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Abstract
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Suicide is one of the leading causes of death in the U.S. among teens and has been increasing over the last several years [1, 2, 3]. The etiology of the increase is unclear, and a successful response from the pediatric community has yet to be perfected. There are a myriad of reasons that mental health service availability is subpar for children and adolescents, and the burden of the care of pediatric and adolescent patients with depression, suicidal ideation, and attempts of self-harm with intent to die is falling to primary care providers such as pediatricians [4]. As a pediatric community, we are woefully unprepared for this unfolding epidemic. The recent article by Schoen et al. has highlighted this by uncovering a significant gap in training for pediatricians that needs immediate attention [5].
Schoen's study was a simple survey of pediatric residency program directors and chief residents regarding the nature of their program's training to assess and manage patients at risk for suicide. The findings demonstrate nearly a universal acknowledgement of the importance of the topic among responders. However, there is a stunning discordance between the perception of importance and the perception of adequacy of the training, with less than one-fifth of respondents feeling that the training matched the need. Even more surprising was the lack of formal training, and specifically the reasons given for the absence of adequate or formalized training. Lack of faculty and curricula were cited, which are understandable for an emerging threat, but the most common barrier mentioned was lack of time [5]. How do we as a medical community not have time to treat an epidemic that is staring us squarely in the face? Would we accept a similar excuse from ourselves if this was a threat from an infectious disease? For example, in the face of a new particularly lethal strain of influenza or respiratory syncytial virus, it seems unimaginable that either the medical community or the society at large would accept the explanation that we are not adequately training to fight it because “we don't have time.”
Additional pertinent questions are generated by this study. Why is the medical education system treating suicide risk assessment and management differently than it would treat an outbreak of an infectious disease? Are we perpetuating dated bias against mental health problems in the manner in which we are structuring our training? It is difficult to find another explanation for the discordance between the magnitude of the problem and the lack of attention in training reported in this study. For example ...
Language: en |