Physician Depression and Suicide Prevention

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Suicide is the 2nd leading cause of death for young people and is extremely high for physicians. Suicide doesn’t have to be a death sentence it is preventable. Below is an article by American Foundation for Suicide Prevention

Suicide Prevention

In October 2002, AFSP sponsored a workshop to address the disproportionately high rates of suicide among physicians and physicians in training. Studies in the last 40 years have confirmed that physicians die by suicide more frequently than others of their gender and age in both the general population and other professional occupations. On the average, death by suicide is about 70 percent more likely among male physicians in the United States than among other professionals, and 250 percent to 400 percent higher among female physicians. Unlike almost all other population groups in which men die by suicide about four times more frequently than women, among physicians the suicide rate is very similar for both men and women.

This initial workshop brought together experts from a variety of different fields to discuss the many factors that appear to contribute to physician suicide, especially the frequent failure of physicians to recognize depression in themselves (and also in their patients and colleagues). Workshop discussions also focused on institutional barriers that interfere with physicians seeking help when they are aware they are depressed. In some states, the mere fact that a physician is in psychiatric treatment can trigger an intrusive investigation by a state licensing board that can lead to sanctioning regardless of whether there is any evidence of impaired functioning. Within some hospitals and medical centers, appropriate concerns about protecting patients from impaired physicians have inadvertently created a climate that leads depressed physicians to be concerned for their academic and career prospects if they seek the treatment that might prevent impairment from developing.

Following the AFSP workshop, a consensus statement was published in the Journal of the American Medical Association that included recommendations for needed changes in professional attitudes and institutional policies to encourage physicians with mental health problems to seek help.

AFSP subsequently played a leadership role in organizing working groups of experts from major healthcare organizations and medical institutions to further develop recommendations in eight key areas: medical student and resident education, medical student and resident health, hospital policies toward physicians with depression and other mental disorders, policies related to licensing of physicians, policies related to physician malpractice and disability insurance, and needed research on physician depression and suicide. In July 2005, AFSP and the Milbank Memorial Fund cosponsored a meeting of these expert groups to share the results of their work and develop actions plans for implementing each group’s recommendations. Results of this meeting were reported in the American Medical Association’s Medical News.

The initial workshop for this project was supported by the Bob and Lynn Bernard Charitable Fund of the Ayco Charitable Foundation.
AFSP is currently working on two new projects aimed at reducing the high suicide mortality rate among physicians:

Physician Depression and Suicide Prevention Film Project

Wyeth and the American College of Psychiatrists have joined AFSP in funding a one-hour documentary film as part of an educational campaign to heighten awareness about physician depression and suicide. The FREDDIE award-winning documentary, Struggling in Silence: Physician Depression and Suicide, premiered on KCET-TV of Los Angeles in the spring of 2008, and has aired on over 300 PBS stations nationwide. The campaign includes educational films and a website, DoctorsWithDepression.org.

A companion film targeted to medical school students, Out of the Silence: Medical Student Depression and Suicide, is being disseminated by AFSP to medical schools across the country, and third film has been created for use in hospitals, residency trainings and at educational conferences and seminars. Both these films include resource materials. The films were produced by the Academy Award®-winning State of the Art Inc.

Through this campaign, AFSP seeks to educate physicians about depression so that they can better recognize the symptoms in themselves and their patients while also cultivating a better understanding of mood disorders in the community at large.

Media coverage of this campaign has been extensive, with more 15 million impressions to date, and an article in Newsweek magazine. More>

Outreach to Medical Students, Residents and Physicians at Risk for Suicide

A pilot project is underway to extend the outreach methods developed through the College Screening Project to medical students, residents and hospital physicians. The goals of this project are to identify individuals with serious depression and other problems that put them at risk for suicidal behavior, and encourage them to get treatment. It is hoped that the anonymous online “dialogues” with a clinician that the screening method allows will prove effective in helping medical students and physicians resolve concerns about treatment that are currently preventing many from seeking help. An initial participant in the pilot project is the University of Pittsburgh. It is anticipated that four more institutions will join the project as additional funds are obtained

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