Overly Freaked Out?

[MajorAllday]

I just finished PGY1 and I've seen my fair share of sick psychiatric patients over the last six months, but today, I had 2 attendings tell me about how they've had patients stalk and threaten them and their families. One seemed pretty minor, but the other more significant. Now, I've had patients in the inpatient unit yell at me and throw out the usual threats here and there, but it ended there. These attendings were describing OP cases. Now these two attendings are pretty old and have seen it all and they tend to work with very sick patients in a major urban setting and my plan was always to be a typical med management psychiatrist in the suburbs. I recently got married and today it just struck me that I don't know how I could handle someone threatening my wife and kids. I don't know if it was the fact that one of these cases was so extreme, but this is the part of psych that always worried me. Then, I think about all the psychiatrists that I've worked with, and how they seem to be pretty happy for the most part, married, and they seem to do OK handling these kinds of concerns. How do you guys handle it?

---

Members don't see this ad.

 

[TexasPhysician]

Define "threaten them or their families"? I'm assuming you are talking to inpatient psychiatrists dealing with a lot of psychosis. In such an environment, there may be monthly "threats" where someone says they want to kill you, but no credible threats by anyone organized to follow through.

In outpatient pp, I haven't had even a vague threat in the 2+ years of work.

There was a study somewhere about relative danger of medical professions, and psych I think was average. ER docs and ob's are higher risk for actual danger.

 

[MajorAllday]

Define "threaten them or their families"? I'm assuming you are talking to inpatient psychiatrists dealing with a lot of psychosis. In such an environment, there may be monthly "threats" where someone says they want to kill you, but no credible threats by anyone organized to follow through.

In outpatient pp, I haven't had even a vague threat in the 2+ years of work.

There was a study somewhere about relative danger of medical professions, and psych I think was average. ER docs and ob's are higher risk for actual danger.

Nah, I've seen the typical IP stuff. That really doesn't worry me cause most often they are just general threats that mean nothing. These two incidents described to me were with outpatients, both of which had serious psychosis it sounds like and were being seen for therapy.

 

[FlowRate]

Could always concealed carry, if that makes you feel any safer.

 

[smalltownpsych]

The combination of psychotic enough to be driven to kill people and organized enough to carry it out is thankfully pretty rare and when it does occur they could target anyone for any bizarre reason so targeting the mental health provider specifically is even more rare. I have yet to run into a psychotic patient that worried me much at all. Now if you happen to be a real jerk that might increase the odds a bit as at least then they have a legitimate reason to target you. Even then, the patient usually just wants to complain about it and is easily deescalated.