When a psychiatric patient commits suicide, it's tragic for everyone involved. At times, however, it can also become an administrative nightmare for the patient's treating psychiatrist -- especially if the patient's family alleges malpractice.
A malpractice claim regarding suicide will definitely attract the attention of the Medical Board of California, so it's important to understand what you need to do to manage the risks that are inherent with your profession.
According to risk managers, here are some of the things that open a psychiatrist up to board complaints over a suicidal patient:
- Not carefully documenting the ongoing monitoring of a patient who has shown signs of being suicidal
- Not responding at all to family members who reach out with warnings that a patient is suicidal (even within the limits of professional confidentiality)
- Not going through the full informed-consent process before prescribing a psychiatric medication that could increase the risk of suicide
- Not carefully evaluating the patient's environment for additional risk factors (like the access to firearms)
- Not taking into account a patient's previous attempts at suicide
- Not carefully documenting changes in medication or changes in monitoring and the therapeutic basis for those changes
- Not responding promptly and appropriately (to the best of your ability) to a patient who is clearly in crisis and reaches out for assistance
- Not keeping a patient who has a definitive plan for suicide in the hospital under observation
Even the best psychiatrist may lose a patient to suicide from time to time. Psychiatry, like all other medical disciplines, cannot cure every patient or prevent all patients from harming themselves. With that in mind, it's important to carefully document everything you do to help the suicidal patient -- just in case it becomes an unfortunate necessity to defend your medical license later.