Greater support for senior house officers

Sir: The paper by Dewar et al (Psychiatric Bulletin, 2000, 24, 20-23) makes a very interesting read and triggered memories of a suicide I faced as a senior house officer in training. I had seen a young man in the accident and emergency department while on call. He expressed suicidal ideas and had a primary diagnosis of personality disorder. A decision was taken to discharge him to his general practitioner's care after discussion with a senior consultant. Unfortunately he committed suicide seven weeks later.

I was unprepared for my own reaction, a mixture of surprise, disbelief and guilt. I had been the last professional in contact with the patient and I was required to prepare a report and appear in the coroner's court. Over the next six months I was fraught with fears and anxiety. I received no support from colleagues and seniors and the only person who was any help was the solicitor instructed by my trust to defend me in court.

Having read the paper by Dewar et al, I feel I would have benefited from some training for the consequences or the organisational procedures following suicide. I feel I should have had a mentor or a similar senior person to open up to.

Senior house officers are the most vulnerable doctors, owing to their relative inexperience and the fact that it is often the first time they come across suicide. There should be a better support network when something on these lines occurs.