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IntroductionThe loss of a patient to suicide is a common experience among mental health practitioners and trainees. Research suggests that younger, less experienced clinicians are often most keenly affected by the experience. Given the prevalence of patient loss to suicide and the subsequent emotional aftermath, our goal in creating a multidisciplinary suicide symposium was to provide a safe, structured environment where trainees and mental health practitioners could obtain collegial support and education to reduce the stigma surrounding patient suicide.MethodsMental health trainees and practitioners (including medical students, nurse practitioner students, psychiatry residents, psychology interns, and practicing psychologists and psychiatrists) were invited to a 4-hour symposium. The curriculum focused on assessment of risk and possible interventions, as well as addressing the loss of a patient to suicide. Teaching methods included a PowerPoint lecture; case-based, small-group discussion; and role-play. Attendees completed numbered, anonymous surveys looking at attitudes about loss and suicide before and after the symposium.ResultsOf 35 total attendees, 22 completed both pre- and postsymposium surveys. Paired t tests revealed several statistically significant increases, including increases in comfort seeking support from a colleague after losing a patient to suicide (p = .043) and comfort seeking support from a professional after losing a patient to suicide (p = .030).DiscussionThe symposium appears to have had the desired effect of increasing attendees' comfort working with patients at risk for suicide, as well as their comfort reaching out for support from others following the loss of a patient to suicide.

Suicide risk assessment and coping with the loss of a patient through suicide are two of the more challenging aspects of psychiatry residency. Over the last decade, the Department of Veterans Affairs has focused on a significant effort into the development of a comprehensive suicide prevention. This article aims to describe the initiatives and resources in place at the VHA to help address the issue of suicidal behavior in veterans and how residency programs can use this to enhance teaching of suicide prevention and postvention.

Objective The USA needs to produce more psychiatrists to meet projected workforce deficits. The American Association of Directors of Psychiatric Residency Training Directors (AADPRT) sought to examine opportunities for and obstacles to expanding or creating residencies and fellowships. Methods In November 2019, the authors conducted a survey of residency and fellowship directors. The survey gathered information about new positions, new programs, participation in interprofessional education, and loss of residency or fellowship positions. Results The survey was distributed to psychiatry residency (N=231) and fellowship (N=194) directors, with a response rate of 33.4%. One quarter of responding residencies and fellowships reported creating new programs; 24.7% of residency and 17.5% of fellowships reported expansion. The most common reason to develop or expand programs was the shortage of psychiatrists, with the local institution as the most common funding source. Fifty-seven percent reported that they had wanted to expand, but faced barriers, primarily lack of funding. Recruitment and retention of faculty are major challenges. Psychiatry departments frequently (87.5%) participate in interprofessional education, generally perceived as positive. Unfortunately, 15.7% of respondents reported loss of positions or closure of programs. Conclusions Creating and expanding residencies and fellowships are common strategies for addressing the shortage of psychiatrists. Barriers include lack of funding and challenges recruiting/retaining faculty. The loss of residency/fellowship positions or closure of programs is a worrisome trend.