Medical know-how raises doctors' suicide rate

Your health or your career?
Depression is often the problem.

Depressed doctors frequently decide to self-medicate but don't seek psychotherapy that could help them deal with underlying issues, said Dr. Glenn Siegel, who runs a suburban Chicago program that treats doctors with drug abuse, depression and other psychiatric problems.

"It's not a safe topic to be as open about in that profession because you're responsible for the well-being of others," Siegel said. "If you're admitting something like that, you're saying maybe you're not fit to do your job."

Adds Lehmberg, the Arkansas surgeon, who is featured in the documentary: "You just would rather take a risk with your health than your career. It's not like you get a second chance with it."

A psychiatrist in the New York area who asked to remain unidentified said he had suicidal thoughts every day for several years. But in medical school in the 1980s, he said he was so embarrassed about seeking help for depression that he went to a pay phone instead of his dorm to call a therapist.

Since then, some schools have begun teaching medical students about depression among doctors, but, he said in an interview, "so much more needs to be done."

Because the stigma persists, he said he didn't want his name used to avoid hurting his family and relationships with colleagues and patients.

Some studies have suggested depression is more common among doctors, especially women physicians, and that the high demands of a job dealing with life-and-death issues makes them prone.

But Frank questions that and said she worries that singling out physicians risks "pathologizing" a profession whose members generally "have it awfully good."

"I think the situation gets portrayed as far more grave than it really is for physicians compared to anyone else in the world," Frank said.

There could be reasons why the stigma would be worse for doctors, "but you can come up with just as many reasons why physicians would be better equipped to acknowledge" mental illness, she said.

"We've all done psychiatric training. We all know bad mental health outcomes happen to good people," she said.

‘We have to stop the hiding’
A study in Denmark, published last year, found more suicides in doctors than among more than 20 other professions, including nurses, factory workers, elementary school teachers, corporate managers and architects.

But there are few comprehensive studies on suicides among U.S. doctors.

Some have been based on newspaper obituaries, which are "flawed at best" because suicide often isn't listed as a cause of death, said Dr. Morton Silverman, a University of Chicago suicide expert.

New Jersey physician Ron Brown suffered from depression and killed himself in 2002. His widow, Mumtaz Bari-Brown, said she believes the stigma kept her husband from getting help in time to save his life.

As a boy, Brown had been told his father died of a heart attack, not the real cause of suicide, the widow said.

"We have to stop the hiding and the ignorance and recognize it as a disease like high blood pressure or diabetes," said Bari-Brown, who also is featured in the new documentary.

Dr. G. Richard Smith, Lehmberg's doctor and director of the University of Arkansas for Medical Sciences' psychiatric research institute, said doctors need assurance they won't risk their jobs if they seek psychiatric help.

Smith succeeded in getting changes to questions on medical license applications in Arkansas that he believes will help. The old application asked doctors if they were being treated for mental illness or ever had been. A "yes" answer required a psychiatrist's note declaring they were fit to practice medicine. Now, they need only disclose mental health treatment that was advised or required by medical authorities.

The previous form didn't keep doctors with psychiatric problems from practicing, Smith said. But it did keep "doctors who needed treatment from getting the treatment that they needed."

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