As fall begins, marking the end of September (also Suicide Prevention and Awareness Month), SGIM Forum almost imperceptibly shifts from last month’s “Physician and Patient Well-being and Mental Health” theme issue. Observant readers might have noticed that last month’s articles offered a prismatic view of experiences and perspectives focusing on physician well-being. An abundance of submissions means this issue is an ad hoc Part Two along the theme, reflecting the unforgettable imprints of the recent past on our hearts and minds. They resonate in our social, political, and especially our local work and learning environments that continue to experience the polarizing and painful mortal consequences of the COVID-19 pandemic. In this issue, the well-being dialogue continues to explore additional facets of physician mental health and well-being while also beginning to shift to what can be done to address both physician and patient mental health and well-being as two parts of a common issue.
Despite or because of the pandemic, some readers, colleagues, and friends might also have recognized and even commemorated National Physician Suicide Awareness Day (#NPSADay) on September 17th. NPSA Day echoes annually as a reminder of the tragic and perhaps ultimate never event among our distressed physician and healthcare communities. Intentional and open conversation, with grace and non-judgment, and linked tightly with advocacy and action can enable meaningful change.
For example, the Journal of General Internal Medicine published a policy paper from the American College of Physicians Ethics Committee on physician suicide prevention in June 2021.1 The paper offers thorough and thoughtful ethical considerations on physician suicide prevention, appropriately shifting the paradigm from individual failure and need for helpseeking towards shared responsibility and systemic change. Aligned with this, but altogether a separate effort, was the U.S. Senate passage of the Dr. Lorna Breen Health Care Provider Protection Act (S. 610) on August 6, 2021 that “aims to reduce and prevent suicide, burnout, and mental and behavioral health conditions among health care professionals.”2 Passing with bipartisan support and the backing of numerous organizations, including the American Foundation for Suicide Prevention and the American Association for Suicidology, as of this writing, a companion bill (H.R. 1667) awaits consideration in the U.S. House of Representatives.3
In this issue, Lypson, SGIM President, reflects on SGIM history to address COVID-19 vaccination hesitancy and plans for the future, while Bass, SGIM CEO, and Gerrity, chair of SGIM’s Philanthropy Committee, also look ahead on bolstering SGIM’s community through the Forging Our Future program. Anampa-Guzmán, a medical student, courageously shares her experiences as a physician mental health and neurodiversity advocate. Torres-Deas and Moise call for greater attention to the link between physician well-being and patient well-being in their perspective. As one example, Malik, et al, share preliminary findings linking physician perceptions of e-cigarette use and advice given about using them as tobacco cessation tools. Miller offers a guide for primary care physicians to seek key competencies in a behavioral health clinician who can be a part of an integrated primary care team, while D’Amico, et al, describe the importance of screening for and addressing adverse childhood experiences among patients.
SGIM members excel at directly and deftly disrupting stigma-perpetuating barriers to well-being, including social and workplace injustices, using the tools of our trade: scientific evidence, expertise, and professionalism, weaved together by our shared human experiences and commonalities. Although 2022 is just around the corner, there is still so much more to be done to advance physician and patient mental health and well-being. Let’s be sure to keep going forward together, with and for each other and for our patients!