The medical school recognized September as National Suicide Prevention Month and September 17 as National Physician Suicide Awareness Day.
On Saturday, September 25, a group of about 25 WMed faculty and staff took part in the 8th Annual Gryphon Place Suicide Prevention Walk in Bronson Park. The 5K walk raises awareness for suicide prevention and proceeds go to Gryphon Place, a non-profit organization whose mission is to help people navigate conflict and crisis, foster resiliency, restore community and support healing.
An estimated 300 to 400 physicians die by suicide each year, according to the American Foundation for Suicide Prevention (AFSP). That statistic equates to roughly one doctor dying every day and is a rate nearly double that of the general population.
The suicide rate among male physicians is 1.41 times higher than the general male population. Among female physicians, the suicide rate is more pronounced at 2.27 times greater than the general female population.
Physicians who took their own lives were less likely to be receiving mental health treatment compared to non-physicians who died by suicide even though depression was found to be a significant risk factor in both groups, according to the AFSP. Among physicians, risk for suicide increases when mental health conditions go unaddressed and self-medication occurs as a way to address anxiety, insomnia or other distressing symptoms. Even though self-medicating may reduce some symptoms, it does not treat the underlying health problem and can lead to a tragic outcome, according to the AFSP.
The Council of Residency Directors in Emergency Medicine’s “Vision Zero” mission asks individuals, residency programs and health care organizations to break down stigma, increase open conversations, decrease the fear of consequences, reach out to colleagues, recognize warning signs and learn to approach colleagues who may be at risk.
“Each physician touches so many lives in ways that we underestimate,” said Paula M. Termuhlen, MD, dean of the medical school. “The recent loss of our faculty member Dr. Rebekah Sharp to suicide has been so profound for me to see. She touched the lives of many people and likely did not realize the impact she made in their lives.
“Whenever you lose a physician, particularly to suicide, it has a far-reaching effect because of all the different constituents of people involved – our community, our students, our patients, our colleagues, our families, our friends. We are very public people as physicians and the loss is deeply felt by many.”
At WMed, we need to continue to provide opportunities to talk to each other and learn about suicide prevention, said Karen Horneffer-Ginter, PhD, the medical school’s associate dean for Culture and Wellness. She stressed the need for those who are struggling with depression, burnout or thoughts of suicide to feel safe to reach out to people around them or to confidential mental health resources.
Leaders are encouraging the medical school’s faculty, residents, staff and students to continue to check in with each other, Dr. Horneffer-Ginter said. It’s also essential we work as leaders to ensure everyone in the WMed community has the resources they need to accomplish their work and that structural changes are put into place as needed, she said.
“Medical education and health care tend to draw very committed and gifted people who are willing to work hard and to take on extra responsibilities,” Dr. Horneffer-Ginter said. “A downside of this is that it can feel hard to reach out or to speak up when it’s just too much. This is one reason why it’s so important to continue fostering a culture that is responsive and supportive.”
As a teaching organization, WMed can publicly and intentionally make resources available, focus on programming that teaches wellness, and make sure there are no penalties involved for getting the help when one needs it, Dr. Termuhlen said. She emphasized the need to reach out to someone who may be struggling and making sure that they know that they’re not alone.
“We have to be very intentional in teaching strategies around wellness, around resilience and around being able to speak up when you need help and to not feel shamed about it,” Dr. Termuhlen said. “We need to recognize it’s OK to not be OK.”
Another, harder to solve aspect is being more intentional about the work that is done at the medical school and the stressors it brings into people’s personal lives, Dr. Termuhlen said.
“Figuring out how to make sure people have the flexibility to control their time, how to give them breathing space after they’ve had long days on call and how to build redundancy into the system so no one person has to feel like everything is on their shoulders – these are the other things we need to be more intentional about,” she said.
Building a culture of wellness will help to avoid burnout and avoid struggles that may contribute to mental health crises, Dr. Termuhlen said.
“You have to come at it from a lot of different avenues,” Dr. Termuhlen said. “It’s taught through education and it’s recognizing individuals. As a collective, we’re here to help each other. We’re able to forgive ourselves and forgive others for mistakes. There’s a whole dimension of this that builds a culture of wellness and caring and also helps us be more successful as a medical school.”
Physicians are taught to power through stress in medical school and residency, oftentimes clinging to the myth that “it will get better,” said Perry Westerman, MD, program director for the medical school’s Psychiatry residency program. Often, not sleeping enough and working long hours is seen as a sign of dedication but physicians also need a team to back them up and be willing to share the load.
Physicians should reach out when they notice themselves or a colleague being more short-tempered or irritable, more dependent or more demanding. Sometimes they will try to “double down” on their dedication, rely more on substances or retreat to maladaptive coping mechanisms such as self-medication, Dr. Westerman said.
The reality is that there is still a stigma of mental illness – that someone who is feeling depressed should be able to pull themselves out. But depression can take on a life of its own, especially if a person has a family history of it, Dr. Westerman said.
“Stress and genetics produce a situation that looks like you’re just sad, but it’s there all the time and you can’t get away from it,” Dr. Westerman said. “It’s hard for us to say when we need to get some help. That’s part of the challenge.”
Suicidal feelings are not uncommon and will appear when a person feels stuck in a situation where they don’t perceive there to be any good options, Dr. Westerman said.
“It’s really a marker for distress,” Dr. Westerman said. “Acknowledging suicidal feelings does not mean everyone should be in the hospital. It’s acknowledging I need to do something to help myself and I’m looking for help. That should be something we see as the first step. We should listen and not judge too quickly.”
Listening is the first thing and the most important thing to do for a colleague, he said.
Be aware of these warning signs of suicide:
Talking or thinking about suicide, feelings of hopelessness or helplessness, self-loathing, withdrawing from others, getting affairs in order, and a sudden sense of calm are some of the warning signs of suicide. Learn more about how to spot warning signs.
If you are struggling:
The National Suicide Prevention Lifeline provides free, confidential support and resources for people in distress: 1-800-273-8255. The WMed Critical Incident Stress Management Team has a variety of resources available for our faculty, residents, students, and staff on the WMed Portal.