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Being Our Colleagues’ Keepers: Preventing Our Suicides

September 17, 2019
Moffic
By H. Steven Moffic
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The opinions expressed by Psychiatry & Behavioral Health Learning Network bloggers and those providing comments are theirs alone and are not meant to reflect the opinions of the publication.

“Suicide doesn’t get the last word.” – Pastor Jarrid Wilson

It was the most terrible irony of mental healthcare ironies. On the day before World Suicide Prevention Day, two well-known mental health advocates and professionals died by suicide. You don’t have to be a Freudian scholar to know that was likely not a timing coincidence. They were pastor Jarrid Wilson and Gregory Eells, the new head of mental health services at the University of Pennsylvania. They join the increasing overall prevalence of suicides in the United States.

Pastor Wilson, who was publicly open with his history of personal depression, in 2016 founded Anthem of Hope, a Christian organization designed to provide hope to those battling depression and related problems. He clearly stated that loving Jesus isn’t enough to cure such challenges. Depression, he often said, is a disease, not a result of inadequate faith. Earlier on that Monday evening he went to his son’s baseball event and was reported to be upbeat. Later, he was dead at the age of 30.

Eells, a leader in his field, had been at Penn for about six months, but recently had told his mother that he missed his family, who had not yet moved to join him. Eells had a reputation for his knowledge of resilience and apparently also seemed upbeat at work, once again suggesting that colleagues should not lower their guard about suicide risk just because somebody seems better. Indeed, the at-risk person may have just decided to take his own life and felt relief about that.

These two suicides of those involved in mental healthcare join the many other such tragic losses in our field. Psychiatrists, other physicians, and veterinarians, among whom we have the best data, seem to have the highest rates of suicide of any profession. One might think it would be the opposite because we know what helps and how to get the help. But whether it is from shame, fear or other factors, many do not get such help.

So, what else should administrators and executives try then in order to stem and reverse this tide? It seems to me that we have to try more opt-outs rather than opt-ins, as well as some required activities. Administrators would be responsible for staff, whereas administrations would need the help of their bosses or outside expert colleagues.

Some interventions, perhaps incorporating these recent suicides as case examples, might include:

  • Periodic education about suicide, not just in our patients, which goes without saying, but for our own unique risks;
  • Our own mental health should be monitored, sometimes randomly, all the while carefully guarding confidentiality;
  • Build trust so there will be truthful self-disclosure;
  • Involve family in the education about the mental health risks of working in our field, from the epidemic rate of burnout, to secondary trauma, and to suicide risk;
  • Improve our systems by engaging our staff and clinicians instead of mainly giving top-down directions and orders;
  • If your setting stores medications, including samples, be sure they are tightly controlled and monitored;
  • Form relationships with local religious organizations in regards to mental health and suicide;
  • Recognize that resilience goes only so far and that too much resilience can cause denial of one’s own personal problems;
  • Appreciate that someone who is gung-ho about a particular mental health problem may be dealing with that problem themselves.

The adverse ripple effects of the suicides of mental healthcare professionals is wide and strong. Besides the usual effects on loved ones of any suicide, this traumatic and often unexpected loss can leave guilt in colleagues and a sense of self-blame and abandonment in patients connected to the person.

The more we are on the lookout, as long as we are not being unnecessarily intrusive, the better. A desire to die by suicide is usually fleeting, so interrupting that in any way can be life-saving.

 

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