AbstractHelping medical colleagues with depression and suicidal thoughts and feelings can be more difficult than helping those who are not in the caring professions. The current systems of notification of impairment and supporting troubled doctors, especially in the public sector, are not working well and can make help seeking and help accepting harder. Accessing effective psychiatric help confidentially and in a timely way is difficult unless it is anticipated, facilitated, tenacious and resistant to initial rebuff. When suicide occurs, it is frequently associated with unhelpful generalisations on the value of psychiatric intervention among colleagues that makes others less likely to seek help or believe that the ‘the help will help’. The needs of the children of those who take their lives are often overlooked.