There’s a mental health crisis in the medical profession.
U. S. medical doctors have a higher rate of suicide than the general population. Because of perceived stigma around psychotherapy, many doctors and medical students do not get the mental health care they need—the same mental health care they should be arranging for their patients.
The Boston Globe’s Judith Graham reports that, according to the American Foundation for Suicide Prevention, every year 300-400 doctors commit suicide. A study done by Dr. Eva Schernhammer, of Brigham and Women’s Hospital and Harvard Medical School, confirms that male doctors are 1.4 times more likely to kill themselves than the general population, while female physicians are 2.3 times more likely. “The grim tally is probably an under-count, since many suicides aren’t listed as such on death certificates,” writes Graham. “And it doesn’t include suicides among medical students, which aren’t tracked systematically in the United States.”
Graham notes that physical and emotional demands cause many first-year medical students to become depressed—and the depression continues to worsen as their studies become more intense. Upon graduating and entering their profession, these young, somewhat-fragile doctors experience “An immersion in human suffering. Long work hours. High expectations. A dread of making mistakes.” According to Graham, “They’re often profoundly uncomfortable with acknowledging vulnerability. And they must adapt to a rapidly changing health care environment.” Graham continues that many doctors and students deny themselves therapy and inpatient treatment for depression, fearing that this will count against them in professional advancement.
Some schools and hospitals are trying to understand the suicidal depression phenomenon and provide resources and treatment. Also reporting for the Globe, Joan M. Anzia, M. D., the Physician Health Liaison at Northwestern University’s Feinberg School of Medicine, recommends a three-pronged approach: 1. Educate and destigmatize mental health treatment for physicians; 2. Provide burned-out students and doctors with mental health assessment, support, and treatment; and 3. Lessen the hours and intensity of a typical medical doctor’s workload and emphasize preventive care.
Doctors who suffer from undiagnosed depression may well be linked to the reported failure of medical practices to screen for depression and suicidality among their patients. The Department of Health & Human Services has invested billions of dollars to promote an integrated health system combining behavioral and physical health care, including wellness and prevention. These efforts are premised on primary care physicians making timely referrals of their patients to specialists, including behavioral health professionals.
Clearly, mental health care needs to be part of a physician’s regular treatment, for both their patients and themselves. As the largest behavioral healthcare provider group in the United States, clinical social workers are key team members in integrated care, providing critical services to every element of the patient/client population—doctors included.
Piece by Molly Booth.