It’s estimated that between 300 and 400 physicians die by suicide each year. While September is Suicide Awareness Month, National Physician Suicide Awareness Day (NPSA Day) is a relatively new initiative that focuses on bringing increased awareness to the mental health struggles faced by many in the medical profession. This year, NPSA Day is Saturday, September 17.
Medical learners and physicians are not exempt from mental health concerns. In fact, they are at greater risk of experiencing distress related to demanding work, long hours and the suffering of patients. Studies show that physician death by suicide rates range from 1.41 (male physicians) to 2.27 (female physicians) times higher than that of the general population. Furthermore, studies show that physicians who die by suicide are also less likely to be involved in any type of mental health treatment when compared to those outside of the medical profession.
One of the main barriers to access of care for physicians is mental health stigma, or the societal and/or internalized negative belief that mental health concerns are representative of shameful and disadvantageous personal characteristics. Stigma often operates as a barrier for those in medical settings due to fears surrounding disclosure discrimination, academic reprimands or concerns about long-term career prospects. While it may seem logical or even appropriate to guard yourself from the perceived negative consequences of a mental health disclosure, the long-term implications of an unaddressed mental health concern usually result in more significant distress and possibly more severe professional repercussions later.
Considering the benefits of early mental health intervention (e.g., early diagnosis, onset medication management, specialist referrals, preventive care), it is important to highlight possible warning signs of mental health distress and suicide.
• Withdrawing from social interactions
• Significant changes in hygiene or self-care
• Direct verbalizations of suicidality
• Mentioning feeling trapped or hopeless
• Extreme changes in mood, such as rage and violence, or threats
• Indirect signs of suicidal thoughts, such as giving away belongings and shifting from being very sad to very calm
• Signs of impaired thinking, such as risky behaviors, disorganized speech or thoughts, and paranoia
• Dramatic decline in performance at work or school
While recognizing the warning signs of mental health distress and suicide are important, it is equally important to know how to support and communicate with someone who is experiencing signs of distress. The tips below provide a helpful guide for initiating conversations and expressing concern towards those who may be exhibiting signs of mental distress.
Starting a conversation
Remember the acronym TELL.
T – Tell them your evidence
• “You haven’t been yourself the past few days.”
• “I’ve noticed you’ve been canceling plans a lot lately.”
E – Express your concern
• “I’m worried about you.”
• “I want to be sure you’re doing okay.”
L – Let them talk
• “How are you doing?”
• “What’s going on?”
L – Learn their risk and get help
• “Have you thought about killing yourself? Do you know when? Do you know how?”
• “I know it’s hard now, but things can get better. Let’s get you help.”
As NPSA Day approaches, the IU School of Medicine Department of Mental Health Services encourages you to take a moment to reflect on your own personal well-being. This information is intended to bring helpful insight to the warning signs of mental health distress/suicide and provide education on how to begin a conversation with someone if you are concerned about them. If you or someone you know is experiencing any sign of mental health distress, please consider seeking help by speaking with a peer or a licensed mental health professional.
Need to talk?
For learners/trainees:The Department of Mental Health Services is available to provide mental health and personal counseling services to all students, residents and fellows. There are two ways to access services:
• In an emergency, call 317-278-HELP (4357), 24 hours a day, seven days a week. A licensed clinical health specialist will provide an assessment and help direct you to appropriate treatment options based on the situation. You may also call on behalf of a trainee if you are a family member, friend or colleague concerned about their well-being. You may call anonymously, if desired.
• To request an appointment with the Department of Mental Health Services, send a secure message via the online portal at indianamedportal.pointnclick.com or call 317-278-2383 during normal business hours (Monday – Friday, 8 am to 5 pm).
The IU Employee Assistance Program (EAP) provides 24/7/365 access to licensed mental health counselors via SupportLinc or 888-881- LINC (5462) for IU School of Medicine team members and their households.
The views expressed in this content represent the perspective and opinions of the author and may or may not represent the position of Indiana University School of Medicine.
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