Surgeons and Suicide Ideation

Updated 3/2017-- all links removed as many are no longer active and it was easier than checking each one.

There is a new article on surgeons and the risk of suicide in the January issue of Archives of Surgery (full reference below).

The Kansas City Star’s new article on the study includes this from a colleague who was a plastic surgeon here in Little Rock when I went into practice.  He left his surgical practice a few years ago, retrained and is now in hospice care at the local VA. (photo credit)

Dr. Robert Lehmberg, 63, said it took prodding from close friends to finally get him to seek treatment for depression and suicidal thoughts several years ago. Though he feared losing his license and being stigmatized, neither happened, and he said medication and psychotherapy have greatly helped.

…….

The article notes suicidal ideation (SI) among individuals 45 years and older is 1.5 to 3.0 times more common among surgeons than the general population (P < .02).

This study was commissioned by the American College of Surgeons (ACS) Committee on Physician Competency and Health.  It used an anonymous cross-sectional survey in June 2008. The survey included questions regarding suicidal ideation (SI) and use of mental health resources, a validated depression screening tool, and standardized assessments of burnout and quality of life.

There was a response rate of only 31.7% which resulted in 7905 participating surgeons.  Of these, 501 (6.3%) reported SI during the previous 12 months.

 Only 26% (130/501) of the surgeons with recent SI had sought psychiatric or psychologic help.  More than half [301 (60.1%)] reported the same reluctant to seek help due to concern that it could affect their medical license as Dr. Lehmberg mentions above. 

Burnout with all 3 domains of burnout (emotional exhaustion, depersonalization, and low personal accomplishment), depression, and  report of a recent medical error were independently associated with SI even after controlling for personal and professional characteristics.

The authors conclude:

Although 1 of 16 surgeons reported SI in the previous year, few sought psychiatric or psychologic help. Recent SI among surgeons was strongly related to symptoms of depression and a surgeon's degree of burnout. Studies are needed to determine how to reduce SI among surgeons and how to eliminate barriers to their use of mental health resources.

Related posts:
Doctors with Depression (September 24, 2008)
Stress and Burnout Among Surgeons – an Article Review (April 22, 2009)
Doctors With Depression (September 24, 2009)

REFERENCE

Special Report: Suicidal Ideation Among American Surgeons; Tait D. Shanafelt; Charles M. Balch; Lotte Dyrbye; Gerald Bechamps; Tom Russell; Daniel Satele; Teresa Rummans; Karen Swartz; Paul J. Novotny; Jeff Sloan; Michael R. Oreskovich; Arch Surg. 2011;146(1):54-62.

Restoring Hope

Updated 3/2017-- video and all links (except to my own posts) removed as many are no longer active and it was easier than checking each one.

Yesterday at a family Christmas gathering I learned of my family’s connection to this military effort to prevent suicide.  I posted on my second cousin-in-law Josh Farmer’s suicide back in September 2009.  His wife Stephanie and her mother Gail Gunter (my first cousin) pushed for an investigation, pushed for more to be done in the future for other families.  It resulted in a law named after Josh.  Gail needed to tell us of the video and the law.  I want to pass it on to all of you.

 

 

For more information:

Pentagon.gov  -- Restoring Hope

Suicides and Our Soldiers

Updated 3/2017-- all links (except to my own posts) removed as many no longer active. and it was easier than checking each one. 

This topic has become more real for my family. My first cousin’s son-in-law committed suicide this past weekend. He had had difficulty adjusting since his return from Iraq, but the family was still caught off-guard. If you can make it any worse, he chose his wife’s birthday to take his life. Fortunately, neither she nor their toddler son was home at the time.

The issue of soldier suicide concerns many. Maj. Gen. William D. Wofford, Arkansas' National Guard Adjutant General, recently made a public plea for help asking family members, friends and employers of the state's 10,000 Guardsmen to watch for personality changes or signs of stress overwhelming his soldiers and airmen. There has been four suicides in Arkansas Guardsmen since January.

As Dr Chad Morrow points out the suicide risk for active duty males is now higher than for the general population.

This is particularly noteworthy considering that the military entrance process screens out serious mental illness prior to entry onto active duty, and that the rate of suicide in military males has historically been significantly lower than comparable civilian populations.

Morrow goes on to touch on “the three-way interaction between burdensomeness, belongingness, and acquired capability.” He suggests that “belongingness is less robustly related to suicidal desire than burdensomeness.”

I don’t know if my young cousin-in-law’s suicide could have been prevented. He came back from Iraq physically intact. I’m not sure how much help he sought or took advantage of. I do know he has left loved ones who now have to face their grief, the loss of his presence, and many questions.

Here are some of my random thoughts on suicide prevention in our troops:

They need to feel connected. We know that text messages have been helpful in getting patients to do better with their chronic diseases or take their meds. Is there anyway to use text messages to help them feel more connected?

Could the military and/or guard set up a “facebook” system for the troops where they could interact with each other? Virtual “group sessions” that would overcome distance (living too far from a VA Clinic), like telemedicine.

Solders, like physicians, have a higher completion rate on suicides than the general public. You can’t take away the training needed to do our jobs. The focus has to be on connecting, feeling useful/needed/capable.

Each individual has to reach out and grab the lifeline that is thrown his way.

Sources

Ark. National Guard asks for help as suicides rise; AR State Wire
By Jon Gambrell, Published: Sep 18, 2009

Suicide in active duty military personnel by Chad Morrow, Psy.D; Psychotherapy Brown Bag, September 1, 2009

Army Suicide Rates Hit Record High; Huffington Report by Pauline Jelinek and Kimberly Hefling; January 29, 2009

Fort Campbell hosts suicide run: Run for Resiliency at Destiny Park features 25 information booths By JAKE LOWARY; The Leaf-Chronicle, September 20, 2009