At first glance, the Illinois Violent Death Reporting System data brief released this week has very little to do with pediatrics. The brief describes suicide trends at 3 points in time over 10 years in Chicago and reports that the group most likely to commit suicide in 2015 is white, non-Hispanic, middle age men.
The brief doesn’t provide us detail about the men’s lives, but it is extremely unlikely that they lived their lives in isolation. Most would have left behind wives or romantic partners, friends – and children.
For a child to attain optimal health, it is essential that they are supported by caring, capable and responsive adults. When parents suffer from an untreated mental illness, it is a challenge for them to provide the stable and connected parenting that children need to thrive. For the most part, our current health care system is not set up well to address both the physical and mental health care needs of the entire family. It is true that in recent years pediatricians are doing a better job of screening mothers for postnatal depression and helping connect new moms to resources they need, but pediatricians don’t routinely screen moms for depression after the first 6 months of life and rarely, if ever, have an opportunity to screen dads. This brief encourages us to rethink this approach.
As a pediatrician, I can understand how uncomfortable it can be to ask parents personal questions about their health. After all, as a pediatrician, what do I know about the health of a middle age adult except from my own personal experience as a middle age adult? But screening, in the context of providing optimal care to my pediatric patient, does not mean I am expected (nor I am I trained) to treat that adult. I just need to plan ahead and identify appropriate places to refer anyone who needs additional help.
It makes no sense that our physical health care and mental health care, for the most part, have been kept separate in our current health care system. (The last time I checked my head was connected to my body.) But there are some encouraging recent efforts to increase the number of practices that integrate behavioral health care in the primary care setting. Hopefully as we become better able to treat the whole body, we will be better prepared to treat the whole household.
In the meantime, until we can provide full service mental health care within the medical home what can you do if you are worried about a person? The National Suicide Prevention Lifeline (www.suicidepreventionlifeline.org, 1-800-273-TALK) is a great resource for friends and family who are worried about a loved one and also is a helpful organization for the person who may be thinking about hurting himself. If you are concerned that a person may be in immediate danger of harming himself, take him to the emergency room or call 911.