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2019 is the Austen Riggs centennial year.

Starting in 5 minutes! #MDedgechats

Starting in 5 minutes. #MDedgechats

Good evening! Not one I was working with, but several after we terminated. And it has happened to patients I admitted to Austen Riggs during 35 years as director of admissions. #MDedgeChats

This is an important subject and worth bringing to wider discussion. 38% of clinicians experience a significant reaction to this kind of loss. #MDedgeChats

Assessment of suicide is a big topic. Population based risk and protective factors are important, but in the end, in outpatient settings, one clinician is sitting with one patient. #MDedgeChats

Forensic psychiatrist Robert Simon said that there are two kinds of psychiatrists: those who have had a patient commit suicide and those who will. #MDedgeChats

Tillman reports 8 responses to suicide: Traumatic, affective, impact on Relationships with patients and colleagues; Risk management concerns; Feeling shame, humiliation, guilt, judgment, self-blame, grandiosity; Sense of crisis; Effect on work with other patients. #MDedgeChats

This year Riggs is 100 years old. Our Centennial Conference on September 21-22 is entitled The Mental Health Crisis in America: Recognizing Problems and Working Toward Solutions. Jane Tillman will speak on the 30% increase in suicide austenriggs.org/centennial-con… #MDedgeChats

If you lose a patient to suicide, seek consultation and support from a trusted colleague. Remember that isolation will be part of the problem, not the solution. Remember to call your insurance carrier for consultation regarding risk management issues. #MDedgeChats

In M&M reviews, avoid the twin perils of premature reassurance and blame. #MDedgeChats

Meeting with family is an issue: The primary purpose of such meetings is to meet their needs-not your own. Help them deal with a traumatic loss causing powerful and complicated feelings. If it helps you, that’s a bonus rather than the goal of the meeting. #MDedgeChats

There is hope. Results with suicidal patients at Austen Riggs suggest 75% are free of suicide as an issue in their lives an average of 7 years after admission (Perry et al, 2009). #MDedgeChats

Here’s a link to a paper on the impact of suicide that Jane and I wrote austenriggs.org/sites/default/… #MDedgeChats

On the Riggs website Jane Tillman offers a CME course on responding to the impact of suicide on clinicians austenriggs.org/course/impact-… #MDedgeChats

An expert panel reviewed evidence based therapies for suicidal patients to find shared elements-Plakun EM. Psychotherapy With Suicidal Patients Part 1: Expert Consensus Recommendations. J of Psychiatric Practice, 2018;24(6);420–423. DOI: 10.1097/PRA.0000000000000344. #MdedgeChats

Making suicide an interpersonal issue with meaning in the relationship can help with suicidal patients: Plakun. Psychotherapy With Suicidal Patients Part 2: An Alliance Based Intervention for Suicide. J Psych Practice, 2019;25;41–45.DOI: 10.1097/PRA.0000000000000355. #MDedgeChats