The wall of silence is slowly coming down. The tragic deaths of two newly minted residents in New York City in 2014, both of whom jumped off of buildings within one week of each other, has brought attention from ACEP, the Accreditation Council for Graduate Medical Education (ACGME), the Society for Academic Emergency Medicine (SAEM), the Council of Emergency Medicine Residency Directors (CORD), and other national organizations to this problem. In 2015, ACGME held its first-ever symposium on physician wellness, and ACEP, SAEM, and CORD have also introduced wellness initiatives, including ACEP’s Emergency Medicine Wellness Week.
Explore This IssueACEP Now: Vol 36 – No 01 – January 2017
What will it really take to reduce the rate of physician suicide? Many suggest a three-pronged approach:
- Destigmatize seeking help through education, with a change in culture and policies that makes it easier for physicians to access mental health care when it is needed.
- Inform the medical community of how to recognize the signs of depression and burnout and the knowledge of how to refer colleagues who need help.
- Research to understand and change the factors related to the practice of medicine that create higher rates of burnout and depression in physicians.
These are not easy tasks but are necessary to help avoid the loss of precious physician lives.
As the push continues on a global level, the question remains, is there more that we can do in our own shops to help our colleagues and friends? Keeping with the three-pronged approach, here are some suggestions:
1. Although it is not always possible to know when someone is contemplating suicide, some common warning signs include:
- Talking about their own death or being preoccupied with death/dying
- Obtaining the means to take their own life
- Withdrawing from social contact
- Feeling trapped or hopeless
- Increased use of drugs or alcohol
- Engaging in risky or self-destructive activities
- Giving away belongings or getting affairs in order without a logical reason
- Saying good-bye to people as if they will not see them again
2. If you suspect someone you know may be contemplating suicide, be willing to ask the difficult questions and to listen. You are not responsible for preventing someone from taking their life, but your intervention may help. Examples of questions to ask include:
- How are you coping with what is happening in your life?
- Do you ever feel like giving up?
- Have you thought about harming yourself?
- Have you ever attempted to harm yourself before?
- Do you have access to a means to harm yourself?
3. If someone shares with you that they are contemplating suicide:
- Encourage them to seek help; be aware of local resources including your institution’s well-being committee
- Provide them with the National Suicide Prevention Lifeline at 800-273-8255
- Offer to help them in seeking assistance and support
- Remind them that things will get better
- Encourage them to avoid alcohol and drug use
- Remove dangerous items from the person’s access, if possible
For more information about suicide and suicide prevention, go to www.suicidology.org, www.afsp.org, www.survivorsofsuicide.com, and www.acgme.org, which has developed a new set of resources particularly for physicians in training.