disciplinary action would be taken which varies from suspension to license removal to imprisonment.

During my training in the UK, I met colleagues who have been through this process and they reported feelings of shame and self blame that changed their lives some had to take early retirement because they could not cope with the emotional toll that followed the enquiry however one needs to look at the positive side of the process which is reviewing facts and learning how to prevent the next suicide.