Mental Health

“I Should Have Known”—Identifying Suicide’s Warning Signs

Posted on Sep 14, 2020 in Carousel, Mental Health, Scroll Images, Uncategorized

A message from John Boyd, PsyD, Sutter Health’s CEO of Mental Health Services, during Suicide Prevention Awareness Month.

When I learned the news that I had lost someone to suicide, my first thought was, “I should have known.”

As a long-time mental health advocate and practitioner, I knew my response was the most common thought to cross the minds of those touched by suicide. I knew that family and friends repeatedly consider what difference it may have made had they known and intervened. I knew my years of education and training did not make me immune from this sense of responsibility and guilt.

It can often take a community to detect the warning signs that surface as pieces of a puzzle, appearing at different times and before different people. That people considering suicide are often afraid to speak up due to the stigma surrounding the mental health and addiction issues that most often lead to suicide. And while mental health issues are the most common reason for death by suicide, there are more hidden and less known reasons—financial problems, traumatic stress, relationship issues, the loss of family acceptance, academic failure and bullying.

This is why it’s so important that all of us learn as much as we can about the warning signs that lead to this irreversible outcome. National Suicide Prevention Awareness Month gives us all the opportunity to learn and share more.

We can all relate to struggling with despair and hardship. And there are specific signs that point to it all becoming too much for someone to bear—things like hopelessness about the future, sleep problems, withdrawal from friends or social activities, changes in personality or appearance, dangerous or self-harmful behavior, making preparations to put personal business in order, or threatening or talking about suicide. Mental health challenges are the leading factor, with 30% to 70% of suicide victims suffering from major depression or bipolar (manic-depressive) disorder, according to Mental Health America. The organization also notes that those with substance abuse disorders are six times more likely to complete suicide than those without.

Strikingly, this is an issue particularly common among healthcare workers who spend their days caring for others. Research cited by the Journal of the American Medical Association (JAMA) estimates that one doctor commits suicide each day. Physicians’ suicide risk is higher than any other profession due to higher rates of anxiety, depression and burnout. Yet, due to long-held stigmas, it is often more difficult for healthcare providers to reach out for support, notes the American Academy of Family Physicians (AAFP). Studies show that this risk is only increasing as providers care for themselves, their families and their patients during a global pandemic. At Sutter Health, we make our physicians’ and employees’ mental wellbeing a top priority, creating awareness, providing resources and reducing the stigma surrounding speaking up and asking for help.

Coming Together for Human Health

In what ways do we—as a community—address these alarming facts? It starts with understanding that mental health is human health. We are all human, deserving of compassion and grace. It starts by each and every one of us talking openly, sharing our experiences and listening to others to break through the stigma associated with mental health and addiction challenges.

In sharing our stories and experiences, we can reduce stigma. In opening our hearts and minds, we can heighten awareness. Most importantly, in coming together with care and compassion for one another, we can work together to recognize when someone needs us most.

Crisis Lifelines

If you or someone you know is in distress, please contact the National Suicide Prevention Lifeline at 1-800-273-8255. Or you can connect with a trained crisis counselor through the Crisis Text Line by texting 741741.

“Tell me your life story, I’m listening, I see you.”

Posted on Sep 3, 2020 in California Pacific Medical Center, Community Benefit, Expanding Access, Health Equity, Innovation, Mental Health, People, Quality, Research, Scroll Images, Sutter Medical Center of Santa Rosa, Sutter Medical Center, Sacramento

Faculty and residents in Sutter’s Family Medicine Residency Program

We are a mosaic of our experiences, lifestyle, social and family connections, education, successes and struggles. Apply those factors to our health, and a complex formula arises that clinicians commonly call the patient experience.

Learning the skills to assess these factors and deliver compassionate care to patients is what Sutter’s family medicine resident physicians aim to enhance. The newly enhanced Human Behavior & Mental Health curriculum is helping lead the way.

“We encourage faculty and residents to think about context, systems and dynamics within population health to address social determinants of health,” says Samantha Kettle, Psy.D., a faculty member in Sutter’s Family Medicine Residency Program.

She and colleague, Andy Brothers, M.D., a family medicine physician in Sacramento and faculty member in the residency program, are bringing health equity to the patient experience and training family medicine residents in Sacramento and Davis.

Family medicine faculty and residents at Sutter Medical Center, Sacramento

Seven residents each year learn to screen patients for social determinants of health (such as financial challenges, environmental and physical conditions, transportation needs, access to care and social factors) that may impact patients’ risk of depression and anxiety, substance use disorder and suicide.

This year’s residents may train in addiction medicine, psychotherapy, chronic pain, spirituality in medicine, well-being and the field of medicine that supports those who are incarcerated.

And in a community as diverse as the Sacramento Valley Area, statistics suggest these factors may significantly impact the health of its residents:
• 15.9% of California adults have a mental health challenge(1)
• Nearly 2 million Californians live with a serious mental challenge
• Substance misuse impacts 8.8% of Californians
• The prevalence of mental health challenges varies by economic status and by race/ethnicity: adults living 200% below the federal poverty level are 150% more likely to experience mental health challenges; 20% of Native Americans and Latinos are likely to have mental health struggles, followed by Blacks (19%), Whites (14%) and Asians (10%).

“Taking care of our local population’s health is a moral imperative,” says Dr. Kettle. “Many residents have entered our program to continue their quest in helping people in underserved communities.”

For instance, third-year Sutter family medicine resident Mehwish Farooqi, M.D., is studying ways to screen for post-partum depression using an approach developed through the ROSE (Reach Out, Stay Strong, Essentials for mothers of newborns) program.

“Women are most vulnerable to mental health concerns during the post-partum period: as many as one in seven women experience PPD. ROSE is a group educational intervention to help prevent the diagnosis, delivered during pregnancy. It has been found to reduce PPD in community prenatal settings serving low-income pregnant women,” says Dr. Farooqi.

“Sutter has clearly demonstrated a commitment to health equity and social justice that has propelled our residency program toward a future vision of health care in which all patients are cared for as individuals with unique life stories, struggles and successes,” says Dr. Brothers.

Advancing Social Determinants of Health through Graduate Medical Education at Sutter:
Other family medicine programs across Sutter’s integrated network incorporate health equity into ambulatory training for residents. The family medicine faculty at California Pacific Medical Center include a social worker who teaches residents to address concerns like financial and food insecurity, as well as social isolation. Residents learn how to care for people with depression and anxiety, and lecture series are offered on topics like addiction medicine and chronic pain/narcotic management.

Sutter Santa Rosa Regional Hospital’s Family Medicine Residency Program incorporates social justice through a Community Engagement and a Diversity Action Work Group—a committee comprised of faculty and residents who help tackle issues around inequity and structural racism.

“We are committed to strengthening a relationship between the residency program and the diverse communities we serve, guided with cultural mindfulness and compassion in our pursuit of overall wellness for all,” says Tara Scott, M.D., Program Director of the Family Medicine Residency Program in Santa Rosa.

Learn more about Sutter’s Family Medicine Residency Program.
• Find out how Sutter is advancing health equity.

Reference:

  1. California Department of Health Care Services.

Can COVID-19 Spur Change in Mental Health?

Posted on Sep 2, 2020 in Mental Health, Scroll Images

Mystery still surrounds COVID-19. How will it impact the upcoming flu season? Will younger generations eventually experience more severe symptoms?

COVID-19 has also brought attention to matters important to the here and now, like the broader need for mental health support, especially in times of crisis. A recent report in Psychology Today notes that one-third of U.S adults have reported clinical anxiety and depression symptoms related to this public health crisis. Professionals are concerned that suicide rates will greatly increase over the next few months, and they’re calling for change in how we care for and talk about mental health.

John Boyd, PsyD.

“We need to create organizations, healthcare systems and communities where it’s ok for our young people and others to openly talk about needing additional mental health support,” said Sutter Health’s Mental Health & Addiction Care CEO, John Boyd, PsyD. “That means bringing human design back into mental health and addiction care. At Sutter Health, we believe mental health is human health, and we are studying new ways for youth to manage mental health in their everyday lives.”

Hear more from Dr. Boyd on this topic in the Healthcare Executive Podcast, a program by the American College of Healthcare Executives.