Amidst the demanding pace of medical training, feelings of stress, exhaustion, and overwhelming workloads are frequently voiced. These shared experiences not only resonate with many medical trainees but also serve as potential precursors to the emergence of profound mental health challenges, with suicide being among the most concerning. Medical learners and physicians are not exempt from mental health concerns but are in fact at a greater risk for experiencing distress related to the concerns of demanding work, long hours, and increased exposure to the suffering of patients. Suicide within the physician and medical learner community is an important topic deserving of attention due to the alarming rates of suicidal ideation and completed death by suicide among medical student and resident populations.
Examining this critical issue more closely reveals the pressing need for comprehensive strategies and support mechanisms. For these strategies to be effective it is imperative that barriers to care be removed and that the stigma associated with mental health be reduced. Mental health stigma oftentimes 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. Research has found when compared to same aged peers, medical learners experience significantly more concerns related to burnout, stress, anxiety, and depression. Moreover, research has demonstrated that in contrast to individuals outside the medical field, physicians who die by suicide are typically less inclined to engage in mental health treatment.
Here at the Department of Mental Health Services (DMHS) we recognize that medical education is a challenging endeavor and that the provision of medical care to patients can also be difficult to manage. We recognize the importance of being able to create a supportive environment for medical learners across the training spectrum to feel heard, seen, and cared for in their academic and professional pursuits. DMHS is committed to increasing the awareness of suicide, reducing the stigma of mental health, and providing helpful resources to address this growing concern for a vulnerable population.
This September we hope that you would join us in this pursuit of hope and healing and engage with the variety of resources and activities below:
Warning Signs
Considering the benefits of early mental health intervention (e.g., early diagnosis, onset medication management, specialist referrals, preventative 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
Starting a conversation
While recognizing the warning signs of mental health distress and suicide are important, it equally as important to know how to support and communicate with someone who is experiencing signs of distress. The tips below provide a helpful guide in initiating conversations and expressing concern towards those who may be exhibiting signs of mental distress. Remember the acronym T.E.L.L.
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 though 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.”
DMHS Suicide Awareness Activities
1,000 Paper Cranes
Folding hope, one paper crane at a time. Join us in creating 1,000 paper cranes for suicide awareness — a symbol of unity, resilience, and the power of community.
DMHS Mental Health Questionnaire
Checking in on your own mental health is an important part of staying healthy and caring for yourself. The DMHS Mental Health Screener is a chance for you to reflect on various aspects of your mental health and well-being. It is fully anonymous, and nobody will contact you in response to your answers. You won’t receive a score at the end, but completing the screener may enable you to reflect on how you feel and whether it may be appropriate to take some steps to better care for your mental health. At the end of the screener, you’ll find a list of resources that you can access if, in completing the screener, you realize that you may benefit from additional tools or support.
Take the mental health screener.
DMHS Podcast
The Department of Mental Health Services introduces our new monthly podcast, “Well Beings: Strategies for Surviving and Thriving at the School of Medicine and Beyond.” Monthly episodes will take short, in-depth dives into self-care strategies. This September, we focus on the critical topic of addressing suicide and difficult conversations.
Upcoming DMHS Events
Suicide Awareness Tabling Event
If you are an Indianapolis trainee, then join us on Thursday September 14th from 12–1 p.m. at the Ruth Lilly Medical Library. Discover suicide resources, craft paper cranes, and recharge with snack. See you there!
On a regional campus? No worries, check-in with your lead advisor to gain access to the available suicide prevention resources.
Dean’s Grand Rounds — Invited Guest Speaker Dr. Mike Myers
Join us on October 25th from 12–1 p.m. to hear from Dr. Mike Myers who is an expert in the field of physician suicide. His presentation will cover how bullying, microaggressions, and stigma may contribute to worsening mental health among medical learners and will also cover strategies for a helpful pathway forward.
Need to talk?
For 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 a few ways to access services:
- To request an appointment with the Department of Mental Health Services, send a secure message via the online portal or call 317-278-2383 during normal business hours (Monday–Friday, 8:30 a.m. to 5 p.m.).
- For urgent matters, call 317-278-HELP (4357), 24 hours a day, 7 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.
- TimelyCare is a free resource to all IU students that allows them to have 24/7 on-demand emotional support as well as scheduled telehealth visits (with some after hours and out of state access) through a national vendor. You can engage with a clinician via phone, video, or video chat. Signing up just requires your student email.
For IU Health employees:
- IU Health Physicians Employee Assistance Program
- IU Health Spiritual Care and Chaplaincy Services; call 317-962-8611
- National Crisis Hotline; call or text 988 (available 24/7)
For IU Employees:
- 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.
Access to Anthem LiveHealth Online is included with your IU-sponsored medical coverage. This service allows you to engage with a mental health provider via telehealth using your IU insurance provider.
