I’ve come across a couple of articles recently that got me thinking about their applicability to the lives of physicians, especially suicidal male physicians. One is about the use of an app for the military1 and the other about an online intervention for men in general2. Research on well-being and resilience in interns and residents has introduced this technology, using a cognitive behavioral approach to suicidal thinking, and we await studies of its effectiveness in reducing morbidity and mortality3. But what about physicians beyond training—especially men in their middle years, a group that in general is known to have higher rates of suicide4? Could an app become something in our arsenal to prevent male doctors from acting on their desperate decision-making and instead, seek professional help?
Objective Zero1 is a foundation and mobile app that instantly and anonymously connects veterans to other veterans during moments of crisis. How it differs from conventional 1-800 crisis center numbers is that for many vets “it’s crucial to speak to someone who’s walked where you’ve walked.” Could it be that some male physicians struggling with burnout, depression, or substance abuse feel the same way? They may need to talk to another physician, may believe that the fellow physician will “get him” and might be able to assuage his fears of being alone and unique. A mechanism like this would require many volunteers but this should not be a deterrent. Much like individuals in Alcoholics Anonymous who become sponsors, there could be committed physicians who would gladly put their name forward as someone to call. This would be especially appealing to physicians who have been treated for depression and are now well, or doctors in recovery for substance use disorders. Many are interested in helping colleagues who are struggling.
Man Therapy is a resource here in the US that is designed for men with depression5. Its messaging is gender-specific and uses humor in a sensitive way to appeal to men. It has been endorsed by the Suicide Prevention Resource Center. In Australia, the Black Dog Institute has established a brief web and mobile phone intervention for men with depression2. Because men do not always access the usual health services (much like doctors in this country!) they have created content tailored to men’s specific mental health needs. My hunch is that this type of resource could appeal to physicians in need who pride themselves on ruggedness and self-sufficiency and who think that going for mental health care represents failure of autonomy. I can recall many physicians whom I’ve treated who at intake felt embarrassed, weak, and angry at themselves that they had to consult a psychiatrist for help. Fortunately, they are the ones who did “knock on my door” and avail themselves of care for treatable psychiatric illnesses.
My argument is that all of us in the mental health field need to be creative in making it easier for symptomatic and frightened doctors to seek help when they need it. The motto of “one shoe does not fit all” is so apt when it comes to distressed and hopeless doctors. This piece is about male physicians. My next blog will apply a different lens and address thinking outside the box in saving the lives of women physicians. Stay tuned.
- Objective Zero. https://www.objectivezero.org/. Accessed December 13, 2017.
- Forgarty AS, Proudfoot J, Whittle et al. Preliminary evaluation of a brief web and mobile phone intervention for men with depression: men’s positive coping strategies and associated depression, resilience, and work and social functioning. JMIR Mental Health. 2017;4(3):e33.
- Guille C, Zhao Z, Krystal J et al. Web-based cognitive behavioral therapy intervention for the prevention of suicidal ideation in medical interns: a randomized clinical trial. JAMA Psychiatry. 2015;72(12):1192-1198.
- U.S.A. Suicide: 2015 Official Final Data. http://www.suicidology.org/Portals/14/docs/Resources/FactSheets/2015/2015datapgsv1.pdf?ver=2017-01-02-220151-870. Accessed December 13, 2017.
- Man Therapy. Suicide Prevention Resource Center Web site. http://www.sprc.org/resources-programs/man-therapy. Accessed December 14, 2017.