Physicians more likely to be depressed or suicidal, psychiatrist says

Thursday, February 10, 2011 | 9:50 p.m. CST; updated 9:42 a.m. CST, Friday, February 11, 2011

COLUMBIA — Judith Grimmond wants to see physician suicide rates shrink.

In her presentation, “Doctors Who Kill Themselves: Physician Depression and Suicide,” Grimmond, a psychiatrist, tried to raise awareness of physician suicide among members of the medical community, including the more than 50 people who showed up to hear her speak Wednesday at University Hospital.

Three hundred to 400 doctors kill themselves every year, giving physicians a higher suicide rate than any other profession, Grimmond said.

“This is an issue we should all be concerned about,” Grimmond said to an audience mostly made up of members of the medical community.

Grimmond said in order to effectively prevent suicides among physicians there should be programs in place at an institutional level; hospitals should be trained to recognize depression in colleagues and patients; medical schools should educate and encourage treatment; and state licensing boards should have regulations, policies and practices in place that are nondiscriminatory and focus on impairment rather than diagnosis. 

While MU doesn't have any physician-specific programs in place, it does have programs to help people get treatment for and deal with illnesses such as depression. 

The University's forYOU team, a group of volunteers trained in critical incident stress management, and University Employee Assistance, a service for university employees, are both confidential avenues for depressed people.

“We’re getting closer, but it’s not really physician focused,” Grimmond said.

Grimmond also said social and family support, religious faith, coping skills and effective treatment — including a regular primary care doctor — can help prevent suicide among doctors.

The issue of physicians struggling with depression and suicide is not a new one, she said.

Grimmond cited one study that found the suicide rate for male physicians was roughly 40 percent higher than that for other males and the rate for female physicians was 127 percent higher than for other females.

Grimmond said that while the research varies, the general trend is the same. 

Long hours, professional demands, conflict between work and personal life and career dissatisfaction can contribute to depression among physicians, Grimmond said.

However, there is no solid evidence proving the links exist, she said.

Many physicians don't know what will happen to them or to their careers if they admit to having a mental illness such as depression, Grimmond said. 

According to Grimmond, the fear is that by checking the box next to "mental illness" on a State Medical Board examination or review, the diagnosis alone could lead to sanctioning and have serious repercussions for the physician.

Thirty-five of 50 states participated in an analysis of state medical boards and their policies regarding mental illness. In one-third of the participating states in the analysis, a diagnosis meant sanctions or other repercussions.

"Missouri seems to be halfway there," Grimmond said in response to the analysis. Missouri asks about previous hospitalization for mental illness and current impairment. 

Niels Beck, chief of psychology at MU, said he's seen many physicians as patients. He said physicians are similar to college and professional athletes in their approach to treatment.

Beck said they both fear their careers could be limited if peers found out they were seeking help for a mental illness and they tend to have a sense of entitlement and expect they will be treated in a "special" way and in many cases physicians feel pressure to actually give them special treatment.

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