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What Physicians Can Do to Prevent Suicide

By jfellows@healthleadersmedia.com  
   November 05, 2015

"Half a million people are dead who should not be dead," says a researcher who has identified a steep rise in deaths among middle-aged whites. With data like this, how can physicians not seek out more mental health training to help them understand how to effectively treat patients?

Suicide is among the reasons mortality among middle-aged whites has unexpectedly increased, according to an unsettling report published by a pair of Princeton economists this week. In order for physicians to effectively respond to these patients' needs, they should demand more access to mental health training and resources.


>>>Rising Morbidity and Mortality in Midlife Among White Non-Hispanic Americans in the 21st Century Source: PNAS

A couple of weeks ago I wrote about the Accreditation Council for Graduate Medical Education's focus on improving mental health resources for residents. The ACGME is holding a national symposium on the subject in a couple of weeks and it could prove to be a turning point in reducing mental health stigma within the physician community.

But the report published this week showing a marked increase in death rates among middle-aged white men points to a need to include more mental health training for physicians to address patients' needs. And a study published last year showed high rates of suicide among elderly white males. "Half a million people are dead who should not be dead," the paper's co-author, Nobel laureate Angus Deaton, said.

According to a study, published in the Proceedings of the National Academy Sciences, (after it was rejected by JAMA and others) increases in drug and alcohol poisonings and suicides "were large enough to drive up all-cause midlife mortality," specifically for whites age 45 to 54. Other causes of death include chronic liver disease and cirrhosis.

The findings are significant because they are limited to middle-aged whites, according to the report. Death rates among blacks and Hispanics continued to fall in these categories. Researchers estimated that 7,000 deaths in 2013 alone could have been avoided.

With data like this, how can physicians not seek out more mental health training to help them understand how to effectively treat patients?

Maria Oquendo, MD, president-elect of the American Psychiatric Association, attributes it to the stigma that persists among physicians about patients who present with mental illness. "There is a belief that psychiatric conditions are not real, and not that big of a deal," she says.

Stigma in Practice
Such thinking is short-sighted particularly because of numerous studies that show mental and physical health are connected. Treating diabetes, for example, without addressing a patient's depression likely decreases the chance of positive outcome.

Jacqueline Fellows is a contributing writer at HealthLeaders Media.

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