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Struggling in Silence

Do you know which professional group in the United States experiences the highest rate of suicide? According to the most recent edition of Newsweek magazine, the highest rate of suicide in our country, higher than among any other professional group, occurs among doctors.This startling assertion is the theme of an upcoming public television documentary entitled, “Struggling in Silence.” According to the producers 300 to 400 doctors in America commit suicide every year. That’s one every day.

Dr. Charles Reynolds, professor of psychiatry at the University of Pittsburgh School of Medicine, has done extensive research into physician suicide. Interviewed for the documentary, Reynolds offers a stark assessment of the problem. “Undiagnosed and untreated depression is the culprit here.”

But why? Why would doctors suffering from depression not seek treatment for it? Who else would be in a better position to understand the physiology of the disease and the consequences for not dealing with it?

The problem, according to one doctor who actually suffers with depression, is the stigma associated with mental illness. Dr. Robert Lehmberg battled depression for years, but did not seek medical help until late in his career.

“I did not want it to go on my medical record that I had been treated for depression,” he says in the film. “Once I got treated, I realized how foolish I was.”

How ironic that those who are best positioned to understand depression as a disease are kept from treatment by a misinformed social bias about mental illness. Unfortunately this bias towards mental illness impacts not only medical professionals but people in every walk of life.

According to an article in Nation’s Health magazine this past December, mental illness and substance use disorders are the leading causes of disability and premature death in the United States. Despite this fact, however, many if not most health insurance plans continue to provide less coverage for mental health issues than they do for other health matters.

This is not a new development. In fact, the refusal to provide equal coverage for mental illness has a long and sad history.

“The first objections to parity,” according to Howard Goldman, professor of psychiatry at the University of Maryland School of Medicine, “were on the basis that mental disorders were not real ┬Žand you shouldn’t cover conditions that aren’t real.”

“In the colonial period in the United States,” says Ron Manderscheid, director of mental health programs for the Constella Group in Rockville, Md., “if you were mentally ill you were put into a mental hospital where you were very likely chained to a wall. We treated mentally ill people no better than animals were treated in many of those facilities.”

Of course we’ve made some progress from those images, but the social stigma remains. Much of American society continues to regard those who suffer from various forms of mental and emotional disorders as somehow responsible for their own plight. And so strong are these prejudices that insurance companies are able to provide reduced coverage and doctors are forced to struggle in silence.

It’s interesting to note the special attention Jesus gave to people suffering from mental anguish in his day. Of course back then mental and even physical ailments were attributed to demons. But Jesus refused to fix blame for their predicament. Instead he loved those who suffered and offered them healing and hope.

And for a soul so in despair that suicide seems a viable option, hope is the key to salvation.

James L. Evans is pastor of Auburn First Baptist Church in Auburn, Ala.