Ffs just make it easier for us to die.
All we ever do is just feed the machine.
The tragedy of suicide is a social construct. We should celebrate what can be achieved with a life, not just insist on its extenuation for sentimental purposes.
Every aspect of law is designed to retain human life at all cost. But no thought is given to the ultimate purpose of that. Its an emotional knee jerk reaction that does nothing for the afflicted, and only pain for those caught up in it. The train drivers, the police, forensics.
Honour the intentions of the suicidal. Allow it.
It will make life that much more beautiful in the meantimes.
Questionnaires are objectively ineffective on so many levels.
One of the root cause issues has to do with the lack of relationship between patients and their Doctor. The lack of relationship is most largely caused by time constraints put on physicians due to insurance policies and impracticable patient load.
Time constraints lead physicians to “rush” through the chief complaint and history of present illness – causing interruptions by the physician when a patient is explaining “what’s wrong” which understandably results in patients shutting down and not feeling that it is safe to expose themselves.
This holds true in Psychiatry as much as it does in primary care.
Physicians FAR more often than not don’t really get to know their patients. That leads them to not notice when someone “acts” differently than they normally do. They miss those intangible details… that prompt them to evaluate more than the “vitals.”
I don’t know of (and frankly can’t imagine that) many physicians who don’t desperately want to help people in need or crisis.
I do know of MANY physicians that hate practicing medicine today because they don’t feel they can treat patients to the best of their ability due to time constraints.
Personally, I think the use of a “questionnaire” to try and catch those in distress is implemented as a CYA mechanism to protect against legal action against the institution. I can’t possibly believe that anyone sincerely thought it would help identify a patient in need, or add to the diagnostic process. A basic undergrad level of knowledge in psychology would suggest several FAR more effective ways, to frame an adaptive questionnaire that might have a chance of identifying patients with risk factors – so why the nearly useless questionnaire.
What is frustrating for me is that I think the problem of time constraints is obvious to so many people, and a lot of people suffer because of it.
There are many, many, sides and challenges regarding this issue. Those are not lost on me. I am simply adding one aspect that I think is often overlooked and under communicated.
I agree entirely. We are in an underserved area, and the best doctors are overworked. I was overworked while I was full time as a Clinical Laboratory Scientist, until I went half time at 66 years old. Upper management uses “productivity standards” and pressures the supervisors to send staff home when they could be doing other productive things. This happens in Physical Therapy, Occupational therapy, as well as all the Main and Ancillary services. Two weeks ago a new lab assistant took a few days stress leave because she was being overworked by the workload. This was on a Saturday from 6PM to 9PM. I was back the next day, but frazzled.
A lot of my coworkers work 2 jobs 72 hours 6 day weeks of high stress, and a few have mental or heart conditions eventually from it. This all contributes to the feelings of being trapped, and ready to scream and run out the door! I and my coworkers have felt this way many times. I am glad I can get out by retiring!
In answering a questionnaire on suicide risk, patients may be reluctant to be completely honest because of fear of involuntary commitment.
To endorse suicidal ideation with a plan may risk the trauma of psychiatric hospitalization.
. . you are right! also (txt if you want) me appreciates the article and (embedded) references. methinks necessary for all (esp mental health professionals or MHPs) to understand fully amd completely the role of PAIN in addiction, mental health illness, mental health disability, othr: think psychic pain or mental pain or ptsd or postpartum depression or bipolar or unipolar “disorder” or even “notnormal ” grievimg!! nb I speak from personal and professional experience):).
Illuminating. Thanks for the article.
We have dehumanized psychiatry! Instead of following Freud’s lead in trying to understand the human psyche, we have funded toxic drugs designed to hide and suppress symptoms. Science helped us to escape from religious domination and abuse, but science aims to be so objective that we become unable to communicate with each other.
It is wonderful what we’ve discovered by understanding the physical universe, but it has left many souls abandoned.
I’ve never been religious, in the sense of belief in a god, but I enjoyed scientific achievements, and when I heard of Freud’s efforts to understand our psychies, in first year medicine, I realized I needed that kind of help, and that I could learn to help others, which I did for 50 years.
Unfortunately medicine is so attached to the physical that the psychological is dismissed, leading to our epidemic of mental illnesses and addictions, and suicides.
my comment just posted to respond to the nurse who also commented on this article should have (also) gone to you (not least becuz you are an MD but also becuz of the wisdom of everything you said) becuz you are likely to understand what I have to say re the role of PAIN in mental illness / mental health. nb I was on the Board of a sub-national Regulatory Authority (of) Physicians (as LLB not MD); ie me would like to dialog with you re Issues re Regulation of Mental Health Professionals (MHPs) espeshly re what I prefer to call a Mental Health Disability and my Opinion that it is best seen by ALL (but espeshly MHPs as a “Spectrum Disorder”):).
I agree. Yesterday I went to my first psychiatry appointment, what a let down. Dr. was preoccupied the first 10 minutes with his workstation ( a cord had come undone and he couldn’t figure it out) meanwhile I was telling him what brought me there. He wasn’t interested in what I was trying to convey. I wasn’t there to get drugs but to get a psychiatric evaluation that might lead to some diagnosis of why I can’t keep up and function like all the normal humans around me. I work really hard, I need to put twice the effort and time to achieve what is expected of me in the workplace and from myself. My issues were superfluous to this psychiatrist. He directly told me his role as a psychiatrist was to figure out what drugs to give me and after a 20 minute conversation that revolved quite a bit around him, Zoloft was what I needed. An antidepressant so I can feel okay with myself about being mediocre. Thanks but no thanks. Two days have gone by, I still haven’t picked it up. He was convinced I was a perfectionist, I’m not. Anyone who knows me knows there’s nothing impressive about my work other than it’s good enough. My suicide thoughts stem out of anger towards a system that doesn’t give me a way out and wants me to be okay with it messing up my goals and aspirations. I’m a service member that has done as she has been told and allowed herself to be a tool for 16 years. This is my last leg before I can retire at 20, but despite all my sacrifice and work, I’m still a nothing and I don’t matter. I’m not confrontational. I don’t break rules or try to manipulate anything for my gain, my only outlet is to cry in private and plan my end because I’m tired of being a puppet to this system. I still haven’t figured out a sure way out. If it is to be, it has to be 100%, no half dead stuff. Also, I love my cats and I need to ensure they have a safe a loving home but because I’m not close to anyone, I don’t know who that is yet. Yes, there are people who love me and would be very hurt if I were to go out this way, I have no words for them other than I love them. If the military doesn’t let me go (I’m willing to forgo of all my retirement benefits if I can just get out and do me) I see my only option is to check out early. I don’t want to but my anger and rage fuel me to do so. Yes there’s no coming back from suicide but I’m getting old anyway. I have a chance at a family now but I have no right to a family because I belong to the Navy for 4 more years. Damn me for being so stupid and naive despite how old I am and I all the stuff I should have known that I am just now realizing. I’m a retard and the only one benefitting from my state of retardation is the Navy, you know what, No. Sadly not only am I a retard, I’m also a wuss. I don’t have the guts in my natural state of mind to take such a bold move as ending my life, meanwhile this system is doing a great job at killing me from the inside out. That’s the reason of my anger and why I want to rob them from destroying me. Sorry for messing up your post, but this is an outlet for me. I can’t burden the people I know with my thoughts. As I said after more than a month I finally got an appointment with someone who gets paid to listen to people like me who have no other outlets but he didn’t want to hear it.
The pain and rage that I hear in your voice and your struggle… You and I know that we do and give what we can (you made a great sacrifice and served our country), but life isn’t fair. And you want to end it, I hear you. You took a bold and courageous step to see a psychiatrist and he let you down. That’s on him, not you. Medication can truly open a door to healing, AND the real healing, and hard work, comes through building trusting relationships with a therapist, a peer – whomever is open to lending a hand. Sometimes it’s harder to learn to trust in and have compassion for ourselves, but that can be the key. The system often sucks (my own experiences as a mental health provider and a patient/peer), AND there are people in the system who care. These people (psychiatrists, psychotherapists, care coordinators, peer navigators, fellow service members, clergy, etc.) can be found, they’re in the majority, and they will help you do the hard work of being compassionate toward yourself and building a better life. Not just to do their jobs, but out of a caring and moral obligation to others. It takes courage every moment of every day to keep moving. Some days are better than others, AND we struggle to find compassion for others and ourselves. Compassion is a wonderful thing, it helps us to help one another to see what’s possible. Be kind to yourself and I wish you well. – John
Ana, I am so sorry to read about your pain and distress. I had a sister who committed suicide, and I suffer from depression, so I have some little idea of what you’re going through. It might sound like a Band-Aid solution, but I have found that medication has helped me to think clearly and figure ways out of bad situations. It takes a few weeks for the drugs to really work, but it’s worth it. And if the one you try doesn’t work, try a different one. Different people react to different drugs. But in the meanwhile, you need support for your soul, to deal with your current anguish. I have no knowledge of how the US uniform services work, but here’s one suggestion: could you talk to someone at the Veterans Administration? Or call a suicide hotline and get information from them on how to find a more caring person to help you with this? I know it doesn’t change the basic situation of your feeling devalued in your work and service to your country, but it might help you in deciding how to make your life better. I’ve discovered in my own life that true friends can be a great support when I’m in a seriously depressed state. Again, I can’t give you more specific advice because I don’t know you or your situation very well, but I do wish you all the best and hope that you can find a less drastic way to deal with what is clearly for you, a stressful and wounding situation. Please know that there are people who do have sympathy for you and your situation and wish you the best.
Tennessee is a particularly nasty place for life insurance fraud. Relatives of certain insurance agents use life insurance payoffs for luxe vacations and upgraded conspicuous consumption.
With AI devices in a home, it is not at all difficult to hack them or introduce cameras and spyware so that an insurance fraudster and/or real estate shark can introduce suicidal ideation via whispering. Chattanooga, in particular, is notorious for its whispering campaigns where acquaintances of targets are told to whisper “suicide” behind the target’s back. Your interviewee has my sincere sympathy.
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