Gaps in suicide-related clinical competence across European psychiatric training: a multicountry study of trainees and early career psychiatrists

Objective: Suicide prevention is a core competence in psychiatric practice, limited data are available on suicide-related knowledge among European psychiatric trainees and early career psychiatrists (ECPs). The study aimed to examine variation in knowledge and perceived suicide-related competence. Methods: An online survey was conducted in a multicountry convenience sample of psychiatric trainees and ECPs across Europe from May 2024 to October 2025. Participants completed a questionnaire on exposure to patient suicide (PS) and related reactions/support, the Suicide Knowledge and Skills Questionnaire, and the Maslach Burnout Inventory. Results: A total of 259 psychiatric trainees and ECPs from 36 countries completed the survey. The mean percentage of correct responses in the suicide knowledge section of the SKSQ was 76.7%. Participants exposed to at least one PS showed higher knowledge scores than those not exposed. In regression models, suicide knowledge was positively associated with personal accomplishment, exposure to PS, and comfort in asking direct suicide-related questions. Conclusions: Findings reveal variability in suicide-related competence across European psychiatric training, suggesting the need to strengthen structured, skills-based suicide prevention training, regular supervision, and post-event support pathways. Such training should not rely on reactive learning after adverse clinical events, but should address both technical, emotional and ethical competencies of psychiatric practice.