Robin Williams' suicide has saddened the world. He brought laughter and happiness to the world and yet struggled with his own mental health problems privately. The loss of such a vibrant individual impacts everyone, and brings to mind the question of how many individuals in our daily lives are struggling with mental health problems while outwardly appearing to thrive.
All of us have seen a doctor for a physical exam and completed laboratory tests screening for everything from high cholesterol to diabetes. These tests are deemed necessary due to the high prevalence of these physical diseases and the high mortality rates associated with them. Yet few of us have received a mental health screening when seeing our physician and mental illness is extremely frequent and associated with high rates of mortality. This brings up the question of why mental health is less of a priority than physical health and why screening for physical health problems has become standard practice and yet mental health screening is not.
Suicide is the third leading cause of death among youth in the US. Five to eight percent of adolescents (1 million adolescents) attempted suicide in one study, 19% were “seriously considering suicide,” 15% had a suicide plan, and 2.6% made suicide attempts requiring medical attention. Between 1.1 and 4.3% of the population attempts suicide at some point during their life and 13.5% of people are experiencing suicidal thoughts at any given point. Anxiety and depression are the most common types of psychological disorders in adolescents who commit suicide (49-75%) and are highly associated with suicidal thoughts and attempts in adults as well.
It may not be surprising, that depression is linked to high rates of suicidality, given that suicidal thoughts are a symptom of depression. However, despite recognition of the link between depression and suicide, the association between anxiety and suicide is far less recognized. Over half (55%) of individuals who attempted suicide suffered from an anxiety disorder and anxiety disorders increase the risk of suicidal ideation and attempts in individuals with depression.
Unfortunately suicide is all too common in individuals who suffer from anxiety, as illustrated by the story of Andrew Kukes, an adult who suffered from social anxiety and depression for years and who took his own life at the age of 30. For more about his story: http://akfsa.org/andys-story/.
The majority of children and adolescents with anxiety or depression are not identified and do not receive treatment. Many adults with depression or anxiety report that they began suffering from the disorder during childhood or adolescence but it was not recognized and they did not seek treatment for many years. Often individuals who are experiencing depression or anxiety either don't recognize it themselves and think it is just a part of their personality or they recognize the issue but do not know how to seek treatment.
For all of these reasons, mental health screening should be a standard practice in pediatric and general practitioners' practices. Physicians may be ideally situated to engage in early detection of psychological symptoms because they frequently see children, adolescents, and adults for regular well-visits. However, psychological symptoms are under recognized in general medical settings and detection rates among children are especially low for anxiety and depressive disorders.
Mental health care is experiencing a crisis due to lack of funding devoted to screening, prevention, and research and the stigma associated with it. Yet screening, prevention and treatment are what's necessary to prevent suicides like that of Robin Williams and the millions of other individuals who suffer from suicidal thoughts.
So next time that you are in your physician or pediatrician's office, ask whether the physician has mental health screenings available and have a serious conversation about your mental health. The prescription for mental health is screening and prevention so ask for it.
If you believe that you may be suffering from anxiety or depression, help is available.
For more information about anxiety and depression, please see the following websites:
Anxiety and Depression Association of America: http://www.adaa.org/
Andrew Kukes Foundation: http://akfsa.org/
For screenings for anxiety and depression go to: http://www.adaa.org/living-with-anxiety/ask-and-learn/screenings
Copyright Amy Przeworski.
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