Professor says being blamed for people killing themselves worries medical profession

Doctors view suicidal patients as a threat to their reputations and are more concerned with avoiding blame than treating people, a leading expert says.

Professor Roger Mulder, head of psychological medicine at Otago University, said clinicians were afraid of being blamed for suicides and were not acting in the patients' best interests.

Because of the difficulties in predicting when a suicide will occur, Mulder said, clinicians did risk assessments to reduce their anxiety in a "rationally selfish way".

In an article published in the Australian and New Zealand Journal of Psychiatry, Mulder writes the situation has created "a mythology with no evidence to support it, a sense of unease among clinicians and a culture of blame when things go wrong".


Mulder said he now believed "traditional psychiatric models of suicide prediction and prevention were not working.

"Very few psychiatric interventions have been shown to reduce the incidence of suicide," he added.

This week, he told the Herald on Sunday: "I think clinicians start to see patients as a bit of a threat to them. Sometimes instead of acting in the best interests of the patient they'll act in their own interests. They'll admit someone because they're anxious, not because the patient needs an admission."

Despite a large rise in drugs prescribed and ongoing treatment for at-risk patients, suicide rates remain high.

Figures released last week show there were 541 suicides in the 12 months to the end of June 2013, almost exactly the same as when records began in 2007.

Chief Coroner Judge Neil MacLean said Mulder's article was thought-provoking and "worthy of consideration by all working in this troublesome area".

Ahead of World Suicide Prevention Day on Tuesday, Mulder said his thinking had changed in this area after reviewing the evidence.

Mulder is keynote speaker at the Casper annual suicide prevention conference. Casper was set up by Maria Bradshaw, whose son committed suicide. She said Mulder had added credibility to her crusade against the use of anti-psychotic drugs to treat at-risk patients.

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