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#JamesDonaldson on #MentalHealth – Q&A: ACP President Discusses ‘Silent Epidemic’ Of #Physician #Suicide

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The death of #LornaBreen, MD, FAEP, the New York-Presbyterian Allen Hospital clinician who took her own life in April 2020, drew new attention to #physician #suicide, and led to an act of legislation that bears her name.

According to the Dr. #LornaBreen Heroes Foundation, the act “aims to reduce and prevent #suicide, burnout, and mental and #behavioralhealth conditions among #healthcareprofessionals.”

 The quote is: “Physicians are expected to be the people who never get exhausted and never complain about themselves.” The source of the quote is: George M. Abraham, MD, MPH, FACP, FIDS.

A February article in Perspectives in Psychiatric Care reported that 26 #healthcareprofessionals have died by #suicide during the #COVID-19 #pandemic.

Amanda Kingston, MD, wrote in a Missouri Medicine article that there has been an increased rate of #suicide among #physicians for at least 150 years, yet this “silent epidemic” has only recently started to draw significant attention.

A 2019 systematic review and meta-analysis in PLoS One indicated that #physicians in the U.S. were at a higher risk for #suicide than anywhere else in the world. Last month, an analysis in Mayo Clinic Proceedings of a survey taken before the #COVID-19 #pandemic revealed that 1 in 15 U.S. #physicians had thoughts of taking their own life in the past 12 months. A survey recently released by The #Physicians Foundation indicated 55% of respondents “know of a #physician who has either considered, attempted or died by #suicide in their career.”

“Comprehensive efforts are needed to increase access to emotional support for #physicians, to reduce the #stigma associated with seeking help and to cultivate self-valuation among medical #students, residents and #physicians,” the authors of the policy paper wrote.

ACP has embarked on such an effort. The organization recently published a policy paper titled “#Physician #suicideprevention and the ethics and role of a healing community” that stated interventions for #suicideprevention need to take place at individual, interpersonal, community and societal levels.

“The medical community has an obligation to foster a culture that supports education, screening and access to #mentalhealthtreatment, beginning at the earliest stages of medical training,” ACP wrote.

Healio Primary Care interviewed ACP President George M. Abraham, MD, MPH, FACP, FIDSA, professor of medicine at the University of Massachusetts Medical School and emeritus medical staff president of St. Vincent Hospital in Worchester, Mass., to learn more about the policy paper.

#JamesDonaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle

Healio Primary Care: What spurred the recent ACP policy paper on #physician #suicide?

Abraham: The ACP has continuously looked for ways to improve #physician well-being and lower the occurrence of #physician #suicide. Thus, the position paper was to keep the topic of #physician #suicide at the forefront.

Healio Primary Care: Data suggest the rate of #physician #suicide has declined over time in several European countries; however, a similar statistically significant decrease has not occurred in the U.S. Why do you think this is so?

Abraham: We think this is for two reasons.

No. 1, different data sources are being referenced. No. 2, in the #UnitedStates and probably even in Europe, there is probably some under-reporting and #stigma around #mentalhealthissues, especially among #physicians.

Most importantly, we feel that pressure of practicing medicine in the U.S. in today’s environment is extremely stressful. #Physicians, particularly primary care #physicians, are frustrated with electronic medical records and keeping up with workload and demands.

Primary care #physicians are in charge of controlling costs of medications, high-end imaging and tests. They are also responsible for prior authorizations and just about everything else. Many #patients also expect and express frustration with their primary care #physicians when they do not get instant results for their condition.

I cannot motivate any of my trainees to go into primary care, because everybody views this as one of those sinkholes where they are overworked and underpaid. Everybody wants to be a sub-specialist.

Healio Primary Care: Why are #physicians so reluctant to seek #mentalhealthcare ? What is your message to these #physicians?

Abraham: #Physicians are expected to be those people who never get exhausted and never complain about themselves and are always available for others, so seeking #mentalhealth carries the #stigma that they are not able to perform their work appropriately.

In some states, seeking #mentalhealthcare puts one’s medical license in jeopardy. In a broader sense, one might think seeking #mentalhealth means their employer might no longer want them at work. So, #physicians try to cover up their #mentalhealthissues as much as they can, until they crack and can no longer take care of #patients. #Physicians need to be able to have open conversations that treat #mentalhealthconditions as any other illness and that they can seek help without feeling intimidated or embarrassed. If we can return to or maintain wellness, we should have fewer and fewer instances where someone feels so stressed and burned out to go to the extreme of committing #suicide.

#Patients also need to realize that everyone is human, whether a person is a #physician or not, and that the expectations we have for #physicians should be the same ones we have for all non-#physicians.

Healio Primary Care: What are some community‐level activities aimed at improving #physician well‐being that have shown some success?

Abraham: Community groups that focus on wellness and self-care are a good place to start. There are also pharmacological options available, but these community groups should be explored before going that route.


DeCamp M, et al. J Gen Intern Med. 2021;doi:10.1007/s11606-021-06852-z

Dutheil F, et al. PLoS One. 2019;doi:10.1371/journal.pone.0226361.

DrLornaBreen.org. The legislation. https://drlornabreen.org/about-the-legislation/. Accessed Aug. 5, 2021.

Jahan I, et al. Perspect Psychiatr Care. 2021;doi:10.1111/ppc.12739.

Kingston AM. Mo Med. 2020;117(5): 426–429.

Shanafelt TD, et al. Mayo Clin Proc. 2021;doi: 10.1016/j.mayocp.2021.01.033.

The #Physicians Foundation. The #Physicians Foundation 2021 #Physician Survey: #COVID-19 impact edition: A year later. https://physiciansfoundation.org/physician-and-patient-surveys/the-physicians-foundation-2021-physician-survey/. Accessed Aug. 5, 2021.

person with a face mask and latex gloves holding a globe
Photo by Anna Shvets on Pexels.com

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