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Suicide by patients: questionnaire study of its effect on consultant psychiatrists Objective: To identify the effect of patients' suicide on consultant psychiatrists in Scotland. Design: Confidential coded postal questionnaire survey. Participants: Of 315 eligible consultant psychiatrists, 247 (78%) contributed. Setting: Scotland. Main outcome measures: Experience of patient suicide; the features and impact of "most distressing" suicide and what helped them to deal with it. Results: 167 (68%) consultants had had a patient commit suicide under their care. 54 (33%) reported being affected personally in terms of low mood, poor sleep, or irritability. Changes in professional practice were described by 69 (42%) of the psychiatrists: for example, a more structured approach to the management of patients at risk and increased use of mental health legislation. 24 (15%) doctors considered taking early retirement because of a patient's suicide. Colleagues and family or friends were the best sources of help, and team and critical incident reviews were also useful. Conclusions: Suicide by patients has a substantial emotional and professional effect on consultant psychiatrists. Support from colleagues is helpful, and professional reviews provide opportunities for learning and improved management of suicide and its aftermath. BMJ 2000;320:1571-1574 ( 10 June ) David A Alexander, professor in mental health, a Susan Klein, Thompson research fellow, a Nicola M Gray, research assistant, a Ian G Dewar, senior registrar in psychiatry, b John M Eagles, consultant psychiatrist. b a Medical School, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, b Royal Cornhill Hospital, Aberdeen AB25 2ZH Correspondence to: D A Alexander, Centre for Trauma Research, Bennachie, Royal Cornhill Hospital, Aberdeen AB25 2ZH [log in to unmask] BMJ 2000 janet paterson 53 now / 41 dx / 37 onset 613 256 8340 / PO Box 171 Almonte Ontario K0A 1A0 Canada visit my website "a new voice" at: http://www.geocities.com/janet313/