The Necessity

Many individuals have been called to the responsibility of healing and protecting others, so their wellbeing directly and profoundly affects the health and safety of everyone in the communities they serve. It is imperative that they have access to high-quality care and support of their own.

 

ALL lives depend upon their wellbeing.

Difficulty accessing psychiatric care is a widespread problem, and the shortage of physicians continues to grow rapidly. The reasons for the physician shortage are alarming, both in character and in number. In addition to the scarcity of psychiatric care at baseline, many individuals face additional barriers that prevent access to care. Professionals who face these additional barriers have other commonalities: they have a direct and profound impact on everyone's health and safety, and their vocations place them at a high risk of suicide and debilitating mental illness.

Some challenges include geographical and time constraints, absolute requirement of enhanced privacy, legal implications of receiving care, potential career compromise or destruction, inability to obtain unrestricted disability insurance, and other factors that independently create unacceptable risk or opportunity cost. The inherent unavailability of much-needed care, compounded by necessary avoidance, can have devastating outcomes. Working conditions, the nature of the work, and lack of adequate support are the greatest contributors to the high suicide rate within the medical field and other helping professions. These factors also contribute to the high rate of "burnout" and to the incidence, prevalence, and severity of treatable but potentially devastating illnesses like depression, anxiety, PTSD, and substance use problems.

Like any severe illness, mental illness can result in death. Many still die of suicide despite having received appropriate care. There are few psychiatrists who have not endured the devastation of losing a patient to suicide. Medical treatment has no guarantees, and sometimes our best efforts fall short of conquering a powerful illness. We must remember that suicide is not always preventable.

But sometimes, our best efforts are lifesaving. In this day and age, death by suicide is often "unpreventable-preventable," meaning that it was not preventable, but it could have been. A heightened suicide risk combined with many additional barriers to treatment is a recipe for tragedy. Our culture - worse, our culture in medicine - prevents us from preventing death. The stigma of mental illness is even more powerful in the lives of people who face pressure to be superhumanly impermeable to trauma and immune to common illnesses. Instead of avoiding death, we avoid care.

Of note, suicide is not always the result of mental illness. It is not always the result of pathology. It is not always tied to depression or other treatable conditions. Sometimes it is simply the result of untenable circumstances - death becomes the only visible means of escape. In medicine, "illness" occurs when there is deviation from the accepted range of normal. When people are subjected to impossible, heartbreaking circumstances on a frequent basis, a high level of distress falls well within normal limits. Evidence shows that nonclinical peer support is quite helpful in such cases.

We envision a future in which our healthcare system prioritizes people rather than profits. The true cost of healthcare will be transparent, reliance on traditional health insurance and for-profit pharmacies will cease, cost of care will decrease, and the quality of care will improve dramatically. A successful paradigm shift such as this will be the result of a multifactorial approach, which is achievable if we unite for progress.

Your support and generosity will enable us to pursue the conscientious delivery of healthcare and to provide potentially lifesaving care to people who would otherwise have no access, but whose wellbeing affects the health of our nation.

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