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Examining the Nation's Psyche

Surgeon General
David Satchertalks about

Sworn into the job in February of 1998, Dr. David Satcher made the
nation's mental health one of his top priorities. Satcher, who holds a
medical degree and a Ph.D. in cytogenetics, previously served as the
Director of the Centers for Disease Control in Atlanta.

RE: You're the first Surgeon General to seriously examine the state
of America's mental health. What led you to that decision?

DS: When I was sworn in, I said that I wanted to be known as the
Surgeon General who not only talked to the American people, but who
listened to them. I've been trying to do that, and it's really from my
listening that it's become very clear to me that mental health is an area
of great concern.

The general attitude toward mental illness in this country is still
one of blame and stigmatization, one that doesn't permit individuals and
families to feel comfortable coming forward, admitting they have a
problem and seeking help. The Surgeon General's office provides us with a
platform from which we can help change that.

We've also assembled a panel of experts who will produce a Surgeon
General's report on mental health. That will probably be ready within the
next year, and based on that report, we will put a plan into

What's most important to me is that the Surgeon General's positions
be determined by the best available science, and not by my personal
opinion or by politics.

RE: You're calling special attention to the issue of suicide.

DS: For every two people in this country who are murdered, three
people take their own lives. I don't think most Americans are aware of
that. Suicide is an area where we need to do a lot of work in this
country in terms of attitude and research and access to information and

For example, over 70% of those who commit suicide actually visited
a primary care provider in the 30 days before they killed themselves.
We're trying to get physicians to be more alert and helpful in terms of
discussing mood and state of mind with their patients, to really ask them
about feelings of depression and hopelessness. Primary care doctors can
play a big role in identifying people who need help.

RE: What happens when there aren't any signs of the intent to
commit suicide?

DS: If you can create an environment in which people can talk
openly about their thoughts and feelings, you may get an early indication
that someone is thinking about taking his or her own life.

It's just like doctors who commit suicide. Often, they're doing
great work as physicians, and no one who knows them professionally would
think there was a problem. But then the wife will say, "He never quit as
a physician, but a year ago he quit as a husband. The change was in our

So I think there are probably signs there that we're missing,
number one. And two, even when there are no signs, if there's an open and
accepting environment, people will be more likely to come forward and
say, "I would like to talk to somebody about my feelings and my thoughts
and my moods."

RE: So what would you recommend our readers do if they suspect that
someone they know is having suicidal thoughts?

DS: Before you say anything, you should listen. You need to give
the person the opportunity to talk about how and why they're feeling
depressed and considering suicide. Then you should act based on what
you've heard, perhaps guiding them toward counseling or calling a suicide

Here are two suicide prevention hotlines: 888-SUICIDE or