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GPs more compelled to seek legal advice after patient suicide due to increased scrutiny

The number of doctors seeking legal advice in the wake of a patient’s suicide has more than doubled in the last decade, despite an overall decline in suicide rates, the Medical Defence Union has found.

The MDU was contacted about patient suicides 259 times in 2013, compared with 113 in 2004. It has already been contacted 180 times so far in 2014, of which more than half of contacts – 56% – have been from GPs.

Legal experts say the growth in requests for guidance may be a result of increasing scrutiny doctors are under in the wake of a death.

MDU medico-legal adviser Dr Richenda Tisdale said: ‘When a suicide occurs, relatives usually ask what steps healthcare professionals took to help their loved one. There will also be an inquest, at which the deceased’s doctor may be asked to give evidence.’

‘The increase we are seeing in MDU members wanting support and guidance in this area may be because doctors are coming under closer scrutiny when a patient commits suicide.’

Dr Tisdale added managing mental health conditions in particular can be difficult for doctors, saying: ‘GPs in particular are on the front line for the identification and management of mental illness. Of the 180 cases notified to the MDU so far in 2014, over half (56%) were from GPs. Around a third (29%) came from psychiatrists, and the remainder from other specialties.’

The MDU have issued guidance on avoiding common pitfalls when treating patients with depression, including:

  • Be alert to the possibility of depression in patients with a history of mental illness, chronic health conditions and vulnerable groups such as the elderly or young.
  • If it isn’t possible to discuss all of a patient’s mental health concerns in one short appointment then ask the patient to come back for a longer appointment and book this straightaway.
  • Document discussions with patients carefully. If they are seen by a colleague at the next appointment, it should be clear from the notes that the patient has had depressive symptoms or suicidal thoughts.
  • If the patient fails to attend a follow-up appointment, it is advisable to try to contact them to find out why. The MDU is aware of cases where opportunities may have been missed to review a patient.
  • Encourage the patient to allow you to involve close family members or friends who may be able to offer additional support. Bear in mind your duty of confidentiality although it is not a breach of confidentiality to listen to the concerns of a relative or friend.