As a matter of fact, every specialty has some mortality, for Psychiatry, one of the unfortunate loss of the patients can be suicide. In USA the suicide rate has been increasing steady in the past several years due to many reasons.
Suicide is a selfish act in and of itself, almost every religion prohibit suicide. When a person kill him or her self, it is hard on the Physician and the family alike. There is some mixed feelings associated with any suicide, among them is significant guilt and the family is looking for a culprit to get rid of the guilt feeling, the very first person comes to mind is the Physician to blame. In reality the Psychiatrist does not have a “crystal ball” to predict, when a particular patient will commit suicide. Although every Psychiatrist must be aware of high risk patient for suicide, for instance, it is common in white elderly men, previous suicide attempts, current suicide ideation, intention or plan, poor social support, drugs and alcohol abuse to name a few and needs to be fully evaluated during the patient’s assessment.
In my recent case of a patient who was suffering from chronic depression possibly all his life, he was under treatment at Kaiser since 1998, off and on, and multiple hospitalizations due to decompensation. He was under my treatment at Community Behavioral Health Center for 6 days or so, he would be depress, some days and feeling better some days, but during hospitalization, continue to denies suicidal ideation, On the day of discharge he told me that he was ready and was feeling positive and futuristic, he was discharged in the morning, and his wife came to pick him up late during the day, stating she was busy with her work, he went happily with his wife that day, he had a follow up appointment the same day at Kaiser Intensive Outpatient Program, where he was enrolled already. He failed to go to his appointment and the next day his family left him alone, he has told the family that he was going to Pharmacy to refill his medication, but unfortunately went to the field and killed himself, none of us will know why?.
The Medical Board of California made an allegation against me stating it was as a result of “extensive investigation.” After the hearing it was determined that the treatment provided by me was within standard care of practice.