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Coping with a coroner's inquest: a psychiatrist's guide

  • Paul St John-Smith, Albert Michael and Teifion Davies

Summary

During the period 2000–2004 the average annual suicide rate in England and Wales was 10.2 deaths per 100 000 population over 10 years of age. About a quarter of those who take their own lives are in contact with mental health services in the year before their death. This means that an average in-patient, sector or community psychiatrist is likely to experience the death of at least one patient by suicide in most years. Suicides by patients cause considerable distress for the psychiatrist that is unlikely to resolve until after the coroner's hearing. This article discusses suicide prevention and provides guidance for psychiatrists on preparing for a coroner's inquest following a patient's death that may have been by suicide.

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Copyright

Corresponding author

Albert Michael, Wedgwood House, West Suffolk Hospital, Bury St Edmunds IP33 2QZ, UK. Email: Albert.Michael@smhp.nhs.uk

Footnotes

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For a commentary on this article, addressing the situation in Scotland, see pp. 17–22, this issue.

Declaration of Interest

None.

Footnotes

References

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Coping with a coroner's inquest: a psychiatrist's guide

  • Paul St John-Smith, Albert Michael and Teifion Davies

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Coping with a coroner's inquest: a psychiatrist's guide

  • Paul St John-Smith, Albert Michael and Teifion Davies
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eLetters

Psychological reactions to coroner's inquest

Anita D. Damle, Consultant Psychiatrist
13 January 2009

I found the article helpful. It does bring together relevant information for the psychiatrists facing the coroner’s inquest. It was however disappointing that it did not deal with the psychological reactions and the process of bereavement of varying degree that the psychiatrist goes through. Rightly or wrongly, the psychiatrist will hold herself or himself responsible for the outcome and often experiences consequent guilt, self blame, self reproach and sadness. Much of the psychological and psychiatric interventions have a basis of patients putting their trust in the doctor and the caring team and feelings of having failed can be and often are overwhelming, at least initially. The families are expected to grieve, feel the pain but the professionals are expected to remain detached and professional. This can lead to feelings ofhaving nowhere to go to work through the process of loss. The routine clinical work goes on, colleagues no doubt help up to a point but in the end the individual has to come to terms with it. We are all affected by what happens to our patients, and if we are not, then perhaps it is time to retire from clinical medicine. More exploration of these emotions wouldhave helped to normalise and understand the reactions and any suggestions as to how to negotiate this inevitable occurrence in one’s professional career would have added much to the otherwise excellent article. Perhaps this is a topic for another article. ... More

Conflict of interest: None Declared

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