Are you thinking about committing suicide?
Dr. Sejal Mehta, a Plano-based psychiatrist, says that sometimes a direct question like this is best when talking to patients who might be having dangerous thoughts.
"It’s OK to ask questions point blank about suicide," says Dr. Mehta." And that’s what the medical community needs to be comfortable with."
Dr. Mehta is part of the medical community’s efforts in Texas to get general practice medical professionals to be more proactive in identifying patients who are in danger of taking their own lives. One of the ways doctors can do that is by abandoning the idea that talking about suicide is inherently triggering. She says that contrary to popular fears, even among some doctors, asking a patient about suicidality does not increase the risk of suicide.
"On the contrary," she says, "asking about it gives the patient permission to talk about it."
The Texas Medical Association is leading the push for doctors to better identify at-risk patients. In a recent release, the TMA cited a 2002 study in the American Journal of Psychiatry. That study found that nearly half of all patients who commit suicide saw their doctor within a month before.
One tuble, though, is that fewer patients are seeing an actual doctor -- something Dr. Mehta says could be contributing to suicidal patients slipping through unnoticed.
"Many times," she says, "you are seeing mid-level providers or physician extenders and they are focusing on what the presenting complaint is."
Mehta is not against physicians’ assistants, but says that as they increasingly fill in for overstretched MDs, they can get overly focused on just a patient’s physical symptoms in order to help keep busy practices moving.
But, Dr. Mehta says, it's crucial that the medical community ask deeper questions.
"Ask people how they are feeling," she says. "Are they ok? If everything is going well in their life. Are they … not just stomach upset or headache or sinus problem. Overall, as a holistic way, as a whole human being, are they feeling well?"
Dr. Mehta says increased training for doctors and their extenders in looking for red flags in answers to those questions could save a lot of lives.
The Centers for Disease Control recently announced that the suicide rate in the United States is at a 50-year high -- 47,000 Americans took their own lives in 2017.
Dr. Mehta says many of those likely could have been prevented if someone at the doctor’s office had just asked a few extra questions.