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Residents in psychiatry and other specialties endure an onslaught of stress faced by few other people their age. Between one-fourth and one-third of them experience a clinical depression during their training. It is hardly surprising then that several residents each year contemplate or attempt suicide.
There are, however, very few data about how well psychiatrists and other physicians do in identifying these at-risk residents. Moreover, little is known about how many receive treatment for their mental health problems, which professionals treat them, and how residents who make it into treatment respond.
To remedy this critical absence of data, the APA Assembly voted in May in Toronto to request that a roster of APA committees and councils review policies related to physician health and develop guidelines on preventing resident physician suicide.
The proposal's authors, Albert Vogel, M.D., of Albuquerque, N.M., and Michael Myers, M.D., of Vancouver, British Columbia, pointed out, "We know that at least some physicians fall through the cracks and do not receive care at all or receive less than adequate care. . . . Because of the stigma associated with mental illness and recently heightened discrimination by insurance companies against young physicians who [seek] psychiatric treatment during training, it is possible if not probable that many residents are not receiving needed medical care at all."
They also emphasized that data are needed on whether the cost of treatment may deter some residents from seeking care and whether residents are all but prohibited from receiving treatment because their program directors will not grant time away from clinical duties.