Michael Myers wrote a book about an incredibly morbid subject.
Dr. Myers, Professor of Clinical Psychiatry in the Department of Psychiatry & Behavioral Sciences at SUNY-Downstate Medical Center in Brooklyn, N.Y., explored physician suicide in his new book, "Why Physicians Die by Suicide."
Not surprisingly, Myers says burnout is a major cause of physicians taking their own life. However, admitting burnout, as many have done according to research done by the Mayo Clinic, is just one symptom of what could be a major problem. Unfortunately, he says, there is a stigma around doctors asking for mental health help from other medical professionals. If burnout is a "badge of courage," Myers says, physicians admitting they need to see someone for mental health issues is stigmatized.
Myers talked about physician suicide, the so-called shame of doctors' receiving mental healthcare, and much more in an exclusive Q&A with Physicians Practice.
Below are excerpts from this interview.
What kind of research backs up your belief that more and more physicians are dying by suicide?
I'm not sure if more and more are [dying by suicide], but the figure from the American Society for Suicide Prevention, estimates that somewhere between 300-400 die by suicide per year in the U.S., which translates into about one a day. We don't know how many medical students have taken their lives, so we don't know if this is an underestimate.
I've specialized in physician health my entire career. I've looked after a lot of suicidal [thinking] doctors. I've lost a few doctors in my practice to suicide. Two and half years ago, I started a qualitative interview project. I started interviewing family members of doctors who have died by suicide. Then I extended that to colleagues and friends of doctors, and I interview some patients of doctors who took their lives. I also interviewed some of their professors, students, and therapists. I also interviewed doctors who made near lethal suicide attempts, but lived and were able to talk about how awful that was for them, to be so sick. The book really is their stories…that forms the substance of the book.
What is causing these suicides to happen?
There is never one factor that drives a person to kill themselves. Those of us who specialize in suicide have always felt it's a whole number of factors coming together at one time. When it comes to physicians, what we look for is not just whether or not they are stressed by their patients or stressed by burnout, but we also look to see if they have a history in their families, for instance, of mental illness. If they've been previously depressed themselves and could be having a recurrence of that. Are they on particular medications that might be causing them to have suicidal thoughts? Do they have a head injury that could be making them depression prone or suicide prone? Those are the so-called biological factors we look for. The other [factors] are psychological — is there something going on at work, in addition to a lot of work? Has there been a lawsuit recently? Are they in trouble with their employer? Are they going through a divorce? Have one of their children been kicked out of school or had a medical or psychiatric problem? Those are the psychological problems. Then we look for culture problems. Are they experiencing discrimination in the workplace because they are a racial or ethnic minority? Are they struggling with their gender or orientation? Do they have extreme financial difficulties? Even though they are physicians, they could have had a lot of things go wrong, and they could be struggling financially….Those are the socio-cultural factors that could be playing a part.
Why do you believe there is a stigma around doctors receiving mental health care?
First of all, we know it exists. Those of us in mental health, we've done a better job lowering this stigma in the general public than we have for those in medicine. It's still hard for physicians to admit to themselves, "I'm depressed, I'm going to see a psychiatrist."